Dr. Smith's ECG Blog

JANUARY 2, 2025

By Smith with comments from our electrophysiologist, Rehan Karim. (And of course Ken's comments at the bottom) An elderly obese woman with cardiomyopathy, Left bundle branch block, and chronic hypercapnea presented hypoxic with altered mental status. She was intubated. Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonary embolism but bibasilar infiltrates.

EKG/ECG 102

EKG/ECG Sepsis Wellness Documentation/Coding 102

The Bottom Line

JANUARY 16, 2025

Whats new in the Critical Care literature monthly updates

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Science Based Medicine

JANUARY 10, 2025

Defenders of the GBD won't tell you what it actually said. I will. The post Defenders of the Great Barrington Declaration Neither Know Nor Care What it Proposed. The Deliberate Erasure of the We Want Them Infected Movement Has Succeeded. first appeared on Science-Based Medicine.

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ACEP Now

JANUARY 5, 2025

Its 4 a.m., and youre three hours from the nearest tertiary care center. A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. On exam, you see bright red blood trickling down her left tonsillar fossa. Her vital signs are normal, except for a heart rate of 115 bpm. Its going to take time to get her to a tertiary center.

Airway Management 90

Airway Management Operations Resuscitation Pediatrics 90

EM Ottawa

JANUARY 9, 2025

In the acute care setting, steroids have various usages and indications, but their usage can often be nuanced. From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of conditions encountered in the Emergency Department (ED). However, their use is far from straightforwardbalancing […] The post These are the ‘Roids you are looking for – Steroids in the ED appeared first on EMOttawa

Shock 106

Shock Emergency Department Infectious Diseases Sepsis 106

Sensible Medicine

JANUARY 3, 2025

Doctors of a certain age tend to fetishize the physical exam. I think this is because learning the physical exam is an important part of the socialization of the doctor. It is also a skill that doesn’t really wither with time. Though with every passing day I feel more and more like part of the old guard, I can only give the exam a tepid defense.

Urgent Care 101

Urgent Care Ultrasounds Wellness 101

Dr. Smith's ECG Blog

JANUARY 7, 2025

(This was created by Arron Pearce ( [link] ) Online QT calculator for wide QRS (LBBB, RBBB, etc.

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Science Based Medicine

JANUARY 3, 2025

Once again, sheltered laptop-class doctors are treating children's health as a parlor game to advance their political objectives. The post To Spread Mistrust, Dr. Martin Kulldorff Asks RFK Jr. to do an Unethical, Impossible RCT of Vaccines He Knows Are Safe & Effective first appeared on Science-Based Medicine.

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St. Emlyn

JANUARY 2, 2025

St.Emlyn's - Emergency Medicine #FOAMed This feasibility study described the delivery of ECMO CPR (ECPR) for the first time in the UK The post Pre Hospital Extracorporeal CPR (ECPR) in the UK: The Sub30 study appeared first on St.Emlyn's.

CPR 120

CPR Hospitals Resuscitation 120

PulmCCM

JANUARY 2, 2025

Many randomized trials have tested the biomarker procalcitonin as a guide to de-escalate or stop antibiotic therapy in patients with known or suspected infection. A large proportion have concluded PCT is a safe and effective method to shorten antibiotic courses, including in patients with sepsis. But most such trials have been small, often single-center, and vulnerable to bias due to the unblinded nature of the intervention.

Sepsis 98

Sepsis Outcomes Stroke Shock 98

Emergency Medicine Cases

JANUARY 7, 2025

Dr. Patricia Lee is an EM physician in Calgary, Alberta and an Assistant Professor at the University of Calgary in the Department of Emergency Medicine. She reached out to me after listening to Episode 200 How EM Experts Think Part 1 as a longtime supporter of EM Cases, to highlight the importance of recognizing challenges that female-identifying EM physicians may face before, during and after ED shifts.

EMS 108

EMS Leadership Resuscitation 108

EM Ottawa

JANUARY 13, 2025

Methodology: 4/5 Usefulness: 4/5 Vallentin MF, et al. N Engl J Med. 2024 Oct 31. doi: 10.1056/NEJMoa2407616. Editorial: The Way to a Patient’s Heart – Vascular Access in Cardiac Arrest Question and Methods: This RCT compared IO vs. IV vascular access in adults with OHCA, using ROSC as a primary outcome. Findings: No significant difference […] The post Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest appeared first on EMOttawa Blog.

Hospitals 101

Hospitals Outcomes Resuscitation 101

Sensible Medicine

JANUARY 15, 2025

If Robert F. Kennedy Jr. is confirmed as the next secretary of the Department of Health and Human Services, and if he carries out even part of his agenda , he will be a consequential -- and controversial -- cabinet secretary. I am concerned about some of his stances , including his record of objecting to vaccines, but in other areas, starting with addiction, his vision and values could transform lives.

Psychiatric 91

Psychiatric Wellness Outcomes 91

Science Based Medicine

JANUARY 6, 2025

A proponent of the Great Barrington Declaration is comparing rejection of its "natural herd immunity" approach to the pandemic to the rejection of Ignaz Semmelweis and his findings. It's a deceptive comparison beloved of all manner of scientific cranks. The post The Semmelweis gambit: A red flag for defending bad science and quackery first appeared on Science-Based Medicine.

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St. Emlyn

JANUARY 13, 2025

St.Emlyn's - Emergency Medicine #FOAMed Explore the variability in maintaining prehospital anaesthesia for trauma patients in this comprehensive summary of a multinational survey. With insights into drug protocols, administration methods, and governance, the article highlights challenges and opportunities for standardisation in prehospital care.

Administration 70

Administration Research Outcomes 70

PulmCCM

JANUARY 15, 2025

Pulse oximeters for healthcare and consumer use are calibrated on patients with lighter skin. Manufacturers have recognized the devices’ suboptimal performance in darker-skinned patients for decades, but they have faced no serious regulatory or legal pressure to act. In 2013, FDA issued a suggestion that manufacturers test devices on patients “with a range of skin pigmentations.” But the standard was lax: only two darkly pigmented subjects, or 15% of the total pool were needed.

Documentation/Coding 81

Documentation/Coding Academics Administration Research 81

EB Medicine

JANUARY 7, 2025

In this episode, Sam Ashoo, MD interviews Nicholas Stark, MD, MBA & Zaid Altawil, MD about the Emergency Medicine Innovation Collaborative 1. Discussion on EMIC - Overview of the collaborative - Background and formation during the pandemic in late 2021 2. Growth of EMIC - Expansion from three members to over 500 - Focus areas: Education, mentorship, opportunity 3.

EMS 79

EMS 79

EM Literature of Note

JANUARY 16, 2025

This little article has made the rounds, primarily by those who critique it for its many flaws. However, the underlying themes can still be valid, even if an article has limitations. This is a “there is variation in emergency physician admitting practices” article. Literally every practicing physician working in a hospital environment knows there is a broad spectrum of skill, approach to acute illness, and level of risk-tolerance.

Outcomes 75

Outcomes Radiology Radiology Emergency Department 75

EMCrit

JANUARY 10, 2025

Nitty Gritty of All Things Defibrillation EMCrit Project by Scott Weingart, MD FCCM.

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Science Based Medicine

JANUARY 17, 2025

This is what it looks like when doctors treat the pandemic as an intellectual parlor game. The post Dr. Jay Bhattacharya Was Nice to Someone During a Debate. That Doesnt Erase the Consequences of His Misinformation. first appeared on Science-Based Medicine.

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St. Emlyn

JANUARY 6, 2025

St.Emlyn's - Emergency Medicine #FOAMed How does pre-hospital emergency anaesthesia (PHEA) delivered by Helicopter Emergency Medical Services (HEMS) impacts trauma care timelines compared to emergency department RSI (EDRSI). This retrospective study explores time efficiency, injury severity, and patient outcomes, highlighting the role of HEMS in delivering critical care to severely injured patients in remote locations.

Emergency Department 87

Emergency Department Outcomes Hospitals 87

Northwestern EM Blog

JANUARY 14, 2025

Written by: Sasha Becker, MD (NUEM 27) Edited by: Mara Bezerko (NUEM 25) Expert Commentary by : Aaron Wibberley, MD Expert Commentary This is a very nice summary by Dr. Becker and Dr. Bezerko of a troublesome-appearing rhythm occasionally encountered in the emergency department. Thankfully, the majority of presentations are benign. Our role as emergency providers is to risk-stratify for, or rule out, dangerous underlying etiologies of AIVR.

Emergency Department 98

Emergency Department Wellness 98

Core Medical Group

JANUARY 17, 2025

Meet senior recruiter from our permanent placement division, Joe McLaughlin. Joe will help you find your dream healthcare job today.

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EMDocs

JANUARY 8, 2025

Authors: Lloyd Tannenbaum, MD (EM Attending Physician, Geisinger Wyoming Valley, PA); Mai Saber, DO (EM Attending Physician, Hackensack University Medical Center, NJ); Rachel Bridwell, MD (EM Attending Physician, Charlotte, NC) // 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.

EKG/ECG 73

EKG/ECG EMS Academics Emergency Department 73

ECG Guru

JANUARY 3, 2025

Here we see a 30 s long strip of a 1-leadECG, recorded with a modern Smartwatch (Apple watch). The ECG has been graphically processed for better visualization. The paper speed is 25 mm/s as usual. The lead shown corresponds to ECG lead I of the limb leads.

EKG/ECG 83

EKG/ECG 83

Science Based Medicine

JANUARY 1, 2025

In 2020, the GBD was all about herd immunity via natural immunity. Today, its defenders censor that. The post A Challenge For Dr. Edward Livingston: Defend the Great Barrington Declaration Without Censoring the Great Barrington Declaration first appeared on Science-Based Medicine.

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St. Emlyn

JANUARY 7, 2025

St.Emlyn's - Emergency Medicine #FOAMed Mastering likelihood ratios can transform your diagnostic skills. In this podcast with Rick and Greg, discover how likelihood ratios can enhance decision-making and improve patient care. The post Podcast – Likelihood Ratios: Critical Appraisal Nugget 12 appeared first on St.Emlyn's.

Research 101

Research 101

ALiEM

JANUARY 13, 2025

A 55-year-old female presented with the complaint of my right eye popped out. Symptoms started approximately seven hours prior to arrival and progressive, severe pain eventually prompted her visit to the ED. This happened once 10 years ago, requiring reduction in the ED. The patient denied preceding trauma, rubbing her eyes/eye-lids, or any history of thyroid disease.

Academics 67

Academics Emergency Department 67

Emergency Medicine Journal

JANUARY 21, 2025

A short systematic review was undertaken to assess whether intradermal sterile water injections (ISWI) provide effective pain relief in adult patients presenting to the Emergency Department (ED) with renal colic. MEDLINE, Embase, Cochrane and Google Scholar databases were searched, identifying seven relevant studies. Study information, patient characteristics, key results and methodological weaknesses were tabulated.

Emergency Department 52

Emergency Department Research 52

EMDocs

JANUARY 11, 2025

Author: Christopher Blanton, MD, MBA (EM Resident, UTSW / Dallas, TX); Joslin Gilley-Avramis, MD (EM Attending Physician, UTSW / Parkland Memorial Hospital) // Reviewed by: Sophia Grgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Brit Long, MD (@long_brit) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.

EMS 72

EMS Sepsis Shock Fluid Resuscitation 72

ECG Guru

JANUARY 13, 2025

This ECG was sent to me by a friend, I don't know if he did it himself. The question was whether a heart attack can be recognized here. The patient is a 55-year-old man who has typical angina pectoris lasting more than 1 hour. What can you answer?

EKG/ECG 78

EKG/ECG 78

Science Based Medicine

JANUARY 12, 2025

If only they had let more unvaccinated children suffer and die from COVID, we wouldn't be in this position today. The post Science-Based Satire: My Patients are Refusing the MMR Because the CDC Added the COVID Vaccine to the Routine Vaccine Schedule first appeared on Science-Based Medicine.

CDC 83

CDC 83

SCGH ED

JANUARY 9, 2025

Australian Resuscitation Council (ARC) Flowchart KEMH Neonatal Resuscitation Algorithm: The post Neonatal Resuscitation Algorithms: appeared first on Charlie's ED.

Resuscitation 72

Resuscitation 72

Life in the Fast Lane

JANUARY 8, 2025

Chris Nickson Come join the 2025 Clinician Educator Incubator! Expressions of interest are now open for the sixth Clinician Educator Incubator - EOIs close Feb 10th 2025.

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Emergency Medicine Journal

JANUARY 21, 2025

Background Extreme weather events due to human activities have significantly increased the frequency and severity of hydrological disasters like floods, impacting human health and healthcare systems worldwide. This study analyses the patterns of emergency service utilisation of the May 2023 flood in Romagna, Italy, and specifically investigates the differences in emergency department (ED) visits and mortality between individuals exposed and not exposed to the flood.

Emergency Department 52

Emergency Department Wellness 52

ALiEM

JANUARY 10, 2025

A 3-month-old male with no past medical history was brought to the emergency department for evaluation of newly asymmetric pupils. The infant appeared to be asymptomatic per parents, without any behavior changes or associated symptoms noted. The patients mother noticed her sons left pupil was dilated and unresponsive to light the morning of presentation.

Pediatrics 64

Pediatrics Documentation/Coding Academics Administration 64

ECG Guru

JANUARY 3, 2025

This ECG is from a 65-year-old woman who had previously had no cardiac abnormalities but has now suffered several syncopes within 2 weeks. During the last syncope she suffered a fracture of the left femur.

Fractures 81

Fractures EKG/ECG 81