EMDocs

SEPTEMBER 23, 2023

We’ll keep it short, while you keep that EM brain sharp. Her presenting EKG is shown below. Clinical features Patients often present after an episode of sudden syncope, although Brugada syndrome can also be found on a routine EKG. ECG to evaluate for arrhythmia. Neurological exam is also unremarkable.

EMS 84

EMS EKG/ECG Documentation/Coding Emergency Department 84

EMDocs

DECEMBER 11, 2023

As we all know, a critical concern for emergency physicians is identifying patients with heart tissue-threatening ischemia that could benefit from percutaneous catheterization via stent deployment by an interventional cardiologist. The chosen vernacular for these ECG findings has been traditionally called “STEMI equivalents”.

EKG/ECG 110

EKG/ECG Emergency Department Academics Operations 110

Dr. Smith's ECG Blog

OCTOBER 12, 2024

A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. With EMS, patient had a GCS of 3 and was saturating 60% on room air. Vital signs were within normal limits on arrival to the Emergency Department. or basilar ischemia.

EKG/ECG 106

EKG/ECG Documentation/Coding Emergency Department COPD 106

EMDocs

OCTOBER 14, 2024

These are very commonly encountered in the emergency department, so being able to correctly identify the rhythm is extremely important. When you are presented with a tachycardic ECG, we want you to focus on two major factors right away. This ECG comes from a 75-year-old female presenting with palpitations. Let’s dive in!

EKG/ECG 78

EKG/ECG EMS Resuscitation Emergency Department 78

EMDocs

MAY 11, 2024

We’ll keep it short, while you keep that EM brain sharp. A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. Ann Emerg Med. Erratum in: Ann Emerg Med.

Stroke 89

Stroke EMS EKG/ECG Radiology 89

Dr. Smith's ECG Blog

OCTOBER 24, 2024

She was brought to an Emergency Department for evaluation. Here is her ECG: What do you think? This ECG shows sinus bradycardia with massively long QT (or QU?) She then had several more syncopal episodes the next day, and returned to a different Emergency Department. The patient was sent home!

EKG/ECG 99

EKG/ECG Emergency Department Hospitals EMS 99

Dr. Smith's ECG Blog

MARCH 28, 2024

male with pertinent past medical history including Atrial fibrillation, atrial flutter, cardiomyopathy, Pulmonary Embolism, and hypertension presented to the Emergency Department via ambulance for respiratory distress and tachycardia. Here is the prehospital ECG: First ED ECG What do you think?

EKG/ECG 129

EKG/ECG EMS Emergency Department Ultrasounds 129

ECG Guru

JUNE 28, 2024

The Patient This ECG is from a 57-year-old man complaining of sub-sternal chest pain for 30 minutes. EMS found him pale, diaphoretic, and anxious. The ECG The rhythm is normal sinus rhythm at 98 bpm. but rather a STEMI equivalent, warranting emergent treatment in a cath lab.

EKG/ECG 81

EKG/ECG Emergency Department EMS 81

EMDocs

FEBRUARY 9, 2024

Authors: Adam Roussas, MD, MBA, MSE // Reviewed by: Jamie Santistevan, MD ( @jamie_rae_EMdoc, EM Physician, Presbyterian Hospital, Albuquerque, NM); Manpreet Singh, MD ( @MPrizzleER ); and Brit Long, MD ( @long_brit ) Case A 40-year-old female presents to the emergency department for palpitations and lightheadedness.

EKG/ECG 72

EKG/ECG Hyperthermia / Hypothermia EMS Documentation/Coding 72

Dr. Smith's ECG Blog

JUNE 21, 2023

EMS was called, and they recorded the following ECG on scene at 13:16: What do you think? In this medical system, the EMS provider can then be routed to the ED or to a type of urgent care facility that is open 24 hrs/day and staffed by a primary care provider. No troponins were measured! Long term follow up is unavailable.

Urgent Care 98

Urgent Care EKG/ECG EMS Emergency Department 98

The Skeptics' Guide to EM

MARCH 2, 2024

Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. He is the Vice Chair of the Emergency Department at Nassau University Medical Center in East Meadow, NY, the safety net hospital for Nassau County. AEM February 2024.

Emergency Department 118

Emergency Department Stroke Operations Hospitals 118

Dr. Smith's ECG Blog

MAY 23, 2023

EMS arrived and recorded this ECG: What do you think? See same ECG below with computer automated interpretation, using the Glasgow ECG algorithm which apparently is used by many different providers and devices Amazing that the computer calls this normal. Next day ECG. And yet it still says "normal".

EKG/ECG 93

EKG/ECG Wellness Emergency Department EMS 93

EMDocs

NOVEMBER 19, 2024

Recommend obtaining multiple EKGs to aid in the diagnosis of cardiotoxic effects such as dysrhythmias or interval widening, even if not apparent immediately after the overdose. 1,2 Cardiovascular: Obtain an initial EKG to determine the patient’s baseline and repeat. His roommate found an empty pill bottle on the floor next to him.

Poisoning 90

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 90

Dr. Smith's ECG Blog

JUNE 27, 2024

EMS reports intermittent sinus tachycardia and bradycardia secondary to some type of heart block during transport. Smith comment: Go here for a comprehensive blog post on syncope and link to the most detailed version of the Canadian Syncope Rule: Emergency Department Syncope Workup. Troponins were all negative.

EKG/ECG 124

EKG/ECG Documentation/Coding Emergency Department Wellness 124

EB Medicine

MARCH 7, 2022

Episode 67 – Managing Postpartum Complications in the Emergency Department – An Interview with Dr. Nicole Yuzuk, Dr. Joseph Bove, and Dr. Riddhi Desai EMplify – March 2022 Interview with the Authors: Nicole Yuzuk, DO, Joseph Bove, DO, and Riddhi Desai, DO Episode Outline: 1.Why Why is this an important topic in EM?

Emergency Department 52

Emergency Department Seizures EMS EKG/ECG 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. Our first 12 lead ECG was then recorded at 0926. What do you think?

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

EMDocs

DECEMBER 18, 2024

A 36-year-old male presents to the emergency department after being found down at home by his spouse. Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. Acad Emerg Med. This series provides evidence-based updates to previous posts so you can stay current with what you need to know.

Seizures 61

Seizures Emergency Department Hyperthermia / Hypothermia EMS 61

Dr. Smith's ECG Blog

OCTOBER 2, 2021

Triage EKG: What do you think? Today’s pain lasted around 20 mins, but was severe enough that the patient called EMS. Pain largely resolved prior to EMS arrival but completely subsided after prehospital NTG and aspirin. A prior ECG was available for comparison. There is STE present in leads V2-V5. ng/mL (undetectable).

EKG/ECG 52

EKG/ECG Ultrasounds EMS Documentation/Coding 52

Dr. Smith's ECG Blog

AUGUST 9, 2024

Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. These diagnoses were not found in his medical records nor even a baseline ECG. The patient continued having chest pain.

EKG/ECG 92

EKG/ECG EMS Emergency Department Outcomes 92

EMDocs

SEPTEMBER 26, 2024

EKG, labs, and a CXR are interpreted by the EP as normal. An attorney is consulted and a lawsuit filed against the hospital, the first ED physician, the EM group, and the PCP. Too much weight was given to the EKG, CXR, and labs. Plaintiff : You told me you would call me if the radiology report was “different.” Baccei SJ et al.

Radiology 74

Radiology Radiology EKG/ECG Documentation/Coding 74

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. The TOMAHAWK Investigators.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. Jeff: And don’t forget to get the crash details from the EMS crew before they depart! New EKG findings requires admission for monitoring.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

PEMBlog

OCTOBER 18, 2024

Duchenne Muscular Dystrophy (DMD) is a complex and progressive disease requiring highly specialized care, especially in emergency situations. When patients with DMD present in the Emergency Department (ED), an understanding of the nuanced aspects of their care is essential for optimal management. Orphanet J Rare Dis. Pediatrics.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 52

Emergency Medicine Cases

APRIL 26, 2022

Computer interpretation of the ECG has been called a double-edged sword: when correct, it increases physician accuracy, but when incorrect it increases errors. This is especially problematic in the emergency department, where computer accuracy drops as clinical significance increases—with common errors for arrhythmias and ischemia.

EKG/ECG 52

EKG/ECG Emergency Department EMS 52

Critical Care Now

JULY 21, 2024

Patients with OMI have higher mortality and worse left ventricular function than those with NOMI, making detection crucial but challenging in busy emergency departments. OMI signs on ECG include subtle ST elevation, isolated ST depressions, and hyperacute T waves, often missed under current STEMI criteria.

EKG/ECG 75

EKG/ECG Emergency Department EMS Wellness 75

EB Medicine

JANUARY 10, 2020

Show Notes Please click here and take our listener survey Emergency Department management of Non-St Segment Elevation Myocardial Infarction, by Drs Julianna Jung and Sharon Bord. Part 4: Pre-hospital care Prehospital ECGs decrease time to intervention. Diagnostics Telemetry ECG. Patterns to know… Troponin.

Emergency Department 40

Emergency Department EKG/ECG Shock Sepsis 40

ACEP Now

NOVEMBER 6, 2024

A gravid woman presents to your emergency department (ED). 1 If HR is below 60, chest compressions should be started and an ECG placed. Turner , originally trained at the Medical University of South Carolina, is an EM intern at Hershey Medical Center in Hershey, Pa. Garvey AA, Dempsey EM. Adv Med Educ Pract.

Resuscitation 98

Resuscitation Pediatrics Hyperthermia / Hypothermia EMS 98

EB Medicine

DECEMBER 1, 2021

Risk Factors Prehospital Care – what should EMS be looking for? Table 3 ADD-RS score Exam Diagnostics Labs EKG – STEMI? Risk Factors* Prehospital Care – what should EMS be looking for? * It is in Beta and your feedback is welcome. It is in Beta and your feedback is welcome. Table 3ADD-RS scoreExamDiagnosticsLabsEKG – STEMI?

EKG/ECG 52

EKG/ECG Emergency Department EMS Shock 52

EMDocs

SEPTEMBER 19, 2023

Episode 86: Tricky Cases Part 2 Case 3: 56-year-old female with history of seizures, actively seizing, EMS called. Patient seized for approximately 20 minutes prior to EMS arrival. “The application of STEMI ECG criteria on a standard 12-lead ECG alone will miss a significant miry of patients who have acute coronary occlusion.”

Seizures 72

Seizures Documentation/Coding EKG/ECG Emergency Department 72

EB Medicine

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. Jeff: Let’s move on to evaluation in the emergency department. Jeff: You’re right. Let’s move on to treatment.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EM Curious

JULY 8, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. With a bonus brief on disaster management.

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

ACEP Now

JUNE 6, 2023

ECG, CXR, and troponin are negative. A medical student reports a murmur, not documented by either the emergency physician or the cardiologist. Troponins #1 and #2 are borderline and ECG is non-specific. EMS is called and finds his blood pressure 175/100. In the ED, his troponin, ECG, and chest X-ray (CXR) are normal.

EKG/ECG 85

EKG/ECG Stroke Documentation/Coding Operations 85

Dr. Smith's ECG Blog

DECEMBER 13, 2024

Written by Magnus Nossen and Ken Grauer ( with Comment by Smith ) The ECG in Figure-1 was electronically transmitted by the ambulance service for evaluation. He was hemodynamically stable at the time ECG #1 was recorded. QUESTIONS: How would you interpret this ECG? Figure-1: The initial ECG in today's case. ( in duration.

EKG/ECG 65

EKG/ECG Ambulance Services Emergency Department EMS 65

Dr. Smith's ECG Blog

DECEMBER 14, 2022

EMS arrived and administered aspirin and nitroglycerin. Here are his three EMS ECGs: EMS1 at 0735 This was sent to Dr. Smith with no other information. Meyers sent this ECG to Smith without any other info and this was the response: Smith interpretation: "A very rare anterior OMI w high S-wave voltage." Do not miss them!

EKG/ECG 52

EKG/ECG EMS Documentation/Coding Emergency Department 52

EMergucate

JULY 11, 2013

A 53 year old male presents to your Emergency Department following an episode of collapse and this ECG.

EKG/ECG 40

EKG/ECG Emergency Department EMS 40

EMergucate

AUGUST 9, 2013

A 83 year old patient presents to your Emergency Department complaining of lethargy, nausea, and vomiting. This is his ECG.

EKG/ECG 40

EKG/ECG Emergency Department EMS 40

Cook County EM Blog

APRIL 27, 2022

Effectiveness and safety of droperidol in a United States emergency department. Am J Emerg Med. 2019.09.007 What : Retrospective cohort study of all droperidol administrations between January 2012 and April 2018 at an academic and pediatric emergency department in the US with 77,000 annual visits.

Administration 52

Administration EKG/ECG Emergency Department EMS 52