Sat.Jun 24, 2023 - Fri.Jun 30, 2023

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ECG Blog #384 — Why So Fast?

Ken Grauer, MD

The ECG in Figure-1 was obtained from a young man with a history of rheumatic heart disease — who presented with “palpitations”. He was hemodynamically stable at the time this tracing was recorded. How would YOU interpret the ECG in Figure-1 ? How would you treat the patient? Figure-1: The initial ECG in today’s case. What is the rhythm? How would you treat the patient?

EKG/ECG 365
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Congenital Pulmonary Airway Malformation (CPAM)

Pediatric EM Morsels

I’m sure you can recall at least several parents who bring their children into the ED for concern of recurrent pneumonias. Often the parents focus on a possible underlying immunodeficiency. Fortunately, most commonly these pneumonias are due to viral infections, and we can often offer reassurances to the parent. The differential could also include aspiration , asthma , and bronchiectasis depending on the patient’s history.

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An Update On The Electronic Trauma Flow Sheet

The Trauma Pro

It’s been five years since I published my series on the use of the electronic trauma flow sheet (eTFS). Anyone who knows me is familiar with my skepticism about this tool. I’ve been writing about the significant problems it can create since 2008! With the progress in computing power and interfaces we have enjoyed, we would have this problem solved by now.

Hospitals 185
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Hypothermia and drowning

Don't Forget the Bubbles

A PEM adventure It’s time for another PEM adventure. Join us on another journey (with an inbuilt time travel machine) in managing Elsa, a 2-year-old girl who is a HUGE fan of the Disney movie, Frozen. Elsa was found face down in the family pool 20 minutes after last visual contact and was picked up without resuscitation. Emergency Medical Services found her apneic and pulseless.

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Bridging Innovation & Patient Care: The Growing Role of AI

Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

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REBEL Cast Ep119: A Discussion with Scott Weingart on the CT FIRST Trial

RebelEM

Back on June 1 st , 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? This stemmed a lot of discussion in the background between Swami, myself, and Scott. We felt it was worthwhile to record this as a podcast to better flush out some nuanced points. Below you will find some of the points we discussed.

CPR 145
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ICS #SOA23 – Day 1

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed We love a jolly @StEmlyns and true to form we were off to the UK Intensive Care Society State of the Art conference this week in Birmingham. This is always … ICS #SOA23 – Day 1 Read More » The post ICS #SOA23 – Day 1 appeared first on St.Emlyn's.

Research 136

More Trending

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TXA in head injuries

Don't Forget the Bubbles

A PEM adventure Meet Polly, a 6-year-old girl with a penchant for shopping. Besides a few febrile convulsions when she was two, she’s a healthy 6-year-old. Having just bought the most gorgeous pair of red ballet pumps that would go delightfully with the red bow she bought in Harrods last week, she was skipping down Regent’s Street with her nanny. As they crossed the front of Liberty, a huge letter L came plummeting down, crashing in front of her.

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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

RebelEM

Background: Hemorrhage is the leading cause of mortality in trauma patients. Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy.

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ICS #SOA23 – Day 2

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed We’re back for the second day of the Intensive Care Society Sate of the Art Congress here in Birmingham! Yesterday was great and we learnt a lot with loads of … ICS #SOA23 – Day 2 Read More » The post ICS #SOA23 – Day 2 appeared first on St.Emlyn's.

Teamwork 129
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HEMS Debrief #3 – Geoff Healy

Greater Sydney Area HEMS

In this episode, Senior Staff Specialist Dr Geoff Healy reflects on a formative case with unexpected long term follow-up, and how this has shaped his clinical career as both a physician, and mentor.

Hospitals 124
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Penetrating chest trauma

Don't Forget the Bubbles

A PEM Adventure Ranulf is a 14-year-old explorer. He has already climbed Ben Nevis in Scotland, visited the Gobi desert (possibly from the comfort of his parents 4 x 4, but who’s judging) and has his bronze D of E nailed. Whilst you were busy managing head injuries and drownings, Ranulf had been out with a group of boys from school this evening. They had been enjoying a celebratory dinner following their safe return from a trip to the Amazon rainforest.

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Meningitis: symptoms, causes, diagnosis and treatment

Emergency Live

Meningitis is an infection of the meninges, the protective membranes surrounding the brain and spinal cord. It can affect anyone, but is most common in infants, young children, adolescents and young adults The post Meningitis: symptoms, causes, diagnosis and treatment appeared first on Emergency Live.

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PE risk in severe exertional dyspnea

First 10 EM

I think the conclusions of the paper are incredibly obvious, and therefore not practice changing, but I worry that a superficial read might lead to misinterpretation, and therefore the paper is probably worth covering. (This is the same research group that published the infamous PESIT study, and all the subsequent misinformation about PE risk in […] The post PE risk in severe exertional dyspnea appeared first on First10EM.

Research 118
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God save the King!

MEDEST118

An original BlogPost by Mario Rugna

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Single ventricle defects and the hunt for the best shunt

Don't Forget the Bubbles

In this case-based article, we’ll talk about single ventricle defects and their management (both medical and surgical), then look at the two main shunt options during Stage 1 reconstruction. Single ventricle defects Many complex congenital heart defects have single ventricle physiology. This means that one ventricle is too small, weak or obstructed to pump effectively, leaving the other ventricle to supply both systemic and pulmonary circulations in parallel via a shunt such as the ductus

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Tracheitis: symptoms, causes, diagnosis and treatment

Emergency Live

Even the trachea, like other organs, can become inflamed due to viruses and bacteria. In this case we speak of "tracheitis" The post Tracheitis: symptoms, causes, diagnosis and treatment appeared first on Emergency Live.

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JC – Video vs Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults

St. Emlyn

St.Emlyn's - Emergency Medicine #FOAMed Critical appraisal of the DEVICE trial as published in 2023 NEJM. VL outperforms DL in this study of critically unwell patients. #FOAMed #airway @stemlyns The post JC – Video vs Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults appeared first on St.Emlyn's.

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The Electronic Trauma Flow Sheet: Why Hospitals Want You To Switch

The Trauma Pro

Today, I’ll kick off my series on the use of the electronic trauma flow sheet (eTFS). The biggest question is, why does your hospital want you to use it? Typically, hospital administrators pressure trauma programs to adopt an eTFS at some point after implementing the hospital-wide use of an electronic health record (EHR). When I started this series nearly 15 years ago, many hospitals still used paper charting.

Hospitals 100
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Attracting and Retaining Talent using Team Recognition

NRC Health

In this episode Amy Feeder, Customer Experience Program Manager at M Health Fairview and Jon Tanner, Program Director of Human Understanding at NRC Health join us to discuss the importance of team recognition and how it strengthens patient care. The post Attracting and Retaining Talent using Team Recognition appeared first on NRC Health.

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Cardiac arrest, let's talk about defibrillator voltage

Emergency Live

The defibrillator is a device capable of generating a controlled electrical discharge to the heart in order to re-establish the rhythm of its beats in the event of cardiac arrest or rhythm alterations The post Cardiac arrest, let's talk about defibrillator voltage appeared first on Emergency Live.

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Young Man with Very Fast Regular Wide Complex Tachycardia

Dr. Smith's ECG Blog

EMS was dispatched for a 30-something male who feels his heart is racing. Sudden onset. The patient had no previous medical history. Vitals were normal except for a heart rate of 226. A prehospital 12-lead was recorded: There is a regular wide complex tachycardia. The computer diagnosed this as Ventricular Tachycardia. Is it definitely VT?? The patient was given 6mg, then 12 mg, of adenosine, without a change in the rhythm.

EKG/ECG 98
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Don’t go Breaking my Heart: 2022 Heart Failure Guidelines

EM Ottawa

Patients with heart failure are often newly diagnosed in the Emergency Department, or are the presenting location for those with decompensated heart failure. This is why it is important for ER Physicians to remain updated on the latest AHA/ACC/HFSA guidelines for the management of heart failure. In this post, we are going to touch on: […] The post Don’t go Breaking my Heart: 2022 Heart Failure Guidelines appeared first on EMOttawa Blog.

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Intro to ECMO for New ICU Staff

Intensive Blog

Author: Dr Ken Hoffman Peer reviewer: A/Prof Chris Nickson These videos are aimed at ICU staff and trainees who are new to ECMO. Part 1 focusses on nomenclature and components of ECMO (extracorporeal membrane oxygenation). Part 2 focusses on V-V (veno-venous) ECMO. Part 3 tackles V-A (veno-arterial) ECMO and the final video, Part 4, addresses ECPR (ECMO-CPR during cardiac arrest).

CPR 98
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BLSD: what is it? How should the manoeuvres be performed?

Emergency Live

BLSD stands for Basic Life Support Defibrillator, i.e. first aid manoeuvres using a defibrillator The post BLSD: what is it? How should the manoeuvres be performed? appeared first on Emergency Live.

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The Latest in Critical Care, 6/26/23 (Issue #6)

PulmCCM

An expert panel broadened the definition of acute respiratory distress syndrome (ARDS). They announced this at the American Thoracic Society meeting in May 2023. Thirty-two experts virtually to update the 2012 update (in Berlin) , and declared that ARDS shall henceforth include anyone with: PaO2/FiO2 ≤300 mmHg (on an arterial blood gas) or SpO2/FiO2 ≤315mmHg with SpO2 ≤97% (on pulse oximetry without an ABG) That’s while receiving either mechanical ventilation, or (this is

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Stings and envenomations – a buzz-worthy podcast

PEMBlog

It is summertime, so the bees and bugs are out! In this episode, Dr. Ben Grebber, a pediatric resident at Boston Children’s Hospital/Tufts Children’s Hospital, discusses Bee Stings and Spider Bites. A very common pediatric summer complaint in emergency departments, urgent cares, and primary care offices, this episode covers common signs and symptoms, some pathophysiology, and recommended treatments.

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Friday Reflection 24: I Would Rather Go Back in Time

Sensible Medicine

KW was a 58-year-old man with long standing type 1 diabetes mellitus and hypertension. He came to an appointment one Friday afternoon with chest pain. The pain had been present intermittently for 10 days. It was on the left side of his chest and beneath his sternum. It did not radiate anywhere, it was not related to exertion, nor was it associated with diaphoresis or shortness of breath.

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Borderline personality disorder: definition, causes, symptoms, diagnosis and treatment

Emergency Live

Borderline personality disorder is a highly controversial diagnostic entity. Sometimes it is not even recognised as a specific disorder The post Borderline personality disorder: definition, causes, symptoms, diagnosis and treatment appeared first on Emergency Live.

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Neurology Rapid Access Clinic – Referral Pathway

SCGH ED

The Neurology Rapid Access Clinic (NRAC) will commence 3/7/23. This clinic has opened with the intent of diverting patient’s with symptoms consistent with a diagnosis of a Transient Ischaemic Attack from hospital admission for investigation and having them worked up in an expedited fashion as an outpatient. ED will now be able to clinically assess patients, organise appropriate initial investigations (including a CT/CTA) and then discharge them to be seen in the clinic, ideally within less

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Journal Feed Weekly Wrap-Up

EMDocs

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: How to Improve STI Test Accuracy – Swab or Urine? Spoon Feed Vaginal swabs are more accurate than urine samples in diagnosing Chlamydia trachomatis , Neisseria gonorrhoeae , and Trichomonas vaginalis.

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Mandrola Chooses a Favorite Academic Article

Sensible Medicine

Words that pop into my head when thinking about the academic literature: vast, insipid, repetitive, Sisyphus. Then I found this: Ultimately, our success as a profession will depend on our ability to engage in debate, acknowledge different opinions, and seek answers through science. This sentence came seven years before social media and a virus shredded our norms.

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What are congenital heart diseases

Emergency Live

Congenital heart disease: with the term congenital, we indicate something already existing at birth By congenital heart disease, we are therefore referring to an alteration in cardiac structure or function that is present at birth and manifests its first symptoms early on, at conception and in the embryo-fetal phase. However, it can also be discovered […] The post What are congenital heart diseases appeared first on Emergency Live.

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No Good Evidence Proves that NSAIDs Hinder Fracture Healing

Emergency Medicine News

An abstract is unavailable.

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An Intriguing Rhythm: Who Belongs to Whom?

Dr. Smith's ECG Blog

== MY Comment , by K EN G RAUER, MD ( 6/26 /2023 ): == The tracing in Figure-1 was sent to me — without the benefit of any history. How would YOU interpret this tracing? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). MY Initial Thoughts: My attention was immediately drawn to the long lead rhythm strip in Figure-1.

EKG/ECG 97
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Study of the Week: Cardiovascular Safety of Testosterone Replacement Therapy

Sensible Medicine

Dr. Mandrola and I are trading beats this week. I am posting the “Study of the Week” today and John will be publishing a “My Favorite Article” piece later in the week. Over time, I have realized the type of medicine I enjoy practicing. I love evaluating symptoms, making diagnoses, and curing (or more commonly managing) diseases.

Stroke 98
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Electrocardiogram, an overview

Emergency Live

The electrocardiogram, or ECG, is an instrumental diagnostic test that uses an electrocardiograph to record and graphically reproduce the heart's electrical activity through a series of electrodes The post Electrocardiogram, an overview appeared first on Emergency Live.

EKG/ECG 119