Dr. Smith's ECG Blog

NOVEMBER 14, 2023

Learning Point: 1. link] = My Comment by K EN G RAUER, MD ( 11/14 /2023 ): = One of the most helpful clinical clues in support that an acute cardiac event is ongoing — is the finding of " dynamic " ECG changes. Figure-1: Comparison between the first 3 ECGs in today's case. How Would YOU Interpret the Serial Tracings in Figure-1?

E-9-1-1 101

E-9-1-1 Coronary EMS ED 101

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

Angiogram No obstructive epicardial coronary artery disease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. IMPRESSION: 1. hours T-wave are getting larger again The patient went for an angiogram at about 7 hours after arrival. Stroke-volume:50 ml.

Coronary 95

Coronary E-9-1-1 STEMI ACS 95

Pediatric EM Morsels

AUGUST 18, 2023

Myth #1: Musculoskeletal Adverse Events (MAE) This concern is likely the most common reason fluoroquinolones are rarely used in children. Which is a risk of 1 event for 62.5 References: Ross RK, Kinlaw AC, Herzog MM, Funk MJ, Gerber JS. PMID: 26407358 Meesters K, Mauel R, Dhont E, Walle JV, De Bruyne P. Pediatrics.

E-9-1-1 130

E-9-1-1 ACS OR ALS 130

Dr. Smith's ECG Blog

NOVEMBER 9, 2023

Over the last 1 week, her exertional chest pain became worse both in intensity and triggering threshold. This case fits this definition of cardiac memory. == MY Comment , by K EN G RAUER, MD ( 11/9 /2023 ): == I found Dr. What Can Sometimes Be Learned from Intermittent BBB Conduction! link] Shvilkin et al.

E-9-1-1 80

E-9-1-1 ACS ALS OR 80

Dr. Smith's ECG Blog

JULY 30, 2023

Obvious STEMI(+) OMI of inferior, posterior, and lateral walls, now with likely 2nd degree heart block type 1 (Wenckebach). STD maximal in V1-V4, without a QRS abnormality causing it, and in the setting of ACS symptoms, is posterior OMI until proven otherwise. In Figure-1 — The ST-T wave abnormality in lead V2 of ECG #1 is obvious.

E-9-1-1 52

E-9-1-1 STEMI OR ED 52

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. ECG 1 What do you think? Grines, C.

E-9-1-1 111

E-9-1-1 OR Coronary ACS 111

EMDocs

JANUARY 11, 2024

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association (AHA) and Neurocritical Care Society (NCS) released their 2023 Scientific Statement on the critical care management of post ROSC patients. 2023 Dec 1. Administer VTE prophylaxis in the first 48 hours, preferably LMWH.

Critical Care 75

Critical Care E-9-1-1 OR ICU 75

Don't Forget the Bubbles

JULY 22, 2024

study from 200 9. A large proportion of the trials come from Finland (3) and The UK (2) and also from Australia (1) and the US (1), but only a small number took place in the ED. Castro-Rodriguez JA, Beckhaus AA, Forno E. Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, et al. Pediatr Pulmonol.

E-9-1-1 105

E-9-1-1 ALS ACS ED 105

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]. References: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM.

E-9-1-1 119

E-9-1-1 ALS ACS ICU 119

Don't Forget the Bubbles

SEPTEMBER 18, 2023

Antibiotics 2023, 12, 1092. Davidson L, Foley DA, Clifford P, Blyth CC, Bowen AC, Hazelton B, et al. Community-acquired pneumonia Addo-Yobo E, Anh DD, El-Sayed HF, Fox LM, Fox MP, MacLeod W, et al. Addo-Yobo E, Chisaka N, Hassan M, Hibberd P, Lozano JM, Jeena P, et al. cited 2023 Jan 3]. cited 2023 Jan 3].

Emergency Department 143

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

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.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

FOAMfrat

OCTOBER 20, 2023

As reported within the 6th edition Manual of Emergency Airway Management, there are cardiac arrest rates between 1% and 4%, with other complications (mostly hypoxemia and hypotension) as high as 30% in patients with first-pass success [1, pg 29; 4-10]. Recommendations : 1. Why is Physiologic Optimization Important?

E-9-1-1 52

E-9-1-1 ALS ACS OR 52

ACEP Now

NOVEMBER 14, 2023

1 However, it is important to understand that death from hemoptysis is almost always due to hypoxia or asphyxiation (blood impedes gas exchange in the lungs, typically because of bleeding from high-pressure bronchial arteries into the lungs) as opposed to hemodynamic instability. References Deshwal H, Sinha A, Mehta AC. 2023;23(1):87.

E-9-1-1 52

E-9-1-1 ALS Emergency Department OR 52

EMDocs

OCTOBER 7, 2023

1-3 Common causes: Natural disasters such as tornadoes or earthquakes 4,5 Structure or building collapses from home fires or bombings. Accessed February 3, 2023. 2016;20(1):135. Goodman AD, Got CJ, Weiss AC. Stahl K, Rastelli E, Schoser B. 2012;27 Suppl 1:i1-67. Accessed 21 February 2023. J Emerg Med.

EMS 74

EMS E-9-1-1 Emergency Department ALS 74

EMDocs

JANUARY 20, 2024

She describes the pain as left-sided, non-radiating, and 9/10 in severity. Answer: Takotsubo Cardiomyopathy 1-18 Background: Also known as transient apical ballooning syndrome, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, stress cardiomyopathy, Gebrochenes-Herz syndrome, and broken-heart syndrome.

E-9-1-1 74

E-9-1-1 EMS Coronary ACS 74