REBEL EM

NOVEMBER 6, 2024

PMID: 32644703 Robinson PM, Griffiths E, Watts AC. PMID: 27227986 Glover NM, Black AC, Murphy PB. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. Simple elbow dislocation. Shoulder Elbow. 2017 Jul;9(3):195-204. PMID: 28588660 Donohue KW, Mehlhoff TL. Chronic Elbow Dislocation: Evaluation and Management. J Am Acad Orthop Surg.

E-9-1-1 59

E-9-1-1 ACS OR Emergency Department 59

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Overdose 67

Overdose ACS Critical Care OR 67

EM Didactic

OCTOBER 15, 2018

References Meltzer AC, Baumann BM, Chen EH, Shofer FS, Mills AM. 2013 Aug 1;62(2):126-31. If discharging, give strong worsening statements and explain uncertainty about the diagnosis and need for review if symptoms change. Poor sensitivity of a modified Alvarado score in adults with suspected appendicitis. Annals of emergency medicine.

ACS 52

ACS ED OR 52

REBEL EM

JANUARY 29, 2024

Click here for Direct Download of the Podcast Paper: Aykan AC et al. Am J Cardiol 2013. PMID: 23102885 Aykan AC et al. Because the lungs receive 100% of cardiac output, it has been hypothesized that a lower dose of thrombolytic therapy may still be effective with a better safety profile [3][4]. Clin Exp Emerg Med 2023.

ALS 137

ALS ACS OR CPR 137

EMDocs

JUNE 7, 2023

2013; 6:524. Published 2013 Dec 9. 12784 Povey AC, Rees HG, Thompson JP, Watkins G, Stocks SJ, Karalliedde L. Clin Toxicol (Phila) 51: 838, 2013. [PMID: 25031861] Malla G, Basnet B, Vohra R, Lohani SP, Yadav A, Dhungana V. Parenteral organophosphorus poisoning in a rural emergency department: a case report. BMC Res Notes.

E-9-1-1 84

E-9-1-1 ICU Emergency Department ED 84

Don't Forget the Bubbles

JULY 22, 2024

Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, et al. 2013 Jun 4;2013(6):CD004878. Fernandes RM, Wingert A, Vandermeer B, Featherstone R, Ali S, Plint AC, et al. Yao TC, Wang JY, Chang SM, Chang YC, Tsai YF, Wu AC, et al. Annals of Emergency Medicine. 2016 May;67(5):593-601.e3. Arch Dis Child.

E-9-1-1 104

E-9-1-1 ALS ACS ED 104

Pediatric EM Morsels

AUGUST 18, 2023

Etminan 2019) In Belgium between 2010 – 2013, of the 262 children treated with fluroquinolones while hospitalized, only 17% were used for labelled indications. References: Ross RK, Kinlaw AC, Herzog MM, Funk MJ, Gerber JS. Nearly 400,000 prescriptions were written and 22% were found to be inappropriate based on clinical guidelines.

E-9-1-1 130

E-9-1-1 ACS OR ALS 130

EMDocs

JUNE 14, 2023

Published 2013 Dec 9. doi:10.1186/1756-0500-6-524 Ross SM, McManus IC, Harrison V, Mason O: Neurobehavioral problems following low-level exposure to organophosphate pesticides: a systematic and meta-analytic Crit Rev Toxicol 43: 21, 2013. Parenteral organophosphorus poisoning in a rural emergency department: a case report. 2013;6:524.

E-9-1-1 70

E-9-1-1 Emergency Department Plasma ACS 70

Don't Forget the Bubbles

JUNE 14, 2023

2023 May;182(5):2013-2026 QuantiFERON-TB Gold Plus Performance in Children: A Narrative Review. De Alwis AC, et al. N Engl J Med. 2023 May 11;388(19):1755-1766. Guidelines and best evidence Analgesia and sedation in critically ill pediatric patients: an update from the recent guidelines and point of view. Mondardini MC, et al.

ALS 116

ALS ACS ED OR 116

Dr. Smith's ECG Blog

DECEMBER 19, 2023

Because there was proven thrombus (ACS) but the troponin never went above the 99% reference range (and therefore cannot be called MI -- definition of MI requires rise and/or fall of troponin with at least one value above the 99% reference range), this is UNSTABLE ANGINA with ST Elevation.

E-9-1-1 121

E-9-1-1 Coronary ACS BLS 121

Dr. Smith's ECG Blog

AUGUST 9, 2019

But if they do present: The very common presentation of diffuse STD with reciprocal STE in aVR is NOT left main occlusion , though it might be due to sub total LM ACS, but is much more often due to non-ACS conditions, especially demand ischemia. They will add up in varying magnitudes resulting in a variety of ECG presentations.

Coronary 52

Coronary STEMI ACS ALS 52

FOAMfrat

OCTOBER 20, 2023

Heffner AC, Swords DS, Neale MN, Jones AE. 2013 Nov;84(11):1500-4. Epub 2013 Aug 1. Heffner AC, Swords DS, Nussbaum ML, Kline JA, Jones AE. Crit Care Med. 2018 Apr;46(4):532-539. doi: 10.1097/CCM.0000000000002925. 0000000000002925. PMID: 29261566. Resuscitation. doi: 10.1016/j.resuscitation.2013.07.022. 2013.07.022.

E-9-1-1 52

E-9-1-1 ALS ACS OR 52

EMS 12-Lead

APRIL 2, 2022

Anecdotally, had there been symptoms unequivocally consistent with ACS then one could justifiably make the case for a potential D1 occlusion. Given such findings, serial ECG’s are prudent to consider, and carry significant impact moving forward, which has been demonstrated in previous posts. 2] Surawicz, B.

ALS 130

ALS STEMI Coronary OR 130

Dr. Smith's ECG Blog

DECEMBER 12, 2022

You must understand this and the dynamic nature of ACS to provide excellent care for such patients. One year later: EKG#5 (one year later) Inferior Q waves persist, as do inferior T wave inversions. Learning Points: The ECG can pass through normal or near-normal on its way from occlusion to reperfusion, or vice versa.

OR 52

OR ACS STEMI Coronary 52

Dr. Smith's ECG Blog

MAY 8, 2023

8 , 9 The most recent American College of Cardiology and American Heart Association ST-elevation myocardial infarction (STEMI) guidelines (2013) give no direction on diagnosing occlusion myocardial infarction in patients with ventricular paced rhythm.

STEMI 52

STEMI Coronary ED ACS 52

EMDocs

SEPTEMBER 25, 2023

References: Heffner AC et al. Resuscitation 2013; 84(11): 1500 – 4. 2013): 71-78. Incidence and factors associated with cardiac arrest complicating emergency airway management. PMID: 23911630 Kim WY et al. actors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department.

ED 66

ED Emergency Department ALS Paramedic 66

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Although this is considered a "STEMI equivalent" and the ACC/AHA guidelines even approve of thrombolytics for ACS with this ECG, the usual criteria used to alert the cath lab team of an inbound Code STEMI are not met by this ECG. For instance: sepsis, bleeding, dehydration, hypoxia, and mild ACS. Circulation 1970;41:623-627 9.

Coronary 52

Coronary ACS ALS STEMI 52

Dr. Smith's ECG Blog

AUGUST 3, 2017

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Card 1999; 34:748-753. O'Gara et al. Circulation. mm in ≥ 1 posterior lead and has few false positives. (6)

STEMI 52

STEMI E-9-1-1 Coronary ALS 52

EMDocs

FEBRUARY 12, 2024

11) Webb RK, Ralston AC, Runciman WB. 2013 May;14(3):212-7. doi: 10.1136/emermed-2013-202879. Epub 2013 Oct 17. PMID: 11685301. (10) 10) Jubran A. Pulse oximetry. Intensive Care Med. 2004 Nov;30(11):2017-20. doi: 10.1007/s00134-004-2399-x. Epub 2004 Jul 24. PMID: 15278272. (11) Potential errors in pulse oximetry.

Emergency Department 94

Emergency Department E-9-1-1 ED ICU 94

Don't Forget the Bubbles

SEPTEMBER 18, 2023

Davidson L, Foley DA, Clifford P, Blyth CC, Bowen AC, Hazelton B, et al. 2013 Sep 1;88(5):338–40. McMullan BJ, Andresen D, Blyth CC, Avent ML, Bowen AC, Britton PN, et al. References Acute otitis media Csonka P, Palmu S, Heikkilä P, Huhtala H, Korppi M. Outpatient Antibiotic Prescribing for 357,390 Children With Otitis Media.

Emergency Department 143

Emergency Department E-9-1-1 ALS OR 143