ALiEM

MARCH 22, 2024

A 53-year-old woman with no significant past medical history presented to the emergency department with a 3-day history of double vision on leftward gaze. Laboratory Data CBC , CMP , EKG , and Troponins were normal. Given this patient’s relatively young age and vascular risk factors, stroke is highest on the differential.

Stroke 67

Stroke Urgent Care Head Injuries Emergency Department 67

EMDocs

SEPTEMBER 19, 2023

Also think about NCSE in patients with prior cerebral pathology (ie, ischemic stroke); a patient who was seizing, was treated, and is not coming out of their post ictal state; and in patients with unexplained altered mental status with no other cause. Official diagnosis requires EEG, which is not something we can typically obtain in the ED.

Seizures 90

Seizures Documentation/Coding EKG/ECG Emergency Department 90

ACEP Now

JUNE 6, 2023

ECG, CXR, and troponin are negative. Notoriously elusive, with a high misdiagnosis rate, thoracic aortic dissection (AD) can mimic many conditions, including acute coronary syndrome (ACS, the most common), gastroesophageal reflux disease (GERD), stroke, and spinal-cord compression. ECG, CXR, and troponin are all normal.

EKG/ECG 85

EKG/ECG Stroke Documentation/Coding Operations 85

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Post-resuscitation ECGs demonstrating ST segment elevation are significant in delineating which patients might benefit most from advanced reperfusion techniques. Circulation. 2022;145(8):e153-e639. Circulation.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

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. MACE= Major Adverse Cardiovascular Event: including re-infarction, stroke, dysrhythmia, heart failure, cardiogenic shock, and death.

Emergency Department 40

Emergency Department Shock EKG/ECG Sepsis 40

Taming the SRU

JANUARY 26, 2024

Morbidity & MOrtality - Mini Lit Blitz - Post-Rosc Care - Qi/KT Morbidity & Mortality WITH Dr. Yates Case 1: Stroke and Stroke Mimics Early diagnosis of stroke improves stroke outcomes, where misdiagnosis is associated with an upwards of 4-time higher likelihood of mortality Missed strokes most often occur with atypical symptoms, in younger (..)

Stroke 59

Stroke EKG/ECG Seizures Outcomes 59

Dr. Smith's ECG Blog

DECEMBER 26, 2020

An ECG was recorded quickly on return to the ED: (sorry for poor quality, cannot get originals) What do you think? They called their transfer center cardiologist on call, who reviewed the case on the phone with them, as well as the ECG. In my opinion this makes the flutter waves slightly easier to recognize in this ECG.

EKG/ECG 52

EKG/ECG Stroke Administration Seizures 52

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

Dr. Smith's ECG Blog

NOVEMBER 19, 2022

Written by Bobby Nicholson MD, with edits by Meyers A woman in her 50s with past medical history of heart failure, prior stroke, atrial fibrillation on Eliquis, lung cancer in remission, and CKD, presented to the emergency department for evaluation of cough and shortness of breath. I thought the ECG diagnosis was obvious.

EKG/ECG 52

EKG/ECG Stroke Emergency Department Wellness 52

Taming the SRU

AUGUST 4, 2024

to teach you and your learner something new on shift skin adhesives WITH dr. hill Dermabond is a polymer (octyl cyanoacrylate) that can be used to repair lacerations in the Emergency Department faster than sutures, allowing the ED physician to be more efficient.

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

The Skeptics' Guide to EM

SEPTEMBER 21, 2019

Case: A 55-year-old male presents to the emergency department with sudden onset of palpitations and pre-syncope starting one hour ago. His ECG shows atrial fibrillation with a rapid ventricular response. His ECG shows atrial fibrillation with a rapid ventricular response. Reference: Scheuermeyer et al.

Emergency Department 52

Emergency Department Stroke Academics Shock 52

ACEP Now

DECEMBER 11, 2023

Our case seeks to make emergency physicians aware of this phenomenon as recognition is essential in reducing patient exposure to unnecessary and potentially harmful interventions. The Case FIGURE 1: Initial EKG were notable for a leukocytosis of 23.19 k/uL, lipase of 87 U/L and an initial negative troponin of 3 ng/L HEART score of 1.

EKG/ECG 52

EKG/ECG Hospitals Stroke Emergency Department 52

PEMBlog

SEPTEMBER 6, 2023

In fact, some Emergency Departments note that as many as one tenth of their patient volume is mental health. Medical clearance’ of patients with acute mental health needs in the emergency department: a literature review and practice recommendations. Ann Emerg Med. Ann Emerg Med. Health Aff (Millwood).

Psychiatric 52

Psychiatric Pediatrics Emergency Department EKG/ECG 52

Taming the SRU

DECEMBER 6, 2023

Calcium is also now carried in the prehospital setting and should be used when EKGs show signs of hyperkalemia, cardiac arrest with concern for hyperkalemia, and those who have crush injuries. With rare exception, patients with sICH should be admitted to a specialized stroke unit (NSICU).

Leadership 57

Leadership Stroke Airway Management Administration 57

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

We were trying to answer the question: Do all patients presenting to the emergency department with chest pain need to be placed on cardiac monitoring or could some be safely removed? TXA also seems to improve patient-oriented outcomes in epistaxis ( SGEM#53 and SGEM#210 ).

Academics 52

Academics Resuscitation EMS Stroke 52

Dr. Smith's ECG Blog

AUGUST 23, 2017

Here is his 12-lead ECG: The computer reads supraventricular tachycardia. Same stroke precautions as atrial fib A 40-something presented with palpitations and had a regular pulse at 170. What is it? It is atrial flutter with 2:1 conduction. It is not PSVT and not sinus. There are clear flutter waves in lead II across the bottom.

Stroke 52

Stroke Sepsis Emergency Department EMS 52

Dr. Smith's ECG Blog

JULY 3, 2018

Here is his initial ECG: 00:04 What do you think? With no other information other than the first ECG above, I texted this to Dr. Smith and he responded: ST elevation in lead V2 and terminal QRS distortion in V3. Therefore, this ECG would not have met the criteria for ACO by this formula. LAD occlusion. Great case.

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52

ACEP Now

APRIL 5, 2024

2 TTP often presents abruptly, and most patients that develop it first visit the emergency department (ED) as their symptoms worsen. It is thus imperative that emergency physicians be able to recognize and properly treat this disease, especially in the absence of its classical presentation. Am J Emerg Med. J Emerg Med.

Domestic Violence 40

Domestic Violence Emergency Department Outcomes EKG/ECG 40

Taming the SRU

MAY 1, 2023

A retrospective evaluation of phenobarbital versus benzodiazepines for the treatment of alcohol withdrawal in a regional Canadian emergency department Link: [link] Bottom Line: This study in a small regional ED showed a QI project rolling out a Phenobarbital or Diazepam for Alchohol withdrawal syndrome. and NPV(50%).

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

ACEP Now

JULY 6, 2023

Emergency physicians have earned the right to “re-brand” ourselves as indispensable, money-saving change agents in the health care enterprise. Of course, the bill for any episode of emergency department (ED) care can be substantial, exceeding the billed charges for equivalent care provided in some primary care offices.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

EMDocs

DECEMBER 16, 2023

A 12-lead EKG shows sinus tachycardia but is otherwise normal. An 18-month-old boy presents to the emergency department with loss of consciousness. Both can result in heat exhaustion and heat stroke and have many overlapping symptoms. Patients with heat stroke have hot, dry skin and altered mental status (e.g.,

Hyperthermia / Hypothermia 87

Hyperthermia / Hypothermia EMS Stroke Seizures 87

The Skeptics' Guide to EM

APRIL 9, 2022

AEM April 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. AEM April 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: April 7th, 2022 Reference: Wong et al.

Head Injuries 52

Head Injuries Emergency Department Seizures Stroke 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Abnormal ECG – looks for cardiac syncope. Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm. If no previous ECG was available, ECG was classified as abnormal if any abnormality was present. orthostatic vitals b.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EMDocs

NOVEMBER 4, 2024

Pain can be associated with a friction rub on cardiac auscultation, a pericardial effusion on a bedside echocardiogram, or diffuse ST elevations on an EKG. The Treatment of Acute Pain in the Emergency Department: A White Paper Position Statement Prepared for the American Academy of Emergency Medicine. J Emerg Med.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

EMDocs

FEBRUARY 18, 2025

Authors: Lloyd Tannenbaum, MD (EM Attending Physician, Geisinger Wyoming Valley, PA) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations. This week, we feature a post from Dr. Tannenbaums ECG Teaching Cases , a free ECG resource.

EKG/ECG 63

EKG/ECG Documentation/Coding Wellness CPR 63

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, million presentation to ED’s throughout the US Usually occur due to falls Also commonly occur due to sports, MVC’s, etc.

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Taming the SRU

NOVEMBER 18, 2024

This blog post will attempt to serve as a resource to assist in the evaluation of persistent/intractable hiccups and cover the physiology, classification, associated disease processes, evaluation and management strategies of hiccups in the emergency department.

Stroke 86

Stroke Administration Dehydration COPD 86

ACEP Now

MARCH 5, 2025

A 47-year-old male with a medical history of hypertension, and, prior left upper lobe Pancoast tumor status, post video-assisted left upper lobectomy with chest wall and ribs 1-3 resection, presented to the emergency department (ED) with dyspnea, chest heaviness, and near syncope. Figure 2. (A)

Ultrasounds 52

Ultrasounds Resuscitation Shock Stroke 52

EMDocs

FEBRUARY 3, 2025

These complications affect both the central and peripheral nervous systems and encompass a wide range of conditions, including transient ischemic attacks (TIA), stroke, headaches, mood disorders, seizures, psychosis, neuropathy, and cognitive dysfunction (1,6,7).

Stroke 64

Stroke EMS Seizures Outcomes 64