REBEL EM

NOVEMBER 30, 2023

Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Guideline-based and restricted fluid resuscitation strategy in sepsis patients with heart failure: A systematic review and meta-analysis [published online ahead of print, 2023 Aug 9]. Am J Emerg Med. 2023;73:34-39. Studies without a mortality breakdown for patients.

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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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Pediatric EM Morsels

AUGUST 18, 2023

Jackson 2016) Ciprofloxacin was the first fluoroquinolone approved by the FDA in the 1980’s as a broad-spectrum antibiotic. Jackson 2016) It can also be used in UTIs , but is typically reserved for special cases where the infectious bacteria is found to be multidrug resistant or in complicated UTIs. Which is a risk of 1 event for 62.5

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This Podcast Will Kill You

JULY 23, 2024

Official journal of the American College of Gastroenterology| ACG , 118 (1), pp.59-76. Annals of internal medicine , 172 (1), pp.ITC1-ITC16. Caio, Giacomo, et al. ” BMC medicine 17 (2019): 1-20. . ” BMC medicine 17 (2019): 1-20. Cenit, María Carmen, et al. Gastroenterology , 160 (1), pp.63-75.

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Don't Forget the Bubbles

JANUARY 17, 2024

After Meshram et al, 2020 When Orbeez are exposed to water, the water molecules diffuse into the polymer network through osmosis. Image adapted from Mullens et al., Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. After Darracq et al.,

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EMDocs

DECEMBER 18, 2024

Initial vital signs: HR 136 BPM, BP 172/82 mmHg, RR 24, T 37.2C, SpO2 97% RA Physical examination: General: restless, mildly agitated CV: tachycardic, regularly regular, diaphoretic, Abdomen: Soft, NT, ND, intermittently dry heaving Neuro: tremulous in bilateral arms and hands, tongue fasciculations What do you suspect as the diagnosis?

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Dr. Smith's ECG Blog

SEPTEMBER 23, 2024

Here is lead I from ECGs 1 and 2 shown side-by-side to highlight the change in axis from borderline right to completely normal. Consider the following: We become attuned to looking for acute coronary occlusion in patients who present with acute symptoms to the ED ( E mergency D epartment ).

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EMDocs

NOVEMBER 13, 2024

Commonly a monomicrobial infection with gram-negative bacteria like E. Paracentesis is a safe procedure with a low complication rate (< 1%). For the remaining fluid inject 1 mL into a purple top EDTA blood tube for cell count; send 2-3 mL for Gram stain in a red-top tube or sterile urine container. coli (50-90% of cases).

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Don't Forget the Bubbles

JULY 22, 2024

Compare this with the Panickar et al. study from 200 9. The most recent meta-analysis , published in 2016 (comparing eleven studies from 1986 to 2009), struggled to reach a consensus because the trials were too heterogeneous to make robust conclusions. Fortunately, Lee et al. Future of Pre-School Wheeze Whilst Lee et al.

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Don't Forget the Bubbles

JUNE 30, 2023

He has already climbed Ben Nevis in Scotland, visited the Gobi desert (possibly from the comfort of his parents 4 x 4, but who’s judging) and has his bronze D of E nailed. She calls out her findings: A – OK B – 1 puncture mark to the anterior left chest wall, covered with a three-sided dressing. Actively oozing.

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Don't Forget the Bubbles

JULY 17, 2023

’, ‘ Does the language of the patient influence A&E triage? ’, ‘ What is the association between breastfeeding duration and educational achievement? ’, and ‘ What are the findings of the SCOUT trial? ’. You will find the list is broken down into four sections: 1.Reviews Sethi SK, et al. Agostino H, et al. 2023 Jun 1.

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Dr. Smith's ECG Blog

AUGUST 14, 2024

R waves 6 through 9 have no preceding P waves and are suspiciously regularly spaced. Depolarization wavefronts exit the sinus node through one or several sinoatrial conduction pathways (SACP) as seen in the histology section below taken from Li et al. Impulses E, F, G, H, and I were blocked. This is consistent with sinus rhythm.

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This Podcast Will Kill You

JANUARY 2, 2024

2002): 1-7. 2016): 62-76. Nature Reviews Endocrinology , 7 (9), pp.540-557. Devogelaer, Jean-Pierre, et al. ” Orthopedic research and reviews (2016): 41-55. Endocrine reviews , 43 (1), pp.61-90. Molecular and Cellular Pediatrics , 7 (1), pp.1-9. Sochett, E. and Glorieux, F.H., Forlino, A.,

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Dr. Smith's ECG Blog

JULY 22, 2023

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. 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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Don't Forget the Bubbles

MARCH 18, 2024

The Royal Children’s Hospital in Melbourne summarises them in an easy-to-follow flow diagram (figure 1). Typical HUS has a diarrheal prodrome, usually caused by an infection with a Shiga-toxin-producing E. Blood tests Urine Stool Full blood count with blood film Urinalysis Stool MC&S Coagulation Urine MC&S E.

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EMDocs

JUNE 27, 2024

Abdomen : ND, NT, no guarding or rebound MSK : Tenderness to palpation over L ribs 7-9 Derm : No rashes Imaging: Image 1: Case courtesy of Miriam Leiderer, Radiopaedia.org, rID: 81468 Chest radiograph (CXR) shows new left lower lobe opacity What’s most likely diagnosis? 2022 Jul 5;328(1):57-68. 2020 Feb 12;10(1):2470.

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ACEP Now

FEBRUARY 13, 2024

A radiograph is shown (see figure 1). LEARN MORE The most common nerve blocks in this study are shown in Table 1. 1–4 Emergency physicians commonly prescribe opioid pain medications, and there is significant variability among prescribing patterns. In the January issue of Annals of Emergency Medicine , Merz-Herrara, et al.,

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This Podcast Will Kill You

DECEMBER 10, 2024

Randal, et al. Girard-Madoux, Mathilde JH, et al. Nature Reviews Gastroenterology & Hepatology , 20 (9), pp.615-624. 2016): 1-9. Conficconi, E., BioMed research international , 2017 (1), p.9784565. History Biology Ball, Chad G., ” Canadian journal of surgery 55.2 2012): 125.

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Don't Forget the Bubbles

MAY 29, 2023

A study of teams over a 1-year period highlights that people witnessing incivility are also affected, which could lead to individuals feeling unsupported in their teams. OJIN: The Online Journal of Issues in Nursing [Internet] 2016 :21:3. 2021:36:1–2, NP448–NP473 Available at. Fnais N, Soobiah C, Chen MH, et al.

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Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

To me, it was clearly atrial flutter with 1:1 conduction. Continue Eliquis 5mg BID, should be continued for 3 months == MY Comment , by K EN G RAUER, MD ( 9/18 /2024 ): == I found the following aspects of today's case of special interest. Why did Dr. Smith immediately say the rhythm was AFlutter with 1:1 AV conduction?

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EMDocs

JANUARY 17, 2024

1) There are a limited number of antitussives on the US market which include benzonatate, codeine, dextromethorphan, diphenhydramine, and hydrocodone. 9) The safety announcement highlighted the mortality risk of exploratory ingestions in children under 10 years. 2021;30(1):45-52. 2022;18(4):344-9. 11) A bolus dose at 1.5

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Don't Forget the Bubbles

FEBRUARY 26, 2024

In 2015, Silva et al. 2007 Jan 1;25(1):6-9. 2016 Sep 1;20:24-31. Add in PEFR <33% and SpO2 <92% Management of acute asthma* * as per BTS guidelines Acute asthma is managed in a stepwise fashion using the following guidelines. reviewed the two published randomised control trials. Frontiers in Pediatrics.

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This Podcast Will Kill You

OCTOBER 1, 2024

Medical journal of Australia , 190 (9). Cabezas-Cruz, Alejandro, et al. Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-α-1, 3-galactose. Cabezas-Cruz, Alejandro, et al. Ronmark, E. Ronmark, E. Cabezas-Cruz, Alejandro, et al.

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EMDocs

AUGUST 3, 2023

PMID: 25133498 Ghannoum M, Kazim S, Grunbaum AM, Villeneuve E, Gosselin S. 2016 Jul;54(6):519-22. Epub 2016 Apr 27. Bebarta VS, Kao L, Froberg B, et al. 2004;20(9):649-650. Massive acetaminophen overdose: effect of hemodialysis on acetaminophen and acetylcysteine kinetics. Clin Toxicol (Phila). PMID: 27118496.

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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. Brown, Amanda MV, et al. 2016): 34955. The Lancet Global Health , 8 (9), pp.e1186-e1194. Ferri, Emanuele, et al. Gerth, Michael, et al. Kaur, Rupinder, et al. Quek, Shannon, et al.

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Don't Forget the Bubbles

JANUARY 10, 2024

Maitland K, Olupot-Olupot P, Kiguli S, et al. doi:10.1056/NEJMoa1900100 Maitland K, Kiguli S, Olupot-Olupot P, et al. The study asked TWO questions: 1. Immediate vs delayed transfusion In uncomplicated severe anaemia, immediate blood transfusion did not alter mortality at 1- or six months compared to controls.

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ACEP Now

JANUARY 9, 2024

FIGURE 1: Abdominal X-ray showing particulate radiopaque foreign bodies involving the stool. 1 Children are particularly vulnerable. 9 Lead exerts its toxic effects by interfering with various organ functions, primarily targeting the nervous system and hematopoietic system, as well as impairing liver and kidney functions.

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EMDocs

OCTOBER 30, 2023

1 The shortage in supply posed difficulties for hospitals that significantly depend on GE Healthcare as their supplier, which encompassed approximately 50% of hospitals in the United States (US). 11 Table 1. Preparation 9 Hospitals had to prepare for the impending contrast shortage as soon as potential shortage news occurred.

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EMDocs

NOVEMBER 4, 2023

link] =2969&sectionid=250456991 Moran GJ, Krishnadasan A, Gorwitz RJ, et al. 2008;1(1):165. doi:10.1186/1757-1626-1-165 Hackett B, Sletten Z, Bridwell R E (July 03, 2020) Testicular Abscess and Ischemia Secondary to Epididymo-orchitis. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e.

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Dr. Smith's ECG Blog

MARCH 22, 2022

It meets basically all of the criteria that Dr. Smith has consistently described over the years, after reviewing a large cohort of patients by Wang et al. see below for more info on this) 1. BOTTOM Line: Great point by Dr. Meyers to emphasize the strong likelihood of a benign prognosis associated with tracings like ECG #1 in Figure-1.

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NAEMSP

JANUARY 5, 2023

1] The Adult Cardiac Arrest ACLS algorithm currently includes epinephrine and either amiodarone or lidocaine as recommended pharmacologic therapies. al answered this question with a prospective observational study which showed a significantly shorter time interval to obtain tibial IO access (4.6 1] Table from Hamam et al.

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This Podcast Will Kill You

SEPTEMBER 10, 2024

Perantoni, E., Kaimakamis, E., Longtin, Yves, et al. JMIR Medical Informatics, 9(1), p.e22753. . “Laennec, the Man—1781–1826.” ” The Boston Medical and Surgical Journal 195.5 1926): 208-211. Lung sounds recordings: Rocha, B.M., Vogiatzis, I., Natsiavas, P., Oliveira, A., Marques, A. Springer, D.,

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ECG & Echo Learning

OCTOBER 2, 2022

Most agents exhibit both vasopressor and inotropic effects (Figure 1). μg/kg/min Bolus : 1 mg IV every 3 to 5 min (max 0.2 mg/kg) IM: (1:1000): 0.1 mg (max 1 mg) Safe for peripheral use ++ + N/A Beta-effect more pronounced at low doses. References Overgaard, Dzavik et al. Jentzer et al. Circulation 2011.

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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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Don't Forget the Bubbles

FEBRUARY 28, 2024

Vogel et al. Outcomes were: (1) crusting of the lesions; then (2) complete healing of lesions -the end goal of treatment. The conclusions of this study corroborate with three previous smaller studies (9-11) on immunocompromised children with HZ infection. Although two of these studies were small cohort studies, Heidl et al.

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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. 9 Less likely to be satisfied with their care and have a lower understanding of their discharge instructions. Lion KC, et al. Regenstein M, et al.

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NAEMSP

APRIL 19, 2023

Current AHA guidelines do not recommend routine use of calcium in cardiac arrest (Panchal, et al., Calcium acts as a vasopressor and inotropic agent (Lindqwister, et al., This CI does include 1; and further and further analysis of the data showed that the likelihood that calcium has a beneficial effect (e.g.

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