This Podcast Will Kill You

NOVEMBER 12, 2024

Routledge, 2013. 1996 Jul;10(9):1002-13. Dermato-endocrinology , 1 (3), pp.162-169. International journal of women’s dermatology , 8 (1), p.e003. Aesthetic Surgery Journal , 30 (1), pp.74-77. The Journal of clinical and aesthetic dermatology , 14 (9), p.33. Draelos, ZK, editor. Kligman, Albert M.,

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This Podcast Will Kill You

NOVEMBER 5, 2024

Routledge, 2013. 1996 Jul;10(9):1002-13. Dermato-endocrinology , 1 (3), pp.162-169. International journal of women’s dermatology , 8 (1), p.e003. Aesthetic Surgery Journal , 30 (1), pp.74-77. The Journal of clinical and aesthetic dermatology , 14 (9), p.33. Draelos, ZK, editor. Kligman, Albert M.,

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This Podcast Will Kill You

OCTOBER 24, 2023

2005): 1-6. Bulletin of Science, Technology & Society , 25 (1), pp.37-45. “Insecticide toxicology, mammalian toxicity of 1-naphthyl-N-methylcarbamate (Sevin insecticide).” Stewart, Nelson E., “Acute toxicity of the insecticide Sevin® and its hydrolytic product 1-naphthol to some marine organisms.”

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This Podcast Will Kill You

NOVEMBER 27, 2023

” Cambridge: Cambridge University Press 197 (1993): 9-23. Parasites & Vectors , 15 (1), pp.1-9. 2013): 131-140. The Lancet Global Health , 8 (9), pp.e1186-e1194. 2013): 385-393. ” Infection, Genetics and Evolution 14 (2013): 137-146. Laura Baldo, and Michael E. and Nutman, T.B.,

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Dr. Smith's ECG Blog

DECEMBER 19, 2023

link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. Challenge QUESTION: The relative change in T-QRS-D is not the only thing that changes during period of time that passed between recording of the 2 ECGs shown in Figure-1.

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EMDocs

JUNE 27, 2024

An 8-year old male with a history of sickle cell anemia presents to the ED for evaluation of fever for 2 days and “feeling like I can’t get a full breath”. 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 2022 Jul 5;328(1):57-68. C or 100.4 mg/kg, max 0.4 C or 100.4

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EMDocs

JUNE 7, 2023

F, HR 48, RR 28, BP 104/62, SPO2 88% on non-rebreather mask The patient’s friend who brought her to the ED tells you the patient made suicidal statements earlier in the day and was found in her yard shed. 1-5 Farmers also treat sheep for parasites using OPs and may become symptomatic after exposure, an illness called Dipper’s Flu.

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EMDocs

JUNE 14, 2023

Patellar reflexes are 1+. 1, 2, 4, 9 Organophosphates are one of many types of insecticide and are used worldwide to manage crops. 1, 2 Symmetric sensorimotor axonopathy: leg cramping to extremity weakness and paralysis. 1, 2 Sensory > Motor neurons with predilection for long axons. Muscle tone is normal.

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EMDocs

NOVEMBER 21, 2023

In ED, repeat potassium level was 2.6 Epidemiology: Prevalence of hypoPP is approximately 1 per 100,000. Permanent weakness usually affects the proximal lower extremities, happens in older patients, and develops late. Diagnosis: Can be made in the ED based on history, exam, lab testing. Consult neurology in the ED.

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REBEL EM

SEPTEMBER 13, 2023

Features Urticaria and pruritis Rapid onset (1-2 hours) IgE Dependent (Type I Hypersensitivity) Reactions An allergen cross-links two or more IgE molecules on mast cells or basophils and initiates a signal cascade leading to degranulation. J Emerg Med 2013; 44 (4): 764-772. J Allergy Clin Immune Tract 2017; 5(5): 1402-9.

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Don't Forget the Bubbles

NOVEMBER 29, 2023

Intensive Care Research , 1 (3-4), pp.60-64. Even though sedation after endotracheal intubation (ETI) reduces the risk of self-extubation, uncontrolled pain, and awakening awareness, several small single-centre studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED). Epub 2014 Sep 9.

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EMDocs

SEPTEMBER 23, 2023

A 36-year-old female presents to the ED after experiencing an episode of sudden syncope. Answer : Brugada Syndrome Epidemiology and Etiology Rare genetic disorder that affects approximately 1 in 5,000 individuals worldwide 1. More common in males than females, with a male-to-female ratio of approximately 8:1 1.

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Dr. Smith's ECG Blog

JULY 22, 2023

An ECG was performed in the ED at 1554: Original image unavailable, this is the only recorded scanned ECG available. A prior ECG from 1 month ago was available: The presentation ECG was interpreted as STEMI and the patient was transferred emergently to the nearest PCI center. per year incidence of SCD in this cohort [1].

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Don't Forget the Bubbles

JULY 22, 2024

Pre-school wheezers remain a poorly understood cohort of children despite seeing them every day in paediatric EDs. However, there was no difference in LOS (83 minutes for placebo vs 79 minutes for prednisolone) in participants who were discharged straight from the ED ( 32% ). study from 200 9. What does it mean to our patients?

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EMDocs

APRIL 13, 2024

A 24-year-old male presents to the ED from a mixed marital arts competition after being struck on the side of the right head by a fist earlier today. 1] In a survey of college wrestlers, the incidence of auricular hematoma was found to be 52% for those who do not wear headgear versus 26% who wore ear protection.[2]

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Dr. Smith's ECG Blog

JUNE 30, 2023

Queen: #1: NOT OMI, HIGH CONFIDENCE Queen: #2: NOT OMI, HIGH CONFIDENCE ECG 1 Interpretation: there is terminal T-wave in V3-V6. LEARNING POINT : 1. For clarity in Figure-1 — I've reproduced and put together the 2 serial ECGs that were texted to Dr. Smith in today's case. in ECG #1 ). Smith: Young thin black male.

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EMDocs

MAY 11, 2024

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. CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis?

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Don't Forget the Bubbles

JUNE 30, 2023

The nanny hailed the nearest black cab, and they set straight to our ED. E – Temp 37.2 CRASH 2 , published in 2013 – was huge. When patients were separated into those with a GCS <9, or GCS 9-12, giving TXA to those with a lower GCS didn’t make any difference to survival. Polly’s GCS is not great.

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This Podcast Will Kill You

NOVEMBER 7, 2023

Manne, eds. New England Journal of Medicine, 355(1), pp.51-65. Nature reviews Disease primers, 1(1), pp.1-20. 2013): 141-147. Craythorne, E. International journal of dermatology, 49(9), pp.978-986. Public Health Research & Practice, 32(1). History Biology Heckman, Carolyn J., and Sharon L.

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EMDocs

OCTOBER 30, 2023

” – Musings of an American ED resident in July 2022 when US healthcare was affected simultaneously by supply chain issues from GE Healthcare (contrast media) and Abbott Laboratories (Similac baby formula). 3 A study of CT use trends in the ED has shown increasing use of CTs by almost 60% from 2005 to 2013.

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Don't Forget the Bubbles

AUGUST 4, 2024

You will find the list is broken down into four sections: 1.Reviews 2024 Jul 9:e2023064794. Beaulieu E, Beno S. Vassilopoulou E, et al. Arch Dis Child Fetal Neonatal Ed. 2024 Jul 1:e241956. Antonius E, et al. Reviews and opinion articles Implementing Acute Hospital Care at Home in Pediatrics.

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EMDocs

AUGUST 22, 2024

1 However, we recognize that many patients prefer to speak a language other than English regardless of their English proficiency, and this does not indicate a deficiency. 6 24% more likely to return to the ED within 72 hours of their initial visit in an urban ED with >50,000 annual visits.

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REBEL EM

JULY 18, 2022

TXA has become the standard practice in the ED based on small RCTs, though larger trials have not demonstrated the same benefit ( REBEL EM review ). 2013 Sep;31(9):1389-92. Epub 2013 Jul 30. Medications and cotton pledgets for each arm were packed in blinded boxes by a research nurse outside the ED. Am J Emerg Med.

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Dr. Smith's ECG Blog

APRIL 22, 2022

But these cases show the potential dangers of delayed recognition and treatment of inferior reperfusion Take away 1. ECG’s can be labeled as ‘normal’ by the computer (and confirmed by cardiology) even with diagnostic signs of occlusion or reperfusion References 1. Int J Cardiol 2013 2. JAMA Intern Med 2019 9.

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Dr. Smith's ECG Blog

NOVEMBER 15, 2023

[link] Case continued She arrived in the ED and here is the first ED ECG. IMPRESSION: 1. We know that most type 1 acute MI due to plaque rupture and thrombosis occurs in lesions that are less than 50% (see Libby reference). I don't know if her pain was getting better or not. The Queen no longer thinks it is OMI.

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REBEL EM

JANUARY 19, 2023

Previous studies regarding ambulatory management included randomized trials that lacked adequate power, and recently, a 2013 systematic review that, although showed promise in the ambulatory approach, had poor data quality with a high risk of bias. Patients followed up every 1-2 days till day 4.

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Don't Forget the Bubbles

MARCH 11, 2024

A 4-month-old boy presents to the paediatric ED. New York, USA: The International Society for Pediatric Neurosurgery, 2024 (Accessed January 9, 2024). link] Mitchell, E. Pediatric Annals, 52(1), e10–e17. His parents are concerned about the appearance and shape of his head. They ask how this can be fixed. Vladusic, S.

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Don't Forget the Bubbles

OCTOBER 19, 2023

You, however, are working an ED shift, and when you see the name “Barbie Junior” on your computer screen, your heart does a flutter. It can be in started in the ED, and many of us are already using it. Soon, she was too breathless to feed, and Barbie and Ken were panic-stricken at how pale and lethargic she looked. days compared to 1.50

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Dr. Smith's ECG Blog

MAY 5, 2022

Submitted and written by Destiny Folk MD , peer reviewed by Meyers, Smith, Grauer, McLaren A man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. On arrival in the ED, he was hypotensive with a systolic blood pressure in the 70s. What is it?

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Dr. Smith's ECG Blog

JANUARY 30, 2019

The pattern of STE and STD reminded us of Brugada Type 1 morphology. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. Patients that develop a Type 1 pattern without any precipitating or provoking factors have a risk of SCD of 0.5-0.8% per year incidence of SCD in this cohort [1].

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Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Right atrial diastolic collapse is the earliest sign, but the patient needs to have right atrial collapse for at least 1/3 of the cardiac cycle which can be difficult to identify with ultrasound. Beck’s triad only happens all 3 together in approximately 1/3rd of patients. 2013 Sep;26(9):965-1012.e15. Her pulse is 125.

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Dr. Smith's ECG Blog

AUGUST 3, 2017

There are two main etiologies of ischemic ST-depression: 1) subendocardial ischemia 2) reciprocal to ST-elevation in an opposite wall Here there are distinct R-waves with marked ST-depression throughout most of the precordium. Tips for recognizing Acute Posterior STEMI: 1. References: 1. This can help in confirmation.

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EMDocs

FEBRUARY 12, 2024

As the only respiratory therapist in the ED has been paged and is starting BiPAP for this patient, an overhead call for two incoming trauma alerts from a multivehicle collision sounds. Importantly, the comparison between an ABG and VBG is site-specific, as illustrated below (Table 1) (1, 3-6).

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EMDocs

NOVEMBER 16, 2024

1-3 Despite its commonality it retains a relatively high rate of complications overall and patients frequently present to the ED for evaluation. 10% of patient’s have an ED visit within 30 or 90 days following THA. 9=11 70% monomicrobial, 25% poly-microbial, 5% culture-negative. 2013 Dec;6(4):350-6.

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REBEL EM

MAY 15, 2024

Pathogens ( Gudiol 2013 ) : The pathogens responsible for neutropenic fever have changed over time. 2011 Jun;153(6):773-9. Neutropenic Fever: Fever (one reading of 38.3C Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. Warnick, J., Stretton, K., Littlewood, T. doi: 10.1111/j.1365-2141.2011.08693.x.

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EMDocs

NOVEMBER 2, 2024

A 51-year-old male with a history of AIDS presents to the ED accompanied by his partner with complaints of cognitive decline and confusion over one month. ED Evaluation Neurosyphilis is known as a “great imitator” due to the extensive variability of nonspecific symptoms [11]. 2021 Aug;9(8):e1039-e1040. 2013 Dec;51(12):4060-6.

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ACEP Now

OCTOBER 9, 2023

9 Being bilingual is often not enough to be a medical interpreter, which requires precision, experience, and knowledge of medical jargon, as well as culturally specific idioms and phrases. Reevaluation of the effect of mandatory interpreter legislation on use of professional interpreters for ED patients with language barriers.

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