RebelEM

JUNE 1, 2023

Costs include actual cost of the scans as well as delaying other patients’ scans but also includes time taken away from resuscitation to move the patient to and from CT. The cost difference may be modest here as many of the patients in the standard care cohort were getting CTs as well. IQR 2.2 – 69.5)

Outcomes 144

Outcomes Resuscitation Hospitals CPR 144

EMDocs

SEPTEMBER 14, 2024

2: Human, Take this Patient to the Cath Lab – AI and STEMI Detection Spoon Feed These researchers developed and trained a deep ensemble artificial intelligence (AI) model to classify ECGs as STEMI versus non-STEMI. The AI performed well in both accuracy and in improving sensitivity. PMID: 39032988. #2:

Emergency Department 92

Emergency Department Resuscitation Pediatrics Research 92

Dr. Smith's ECG Blog

JANUARY 30, 2019

I remember Allie well from her days in the Research volunteer program at Hennepin. An initial EKG was obtained: Computer read: sinus tachycardia, early acute anterior infarct. Here is her prior EKG: When compared to the old EKG – Q waves present before, TWI in aVR present before, but all other changes are new.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Wellness Documentation/Coding 52

Medagadget

JULY 19, 2023

Researchers at UCLA have developed a wearable patch that can measure muscle movements in underlying tissues. The researchers hope that the technology will be useful in assessing muscle injuries and in developing personalized physical rehabilitation programs for patients. So far, the technology has been shown to be very sensitive.

EKG/ECG 68

EKG/ECG Research Wellness 68

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

Over some time and the pain moved into her other arm as well as her jaw. She has no previous cardiac history of which she is aware 911 was called and here is her Prehospital ECG: What do you think? link] Case continued She arrived in the ED and here is the first ED ECG. She said this was midsternal and felt like a tightness.

EKG/ECG 110

EKG/ECG Ultrasounds Wellness Stroke 110

Sensible Medicine

AUGUST 21, 2023

On yesterday’s podcast , I talked with Bobby Yeh, an academic cardiologist who made a compelling case for enhancing credibility of observational research. The reasons are multiple, but I will articulate a few: Most epidemiological studies are done from large data sets that are not collected for the purpose of research.

Administration 96

Administration Outcomes Research COPD 96

Taming the SRU

AUGUST 7, 2023

Research Grand rounds WITH Drs. Recent Updates - There are many trials coming up or active to continue to broaden acute ischemic stroke care. This include increasing EVT scope for smaller vessel lesions, treatment of large core strokes, treatment of patients with low NIHSS, and those with previous disabilities.

Stroke 93

Stroke Outcomes EKG/ECG Research 93

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Our first 12 lead ECG was then recorded at 0926. Another ECG was recorded 5 minutes later just before arrival at the hospital: Similar The patient was transported to a nearby suburban hospital with PCI capabilities while my partner cared for her. Smith: this ECG and clinical presentation is diagnostic of LAD Occlusion.

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

Stop and Think

DECEMBER 29, 2023

The doctor would do an ECG and that would diagnose AF. The trials have shown us that old-school AF, wherein it is detected due to symptoms, in a doctor’s office, and by a standard ECG, is different from short duration AF detected on a device. JMM P.S. This newsletter is often critical of industry-related research.

Stroke 92

Stroke Research EKG/ECG Wellness 92

JournalFeed

SEPTEMBER 14, 2024

Friday Spoon Feed : These researchers developed and trained a deep ensemble artificial intelligence (AI) model to classify ECGs as STEMI versus non-STEMI. The AI performed well in both accuracy and in improving sensitivity.

Research 52

Research EKG/ECG Wellness 52

Dr. Smith's ECG Blog

AUGUST 26, 2009

He called 911 and paramedics recorded a prehospital 12 lead ECG which showed a clear inferior STEMI (not shown, tracing could not be found). On arrival, the following ECG was recorded. To diagnose inferior MI, there must always be reciprocal ST depression or T-wave inversion or both in lead aVL (see abstract of our research below).

EKG/ECG 52

EKG/ECG Documentation/Coding Research Academics 52

Dr. Smith's ECG Blog

MARCH 3, 2023

can cause ST-segment elevation (STE) on electrocardiogram (ECG), the distinction between them may be hard and complicated. Furthermore, some ECGs may not meet the STEMI criteria but may still be diagnostic for acute coronary occlusion (ACO). The majority of the ECGs are from Stephen W. Mar for atrial activity ECG).

EKG/ECG 52

EKG/ECG Research Hospitals Wellness 52

Dr. Smith's ECG Blog

OCTOBER 3, 2018

The medics recorded the following initial ECG at time 0: The computer read (see below) gives no further comment beyond ventricular pacemaker. The medic was very worried about the concordant STE and T-wave in aVR, and the downsloping concordant ST depression in II, III, aVF, as well as V5 and V6. What do you think? What happened?"

EKG/ECG 52

EKG/ECG Emergency Department Research Outcomes 52

Dr. Smith's ECG Blog

MARCH 9, 2023

Here is his triage ECG at 0343: What do you think? Annals of Emergency Medicine Cardiology was called to evaluate the patient immediately for emergent cath, but they stated that the ECG did not meet STEMI criteria and elected to wait for further information before proceeding with cath. Vitals were within normal limits.

EKG/ECG 52

EKG/ECG Outcomes Emergency Department Research 52

Taming the SRU

AUGUST 4, 2024

We discussed some practices to push learners outside of their comfort zone and promote learning, based on their level as well as their goals for the shift.

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

Mind The Bleep

JULY 8, 2023

Therefore, I’m sharing the things that worked well and were time-effective, and those that didn’t. Many questions were repeated, and on some, the resources were not included (“look at this ECG” but no ECG was visible). Other resources Flashcards worked very well for me, but aren’t everyone’s cup of tea. Survivorship bias.

EKG/ECG 52

EKG/ECG Wellness Hyperthermia / Hypothermia Poisoning 52

Dr. Smith's ECG Blog

DECEMBER 27, 2018

This ECG comes from Pierre Taboulet ( [link] /)( [link] ) an ECG whiz who codes a lot of ECGs for Cardiologs' Artificial Intelligence Deep Neural Network algorithm ( [link] ). I do research on Cardiologs' algorithm: Smith SW et al. This ECG is displayed on the Cardiologs platform. What an honor. What do you think?

EKG/ECG 40

EKG/ECG Documentation/Coding Emergency Department Wellness 40

RebelEM

MARCH 13, 2023

In this systematic review and meta-analysis, researchers aim to establish an accurate prehospital TCA mortality rate and explore associations between survivability and the many factors contributing to prehospital TCA management. Are any pre- or intra-arrest factors prognostic of prehospital TCA mortality? Discussion: Dead On Scene: The 96.2%

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52

RebelEM

JULY 3, 2023

Currently, the infusion of IV calcium before diltiazem is not well understood, and more studies have focused on administering IV calcium prior to verapamil than diltiazem. What They Did: Researchers conducted a multicenter, retrospective cohort study in three community hospitals and two freestanding emergency departments.

Administration 91

Administration Outcomes Documentation/Coding Emergency Department 91

ACEP Now

JULY 6, 2023

Emergency physicians have become leaders in achieving cost efficiency in health care, predominantly through implementation of new processes and research findings, enabling us to achieve significant financial savings. Pediatric Emergency Care Applied Research Network head injury clinical prediction rules are reliable in practice.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

Taming the SRU

FEBRUARY 22, 2023

Team Environment Own the Resuscitative Real Estate Set up how you want the resuscitation to go Organize your space in the way that will wrok best for you and the patient Patient Special circumstances Peds Pregnant Mechanical circulatory support Update Partner Priorities Clear and well defined Lesson 2 Lead with kindness Being liked is a powerful tool (..)

Hospice 40

Hospice EKG/ECG Resuscitation Wellness 40

Northwestern EM Blog

JANUARY 24, 2022

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. To reverse these effects as well as refractory hypotension, hydrocortisone is the preferred agent due to both its glucocorticoid and mineralocorticoid properties.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Taming the SRU

MAY 1, 2023

Patients must have EKG findings and meet one of a few other criteria (ie family history of sudden death, VF or VT episode, syncope, nocturnal agonal respirations) Most common in patients of Southeast Asian descent and the mean age of death from arrhythmia if untreated is in the 4th decade of life.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Emergency Department Seizures 52

PEMBlog

MARCH 27, 2024

She aims to become a physician-scientist in pediatrics and medical genetics, engaging in bench-to-bedside research that utilizes multi-omics-based approaches to provide a molecular diagnosis and support personalized care for individuals with suspected rare genetic diseases and their families. Or, well, the ringer called me.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

ACEP Now

JULY 8, 2024

1 Other, non-transformer-based ML methods can be used on clean, well-structured data sets, but LLMs are frequently capable of feats of unanticipated competence right out of the box. The evolving capabilities of LLMs far outpace the ability of researchers to test and report their performance.

Emergency Department 52

Emergency Department Operations Documentation/Coding Research 52

Ken Grauer, MD

OCTOBER 4, 2024

The ECG shown in Figure-1 was obtained from a previously healthy 30-year old man — who had this ECG as part of a "routine" pre-employment physical exam. He is otherwise well without medical problems. QUESTIONS: How would YOU interpret the ECG in Figure-1 ? Figure-1: The initial ECG in today's case. (

EKG/ECG 254

EKG/ECG Wellness Research 254

Dr. Smith's ECG Blog

FEBRUARY 8, 2015

Suggestions on management: First , examine the ECG very closely for P-waves. We believe more research is needed in this area, as amphetamine derivatives are one of the most widely abused drugs worldwide, and we expect this problem to worsen in the future." Wells, P.J. Try Lewis Leads!! Cigarroa, R.G. Flores, E.D. McBride, W.

Seizures 52

Seizures Administration Outcomes Hospitals 52

Dr. Smith's ECG Blog

MAY 23, 2022

Written by Jesse McLaren, with comments by Smith and Grauer Four patients presented with cardiorespiratory symptoms, with inferior ST elevation and reciprocal change on their ECG. Note: according to the STEMI paradigm these ECGs are easy, but in reality they are difficult. First lets start with each ECG without clinical context.

EKG/ECG 52

EKG/ECG Documentation/Coding Hyperthermia / Hypothermia Research 52

Dr. Smith's ECG Blog

MARCH 24, 2023

Below is the ECG. There’s minimal concave ST elevation in III which does not meet STEMI criteria, so this ECG is "STEMI negative". Use STEMI criteria to identify acute coronary occlusion: the ECG was STEMI negative 2. A repeat ECG was done on way to cath lab: "STEMI negative" again. What do you think? Stress test?

EKG/ECG 52

EKG/ECG Research Emergency Department Outcomes 52

EMDocs

JANUARY 6, 2024

His electrocardiogram (ECG) is shown below: His chest x-ray is shown below: The patient’s high sensitivity troponin I is elevated to 3,000, and his Brain-Natriuretic Peptide (BNP) is elevated to 14,000 ng/L. 15 The exact incidence or acute coronary syndrome in heart transplant patients is not well characterized. Lab Invest.

EMS 83

EMS Infectious Diseases Shock Emergency Department 83

EB Medicine

AUGUST 1, 2018

Jeff: This DEA designation limits the ability to do research and obtain federal funding for such research. Synthetics were initially developed in the 1980s largely for research purposes. Jeff: And the etiology of CHS is not well understood. And the US DEA maintains cannabis as a Schedule I substance.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

AENJ: Current Issue

DECEMBER 31, 2023

Among nine categories, pediatric nurses were more stressed about patients and families (mean = 22.83, SD = 5.71), as well as death and dying (mean = 19.33, SD = 5.22), whereas they were less stressed about discrimination (mean = 4.21, SD = 4.09) and problems with peer support (mean = 12.11, SD = 4.58).

Pediatrics 40

Pediatrics Emergency Nursing Research Hospitals 40

EMDocs

SEPTEMBER 16, 2024

Stay up-to-date with the latest guidelines and research to enhance the credibility of your presentations. Well what do you want to do with her?” I think we should probably do some tests or something, like an ECG, maybe? I would also like to get an EKG to look for any arrhythmias or ST elevations or depressions.

EKG/ECG 89

EKG/ECG Wellness Fractures Emergency Department 89

Dr. Smith's ECG Blog

APRIL 8, 2015

True Syncope: If, on the other hand, the patient is well, had no other serious symptoms , has a normal sinus rhythm, and normal physical exam , then you need to be certain the syncope was not due to a dangerous brady- or tachydysrhythmia that could recur. Abnormal ECG – looks for cardiac syncope. Vasovagal syncope is generally benign.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EMDocs

JANUARY 20, 2024

ECG shows ST-segment elevation in V3-V6 only with depression in aVR. It was first described in Japan in 1991, where researchers noted a balloon shape to the left atrium resembling a trap used to catch octopuses in Japan. Initial vital signs include BP of 157/80, HR of 96, RR 14, SpO2 of 97% on RA, T 37.5.

EMS 96

EMS Fluid Resuscitation Shock EKG/ECG 96

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. She denies any trauma, swelling, or redness in the joints, as well as fever or weight loss. Neuropathic pain: redefinition and a grading system for clinical and research purposes.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

Dr. Smith's ECG Blog

MARCH 8, 2025

Her first ECG is shown. After this ECG was obtained, the ER physician received word that the patient's husband had died in the crash. Repeat ECG was obtained immediately, just 24 minutes after the prior ECG: Given the context, my top differential diagnosis would be stress cardiomyopathy AKA takotsubo. Overall bland.

EKG/ECG 76

EKG/ECG CPR Resuscitation Wellness 76