2022 and EMR - Paramedicine Now

Alzheimer’s and Ambulance Drivers

Peter Canning

DECEMBER 19, 2024

Volunteer ambulances may have an EMT and an EMR (emergency medical responder), but there is no “ambulance driver” category of certification. The paper looked at people who died between 2020 and 2022 and had “ambulance driver” listed as their occupation.

Ambulance Driver

Ambulance Driver Ambulance Emergency Medical Technician EMT

Proportionality is a major element in the ECG Diagnosis of OMI.

Dr. Smith's ECG Blog

DECEMBER 13, 2023

I published, and Emre Aslanger externally validated, the 4-Variable formula for differentiating the ST Elevation of LAD OMI from Normal ST Elevation. Let's stretch out the QRS vertically so it is not so tiny: On upper left is the original. On the right are the precordial leads stretched vertically, so that the QRS is not tiny.

EMR

EMR Coronary OR STEMI

Dynamic OMI ECG. Negative trops and negative angiogram does not rule out coronary ischemia or ACS.

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

By Smith, peer-reviewed by Interventional Cardiologist Emre Aslanger Submitted by anonymous A 53 y.o. Review of the 2 ECGs in today's case is insightful ( Figure-1 ): The initial ECG shows sinus rhythm, LAHB and meets Peguero Criteria for LVH ( See My Comment in the August 15, 2022 post of Dr. Smith's ECG Blog for more on LVH criteria ).

Coronary

Coronary ACS OR EMR

The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

REBEL EM

JUNE 8, 2023

2022 Sep 5. The retrospective design of this study omitted assessment of ventricular dysrhythmias related to push dose pressor administration, as they were reliant on information in the EMR. 2022 2022 Sep 5. Paper: Singer S, et al. The safety and efficacy of push dose vasopressors in critically ill adults. J Med Toxicol.

Epinephrine

Epinephrine Emergency Department ALS Critical Care

Sometimes even ST Elevation meeting criteria is not enough to be convincing

Dr. Smith's ECG Blog

NOVEMBER 13, 2022

Written by Emre Aslanger. Emre is a new Editor of the Blog. 2022 Mar-Apr;71:44-46. Epub 2022 Jan 31. PMID: 34523597. == MY Comment by K EN G RAUER, MD ( 11/13/2022 ): == Highly interesting case by Emre Aslanger. He is an interventionalist in Turkey. References Aslanger EK. J Electrocardiol. 2022.01.006.

EMR

EMR Coronary OR STEMI

Calcium in Out-of-Hospital Cardiac Arrest

NAEMSP

APRIL 19, 2023

Additionally, low ionized calcium levels have been correlated with increasing mortality in sepsis and other critical illnesses in adults and children (Bora, Ramazan, Oznur, Emre, & Basar, 2021), (Sanchez, et al., Vallentin, Povlsen, Granfeldt, Terkelsen, & Andersen, 2022).

E-9-1-1

E-9-1-1 Advanced Life Support Overdose CPR

Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal

REBEL EM

MAY 11, 2023

J Med Toxicol 2022. History of liver disease, history of substance abuse disorder, and history of delirium tremens were also extracted from the hospital EMR. 1, 2 Phenobarbital has been studied as an alternative or adjunct to benzodiazepines with encouraging results, but primarily among inpatient services. 5 Paper: Lebin J et al.

Emergency Department

Emergency Department ED EMR OR

See OMI vs. STEMI philosophy in action

Dr. Smith's ECG Blog

DECEMBER 22, 2022

by Emre Aslanger Dr. Aslanger is our newest editorial member. Dr. Aslanger is also the author of the DIFFOCULT study: Emre K. Comment by K EN G RAUER, MD ( 12/22 /2022 ): = Brilliant post by Dr. Aslanger — with emphatic illustration of "the difference in OMI vs STEMI philosophy" — in action! Turk Kardiyol Dern Ars. 2021.21026.

STEMI

STEMI EMR Coronary OR

Impact of Emergency Department Crowding on Lung Protective Ventilation

REBEL EM

MARCH 27, 2023

Reason for intubation, severity of illness, ARDS risk score, and ventilator settings were extracted from the electronic medical record (EMR). Data was automatically captured in the EMR so that accurate information was able to be extracted for the study. 2022 Feb 8; PMID: 35156050 Higgins TL et al. 2022 Feb 24;7(1):29603.

Emergency Department

Emergency Department ICU Critical Care EMR

A young patient with diminishing pain with a subtle but diagnostic ECG.

Dr. Smith's ECG Blog

DECEMBER 18, 2022

Written by Emre Aslanger (Emre is our newest editor. 2022 Mar-Apr;71:44-46. Epub 2022 Jan 31. Comment by K EN G RAUER, MD ( 12/18 /2022 ): = Important case with numerous diagnostic Pearls presented by Dr. Aslanger. Here are his publications.) He says that the pain intensity was 10/10 at home but now about 4/10.

EMR

EMR OR ALS Coronary

Are these Hyperacute T-waves?

Dr. Smith's ECG Blog

DECEMBER 5, 2022

Arterial pulse tapping artifact [link] This online article references the article below by Emre Aslanger, a great guy who occasionally corresponds with me about ECGs. Indeed , the patients dialysis fistula was on the left arm and was pulsating with each heart beat, moving the electrode and causing artifact. Aslanger E, Yalin K. 2010.12.162.

EMR

EMR OR

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

J Electrocardiol [Internet] 2022;Available from: [link] Cardiology opinion: Takotsubo Cardiomyopathy (EF 30-35%) V Fib Cardiac arrest Prolonged QTC NSTEMI (Smith comment: is it NSTEMI or is it Takotsubo? -- these are entirely different) Moderate single-vessel CAD. Reference on Troponins: Xenogiannis I, Vemmou E, Nikolakopoulos I, et al.

Emergency Department

Emergency Department E-9-1-1 Coronary STEMI

Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

REBEL EM

DECEMBER 23, 2024

Reliance on a billing dataset, instead of EMR or prospective data, likely affected the quality of outcome measurement. Doing so can help avoid fundamental design errors that might otherwise limit or bias observational data ( Hernn 2022 ). Hospital-free days did not account for hospital days during readmissions.

ALS

ALS ED ACS EMR

An EM Resident’s Guide to Basic Airway Management

Core EM

JANUARY 16, 2025

look them up in the EMR to see if theyve been intubated before, and look at the note on the difficulty and grade of view.) Recently, observational data in intubated asthma patients has shown higher mortality rates associated with smaller ETTs (Kashiouris 2022) with the mortality of a 6.5 et al (2022). 2022): 344-347.

E-9-1-1

E-9-1-1 EMS ALS OR

Paramedicine Now

Alzheimer’s and Ambulance Drivers

Proportionality is a major element in the ECG Diagnosis of OMI.

Trending Sources

Dynamic OMI ECG. Negative trops and negative angiogram does not rule out coronary ischemia or ACS.

The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

Sometimes even ST Elevation meeting criteria is not enough to be convincing

Calcium in Out-of-Hospital Cardiac Arrest

Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal

See OMI vs. STEMI philosophy in action

Impact of Emergency Department Crowding on Lung Protective Ventilation

A young patient with diminishing pain with a subtle but diagnostic ECG.

Are these Hyperacute T-waves?

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

An EM Resident’s Guide to Basic Airway Management

Stay Connected