Sat.Feb 11, 2023 - Fri.Feb 17, 2023

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ECG Blog #363 — How Many Directions?

Ken Grauer, MD

The ECG in Figure-1 was obtained from an older woman — who presented with chest pain and palpitations over the previous hour. She had a history of hypertension, and was on medication for this — but she was otherwise healthy. BP = 140/90 mm Hg in association with the rhythm in Figure-1. How would YOU interpret the rhythm in Figure-1 ? Is this Ventricular Bigeminy?

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Managing Expectations

Mount Sinai EM

Let’s talk about managing expectations. You can do this with almost everyone/everything in your life, your goal being to under sell, over deliver. Some, not all, patients think that when they walk through these hallowed doors, that they’re walking into a place of truth and all-knowing information. They don’t realize the ED is more like a “I’m going to make sure you’re not going to die today or tomorrow, then dispo you as quickly as you came in”-type plac

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Health System Adopts Thermal Printing, Builds on Reputation for Technological Excellence 

PDC Healthcare

Spartanburg Regional Healthcare Improves Patient Safety by Switching to Thermal Wristband and Label Printing Spartanburg Regional Healthcare System, an integrated healthcare delivery system in South Carolina, is building on its reputation for technological excellence with the recent adoption of thermal print patient identification technology. Spartanburg is one of many health systems across the US that […] The post Health System Adopts Thermal Printing, Builds on Reputation for Technologic

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SGEM#392: Shock Me – Double Sequential or Vector Change for OHCAs with Refractory Ventricular Fibrillation?

The Skeptics' Guide to EM

Date: February 7, 2023 Reference: Cheskes et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. NEJM 2022 Guest Skeptic: Dr. Sean Moore is an emergency physician working in Kenora Ontario, where he is Chief of Staff at Lake of the Woods District Hospital, Northern Medical Director for the Ornge air medical transport program and associate medical director with CritiCall […] The post SGEM#392: Shock Me – Double Sequential or Vector Change for OHCAs with Refractory Ventricular F

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6 Common Causes of Cardiac Arrest in Young Adults

AED Leader

Cardiac arrest in young adults typically happens for different reasons than it does in older adults, with young athletes being particularly at risk. While the most common causes of sudden cardiac arrest in people under 35 are congenital (from birth) rather than acquired, knowing the risk factors and common symptoms of heart problems can help Read More "6 Common Causes of Cardiac Arrest in Young Adults" The post 6 Common Causes of Cardiac Arrest in Young Adults appeared first on AEDs for Sale | B

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Three keys to success in healthcare strategy

NRC Health

Sara Vaezy of Providence Digital Innovation Group shares the blueprint for how healthcare can learn from the past, build momentum, and sustain great ideas in the latest episode of NRC Health’s Patient No Longer podcast. The post Three keys to success in healthcare strategy appeared first on NRC Health.

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Cultural Diversity in Healthcare

American Medical Compliance

Cultural consciousness is in reference to the set of policies and behaviors that gives professionals the ability to function effectively in a culturally diverse setting. Health care must be given in a way that is sensitive to cultural influences and differences. This greatly improves the experiences for everyone involved. This calls for cultural diversity training so that providers can understand the communities they serve.

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New CA Laws for Cyclists, Drivers, Pedestrians, and E-bikes

Medical Law

Four new laws, effective on January 1, 2024, will impact safety on California roads for drivers, pedestrians, cyclists, and electric bicycle (e-bike) riders. AB 2537 calls for changes in driver education curricula in grades 7-12 and requires the DMV to create a video regarding proper conduct for peace officers during a traffic stop. AB 2773 requires peace officers to inform drivers why they are being pulled over.

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Keys to delivering humanized care revealed in NRC Health’s 2023 Experience Perspective

NRC Health

Report details new data, trends, and strategies for healthcare organizations. The post Keys to delivering humanized care revealed in NRC Health’s 2023 Experience Perspective appeared first on NRC Health.

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Dental Healthcare Fraud, Waste, and Abuse (FWA) Training

American Medical Compliance

The Dental Healthcare Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. It is everyone’s responsibility to combat fraud, waste, and abuse. No precise measure of healthcare fraud exists. Those who exploit federal healthcare programs cost taxpayers billions of dollars while putting beneficiaries’ health and welfare at risk.

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Journal Club 2 – Diltiazem Dosing in Atrial Fibrillation with Rapid Ventricular Response

Emergency Medicine Cases

Is low dose diltiazem as effective and safer than standard dose diltiazem for rate control in patients with atrial fibrillation with rapid ventricular response? Dr. Rohit Mohindra and Dr. Shelley McLeod critically appraise the latest study on diltiazem dosing and deliver a research methodology hot take on this month's EM Cases Journal Club. The post Journal Club 2 – Diltiazem Dosing in Atrial Fibrillation with Rapid Ventricular Response appeared first on Emergency Medicine Cases.

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Ultrasound of the Month: Can you use Pocus for pneumonia?

Downeast Emergency Medicine

THE CASE A 13-year-old boy is seen in the Emergency Department (ED) for a cough. He reports a viral illness starting two weeks ago, and four days ago, he was seen in the ED because his symptoms were worsening. At that time, he got a chest X-ray showing a right lower lobe consolidation. He was diagnosed with pneumonia and started on high-dose amoxicillin and azithromycin.

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Large Joint Arthrocentesis and Injection

Core Ultrasound

Joint pain is a fairly common complaint and accurately identifying fluid (or lack thereof) can be difficult and frustrating without POCUS! In this video I show you how to identify joint effusions (including shoulder, knee and hip effusions) and how to use ultrasound to accurately stick a needle in it to either drain that fluid or to aspirate it.

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Fraud, Waste and Abuse Training for Workers in Emergency Medical Services (EMS)

American Medical Compliance

The EMS Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. It is everyone’s responsibility to combat fraud, waste, and abuse. No precise measure of healthcare fraud exists. Those who exploit federal healthcare programs cost taxpayers billions of dollars while putting beneficiaries’ health and welfare at risk.

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JJ 23 Laceration Aftercare – Dressings, Antibiotics, Improving Cosmesis, Preventing Infection

Emergency Medicine Cases

In this Part 3 of our 3-part podcast series on management of lacerations Dr. Haley Cochrane joins Anton and Justin to explore laceration aftercare and the evidence for keeping wounds dry or wet, wound dressings, topical antibiotics, prophylactic oral antibiotics, Vitamin E oil, aloe vera cream and UV protection with regards to cosmetic outcomes and infection rates.

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Inclusion in POCUS Part 1

Ultrasound Gel

Special guests Almaz Dessie and Javier Rosario join Mike, Creagh, and Jai to discuss diversity, equity, and inclusion specifically in the point-of-care ultrasound community. This is the first of a two part discussion that covers the recently published articles on this topic and what you can do to help these efforts. [link] Special guests Almaz Dessie and Javier Rosario join Mike, Creagh, and Jai to discuss diversity, equity, and inclusion specifically in the point-of-care ultrasound community.

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Two 70 year olds with chest pain, and 3 pitfalls of the STEMI paradigm

Dr. Smith's ECG Blog

Written by Jesse McLaren Two 70 year olds had acute chest pain with nausea and shortness of breath, and called paramedics. Who needs the cath lab? (photocopy of prehospital ECGs digitized by PMcardio) ECG #1 (top): there’s normal sinus rhythm, normal conduction, normal axis, normal R wave progression, and normal voltages. There’s inferior ST depression which is reciprocal to subtle lateral convex ST elevation, and the precordial T waves are subtly hyperacute – all concerning for STEMI(-)OMI of p

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Aseptic Training for Healthcare Providers

American Medical Compliance

Congress established the Occupational Safety and Health Administration (OSHA), with the purpose of creating safe and health conscience work conditions. Generally, Assisted Living Facility OSHA sets and enforces standards and provides training, outreach, education, and assistance. Furthermore, OSHA estimates that 5.6 million workers in the healthcare industry and related occupations are at risk of exposure to bloodborne pathogens.

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EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing

Emergency Medicine Cases

In this EM Quick Hits podcast: Justin Hensley and Aaron Billin on Wilderness Medicine, Elisha Targonsky on Bowel Prep Hyponatremia, Brit Long on Non-Convulsive Status Epilepticus, Andrew Petrosoniak on Morel Lavallee Lesions, Jesse McLaren on Pacemaker ECGs and Matt Poyner on paying off loans vs investing. The post EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing appeared first on

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165. "Hemolytic Uremic Syndrome, it's what's for dinner"

Board Bombs

Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Anyone craving a hamburger? Let’s talk HUS- presentation, diagnosis, and pearls and pitfalls of this classic condition. Cite this podcast as: Briggs, Blake. Episode 165: HUS: it’s what’s for dinner.

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How UT Physicians improved ratings and increased web visibility

NRC Health

Protecting and building your online reputation is a top priority for health care marketing and leadership teams. Engaging patients in sharing their experiences and building brand awareness and rank helps demonstrate to consumers how much your organization cares about Human Understanding. The post How UT Physicians improved ratings and increased web visibility appeared first on NRC Health.

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HIPAA Training For Emergency Medical Services (EMS)

American Medical Compliance

Congress established the Occupational Safety and Health Administration (OSHA), with the purpose of creating safe and health conscience work conditions. Generally, Assisted Living Facility OSHA sets and enforces standards and provides training, outreach, education, and assistance. Furthermore, OSHA estimates that 5.6 million workers in the healthcare industry and related occupations are at risk of exposure to bloodborne pathogens.

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Big Changes in Cardiology

Stop and Think

A brief housekeeping note. I plan to keep most posts free. But I have enabled payments. So if you feel like donating, great. If not, that’s ok too. JMM Stop and Think is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. There may be a big advance in cardiology coming soon. Really big.

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Best #FOAMed Finds Feb 2023!

Critical Care North Hampton

More to wet your appetite…loads of fab resources, Tweets and more to see. Follow us if you aren’t already. Jonny – @wilkinsonjonny Ashley – @ICMteaching Marcus – @ICUltrasonica Jump Menu JAM pick of the papers! Best POCUS Best FOAM History! Podcasts! Best websites! Best Meetings! JAM’s Pick of the Papers As ever, we recommend you.

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Diversity, equity and inclusion within patient experience

NRC Health

In this episode, we are joined by Cami Mitelman, Customer Success Manager at NRC Health, and Dr. Peggy Greco, Chief Patient Experience Officer at Nemours Children’s Health, to discuss what diversity, equity and inclusion looks like in patient experience, how NRC provides Nemours the capability to identify disparities in the patience experience and more.

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Improvements in Telehealth Access

American Medical Compliance

Telehealth has become the new frontier for healthcare providers. Moreover, telehealth access can make healthcare more accessible for consumers and providers alike. Insurance coverage, broadband access, and interoperability continue to be important issues moving forward to provide equitable telehealth access. Telehealth Coverage Since the pandemic, many healthcare plans have included telehealth temporarily with the idea that this would come to an end following the pandemic.

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Critical Care 2 – Myasthenic Crisis

EM SIM Cases

This is the second case in a series looking at critical care medicine. Patients under the care of the critical care team may develop delayed complications of their illness or injuries. These cases can help individuals and teams prepare to identify and manage these patients who become newly, and sometimes unexpectedly, unstable. This case comes from Dr.

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What is going on in V2 and V3, with a troponin I rising to 1826 ng/L at 4 hours?

Dr. Smith's ECG Blog

I was reading EKGs on the system before a shift, and saw this one: What do you think? I was worried that the ST depression and T-wave inversion in V2 and V3 might be posterior OMI. I went to the chart and found that the patient was a sepsis patient with hypotension and a K of 3.0. There was no chest pain. So I thought it probably is not posterior OMI and I just moved on and kept reading EKGs.

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Zinc Vs. COVID | Tubing in Angioedema

JournalFeed

The JournalFeed podcast for the week of Feb 6 to 10, 2023. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member. Zinc Vs. COVID Spoon Feed Zinc supplementation for patients with COVID-19 decreased 30-day ICU admission rate and led to shorter symptom duration.

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Imaging Case of the Week 541

EMergucate

3 year old with respiratory distress. What can be noticed? Answer will be posted later.

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EMCrit RACC Lit Review – February 2023

EMCrit

All the lit goodness for Feb 2023 EMCrit Project by Scott Weingart, MD FCCM.

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Are anti-coagulated elderly head injured patients at risk for delayed intracranial hemorrhage?

University of Maryland Department of Emergency Med

This study looked at 69,321 head injured patients over age 65 in a health care database for delayed intracranial hemorrhage (within 90 days of vi.

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Chest pain, among other symptoms. What do you see?

Dr. Smith's ECG Blog

This patient had many complaints including chest pain. The computer called this Acute STEMI What do you think? STEMI never has a very short QT. This QT interval is 320 ms, with a QTc of around 350, depending on which correction formula you use. (There is Bazett, Fridericia, Hodges, Framingham and Rautaharju -- see here at mdcalc: [link] If the ST Elevation here were due to STEMI, it would be an LAD Occlusion.

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Lab case 399

EMergucate

38 year old lady presented to the emergency department with recurrent vomiting. She was found to have a slipped lapband.

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High-dose Nitroglycerine in Sympathetic Crashing Acute Pulmonary Edema

University of Maryland Department of Emergency Med

Sympathetic Crashing Acute Pulmonary Edema (SCAPE) (also known as flash pulmonary edema) is an extreme form of hypertensive acute heart fa.

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Does purulent eye discharge need to be treated topically in pediatrics?

University of Maryland Department of Emergency Med

It is often difficult to clinically differentiate between viral and bacterial conjunctivitis, but previous studies have shown that the va.

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Lab case 398 interepretation

EMergucate

Question 1: PH = 7.14, that is severe acidaemia pCO2 = 53 mmHg, So we have respiratory acidosis.

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