This Podcast Will Kill You

FEBRUARY 11, 2025

Journal of Zoological Systematics and Evolutionary Research, 46(1), pp.19-23. Anais da Academia Brasileira de Cincias, 96(1), p.e20230706. Gompper, Matthew E., Diseases of Aquatic Organisms, 66(1), pp.87-90. Pathogens, 9(3), p.230. Carlson, Colin J., ” Science advances 3.9 2017): e1602422. and Okamura, B.,

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Broome Docs

MAY 31, 2024

Welcome to the June edition of the Journal Club for 2024. 2013 Sep;24(9):1848-53. 2023 Nov 28;27(1):465. 2024 Apr 1:e240167. 2023 Sep 8;9(1):73. 117(1) 36–41 DOI: 10.1177/01410768231207260 This is a fascinating read about the history of the humble placebo in science. Psychol Sci. Epub 2013 Jul 17.

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Dr. Smith's ECG Blog

OCTOBER 3, 2024

I agree, however: 1) I don't think you can get a good enough ech o without bubble contrast. 3) E cho is another step that takes time. I had only 9 false positives but I missed 2 OMI. The rhythm for the ECG in Figure-1 is sinus — with normal intervals and axis ( mean QRS axis about +80 degrees ). Time is myocardium.

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Don't Forget the Bubbles

MAY 8, 2024

You will find the list is broken down into four sections: 1.Reviews 2024 Apr 27. 2024 Apr 16:archdischild-2024-326876. 2024 Apr 11 Why all newborn hip screening programs have same results-a mini review. 2024 Apr 9. 2024 Apr;183(4):1543-1553. 2024 Apr;183(4):1485-1497. 2024 Apr 18.

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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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Dr. Smith's ECG Blog

AUGUST 14, 2024

R waves 6 through 9 have no preceding P waves and are suspiciously regularly spaced. Impulses E, F, G, H, and I were blocked. Progress in Biophysics and Molecular Biology , 120 (1–3), 164–178. Science Translational Medicine , 9 (400). Figure-1: I've labeled the initial ECG in today's case to illustrate my theory.

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EMDocs

SEPTEMBER 7, 2024

1 Risk Factors: 1-4 Spontaneous Anticoagulants (Apixaban, Rivaroxaban, etc.) Older Age (median age of 70 years) 1 Abnormal vasculature/neoplasm of the kidney (e.g., 5 Clinical Presentation: 1-3 Variable presentation but may present with dropping hemoglobin/hematocrit without other findings in spontaneous cases.

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REBEL EM

MAY 27, 2024

No significant differences in heart rate 1 minute after cardioversion were observed between the three groups. 2010;17(1):44-49. Qiu, S., & Zhang, Q. Combined modified Valsalva maneuver with adenosine supraventricular tachycardia: A comparative study. The American Journal of Emergency Medicine, 78, 157–162. seconds (range: 22.5,

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EMDocs

JULY 13, 2024

1997 Mar;11(1):203-22. 2024, [link] Accessed 7 February 2024. 1985 Dec 1;153(7):737-9. Kankuri E, Kurki T, Carlson P, Hiilesmaa V. 2024, [link] Mackeen AD, Packard RE, Ota E, Speer L. Infect Dis Obstet Gynecol. 2000;8(2):77-82. doi: 10.1002/(SICI)1098-0997(2000)8:2<77::AID-IDOG3>3.0.CO;2-6.

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Dr. Smith's ECG Blog

NOVEMBER 14, 2023

Learning Point: 1. The Queen of Hearts AI app will hopefully be FDA approved in Q1 of 2024. For examples of such exceptions — See My Comment in the January 9, 2019 — August 22, 2020 — and June 30, 2023 posts in Dr. Smith's ECG Blog ). Figure-1: Comparison between the first 3 ECGs in today's case.

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ACEP Now

NOVEMBER 8, 2024

1 Prehospital endotracheal intubation and EGAs are typically placed without paralytics and are reserved for unconscious, apneic, and out-of-hospital cardiac arrest patients. 9 LMAs use an inflatable mask expanded using a similar technique to the endotracheal tube cuff. Accessed October 17, 2024. 2014;4(1):77-87.

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Don't Forget the Bubbles

JUNE 17, 2024

Here are ten things to think about: 1. Churruca K, Pavithra A, McMullan R, Urwin R, Tippett S, Cunningham N, Loh E, Westbrook J. 2014 Jun 26;23(12):653-9. 2020 Jan 1;35(1):70-6. InHealthcare 2024 Jan 22 (Vol. 2023 Oct 31;21(1):403. cognitive rehearsal techniques ). Organizational dynamics. 2020 Aug 20.

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FOAMfrat

MAY 19, 2024

While transporting to the emergency department, the patient’s mother informed me that PDCD affects less than 1 in 50,000 individuals and is more common in males than females. The patient will thank you for it; we are only human. References 1. Ostergaard E, Moller LB, Kalkanoglu-Sivri HS, et al. 2002 Oct 9.

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FOAMfrat

APRIL 22, 2024

This kid had sticks go through his cheek from running with a lollipop, hit by a car, almost kidnapped, attacked by a dog, and almost burnt his house down by throwing a 9-volt battery in the trash. 2024 Mar 15:1-9. Robichaud L, Ross D, Proulx MH, Légaré S, Vacon C, Xue X, Segal E. 2016;20(1):76-81.

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Don't Forget the Bubbles

MAY 6, 2024

Article 1: Positive urine cultures without pyuria Wang ME, Jones VG, Kane M, et al. Clinical Course of Children 1 to 24 Months Old With Positive Urine Cultures Without Pyuria. 2024;24(1):111-118. 2024 Feb 28:fetalneonatal-2023-326501. Giannoni, E., 2024 Jan 27;403(10424):355-64. Acad Pediatr. PMID: 38418208.

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Dr. Smith's ECG Blog

JANUARY 13, 2024

Spikes 2, 3, 4, 5, 7, 8, and 9 all occur either during or immediately after P waves which should never happen. He had routine follow up for the mitral valve clip approximately 1 month after the procedure, and the note indicated recognition of atrial lead dislodgement on the CT scan from the hospitalization a few weeks prior.

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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. 2023 Sep 2;15(9):e44583. 2024 Jan;83(1):14-21. N Engl J Med.

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ACEP Now

OCTOBER 11, 2024

1 Pediatric rapid sequence intubation (RSI) in the ED is associated with a higher frequency of failed first attempts and adverse effects than in adult patients. Paralytic agents include rocuronium at 1 mg/kg IV and succinylcholine at 1-2 mg/kg IV. References Long E, Sabato S, Babl FE. mg/kg IV, ketamine at 1.5–2

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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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First Responders Childrens' Foundation

DECEMBER 8, 2023

Each VIP experience is available for bidding online at charitystars.com/umg through January 12, 2024. Select packages also benefit the Country Music Hall of Fame, The Store, and C.A.T.S. Foundation.

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Dr. Smith's ECG Blog

JULY 24, 2024

Easy LINK — [link] — My New E CG P odcasts ( 5/28/2024 ): These podcasts are part of the Mayo Clinic Cardiovascular CME Podcasts Series ( "Making Waves" ) — hosted by Dr. Anthony Kashou. 2:25 — Dr. Grauer: The 1st Error : Too many clinicians in 2024 are still stuck in the outdated millimeter-based STEMI Paradigm”.

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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. 9=11 70% monomicrobial, 25% poly-microbial, 5% culture-negative. 9=11 70% monomicrobial, 25% poly-microbial, 5% culture-negative. 2020 Sep 30;5(9):558-567. 2021 Mar;33(1):11-17.

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ACEP Now

DECEMBER 17, 2024

1 His tragic loss underscores the urgent need for mental health support for residents and fellows. link] Published October 5, 2024. Accessed December 7, 2024. Accessed December 9, 2024. link] Published April 15, 2024. Accessed 9 December 2024. link] Published August 28, 2024. Adelman LC.

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REBEL EM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. 1, 4, 6 The overall incidence of VAP is somewhere around 5%-40% of all intubated patients, depending on the study and country from which it is reported. Mimoz (2024). 4, 8 Paper: Dahyot-Fizelier, C.,

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Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

ECG #1 Interpretation: ECG #1 shows sinus rhythm at a heart rate of 77 bpm. Following more detailed questioning — it turned out the patient had started taking 9 different herbal remedies to ease lethargy and unspecific neurological symptoms. For clarity in Figure-1 — I've reproduced the initial ECG in today's case.

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Pediatric EM Morsels

AUGUST 9, 2024

Foles, 2024 ] Early = symptoms appear within the first 2 years of life (usually within first 3 months) Late = symptoms appear after 2 years of age. Worldwide, congenital syphilis complicates about 1 million pregnancies / year. Worldwide, congenital syphilis complicates about 1 million pregnancies / year. 2024 Apr 21.

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Pediatric EM Morsels

MAY 10, 2024

Chest Pain in Children: Hysteria vs Vigilance Diverse pathology can present as chest pain in children Cardiac 1-9% GI 2-10% Musculoskeletal – 2-20% No Identifiable cause – 21-45% of the time! Pediatr Rev September 2020; 41 (9): 469–480. 2021;13(1):2. Pediatrics. 2013 Oct;132(4):e1010-7. 2011;140(4):859-866.

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EMDocs

OCTOBER 19, 2024

to 1 case per 100,000 children. 2][3][9] Hypoxia, respiratory muscle retractions, fatigue, altered mental status, and decreased breath sounds are signs indicative of impending airway failure. [2] 2][3][9] Glucocorticoid were not shown to alter clinical course or patient outcomes. [2][3] Accessed August 11, 2024.

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Broome Docs

MARCH 28, 2024

2024 Jan 22;41(2):96-102. PMID: 34890894 Myth 1: Kayexalate is safe and useful. 2024 Jan 2;53(1):afad255. Yerke JR, Mireles-Cabodevila E, Chen AY, Bass SN, Reddy AJ, Bauer SR, Kokoczka L, Dugar S, Moghekar A. Casey wrote a protocol for peripheral noradrenaline 9 years ago… in 2015! Emerg Med J.

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Don't Forget the Bubbles

NOVEMBER 29, 2024

Step 1: Conversion to Formaldehyde Methanol is broken down in the liver by an enzyme called alcohol dehydrogenase at a fixed rate. This zero-order elimination occurs at about ~8–9 mg/dL/hour. Here’s your step-by-step guide: Step 1: Stabilise the Patient Airway, breathing, and circulation (ABCs): Secure and stabilise. 2024;14(1).

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EMDocs

OCTOBER 5, 2024

Answer : ESBL-producing organisms Background 1-3 Extended spectrum beta-lactamases (ESBL) are enzymes produced by certain bacteria that can break down a broad range of beta-lactam antibiotics. 3 Epidemiology 4-8 ESBL-producing Enterobacteriaceae (ESBL-E) have been reported worldwide. ceftriaxone, cefepime).

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Don't Forget the Bubbles

DECEMBER 16, 2024

Coverage of the 6-in-1 vaccine measured at 12 months of age in England for Q4 2023 to 2024 Source: ONS under the Open Government License v3.0 In the UK, the latest vaccination coverage rates from 2023-2024 show that only 84.3% This contributed to a sharp increase in cases of both diseases in 2024.

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ACEP Now

JANUARY 5, 2025

1 The primary outcome was the frequency of observed hypoxemia, defined as any pulse oximetry reading below 85 percent. 2024:e2415815. Theodorou A, Melanis K, Bakola E, et al. published online ahead of print October 31, 2024]. published online ahead of October 31, 2024]. The obvious winner was NIPPV, whose 9.1

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ACEP Now

SEPTEMBER 3, 2024

1 Immediately after the purchase, the real estate holdings of the hospitals were spun off into a separate company owned by Paladin and other PE investors. 7-9 The PE model then aims to sell acquired businesses for a profit within three to six years. Accessed August 25, 2024. Appelbaum E, Batt R. Accessed August, 2024.

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Don't Forget the Bubbles

JULY 22, 2024

study from 200 9. 2024 Mar 22 [cited 2024 Mar 25];0(0) Methods – What is an IPD meta-analysis? 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.

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Dr. Smith's ECG Blog

OCTOBER 1, 2024

== MY Comment , by K EN G RAUER, MD ( 8/30 /2024 ): == I was sent the ECG shown in Figure-1 — knowing only that the patient was being seen in the ED ( E mergency D epartment ). Figure-1: The initial ECG in today's case. After seeing ECG #2 — Can you explain: i ) Why no negative P wave was seen in lead V1 of ECG #1? —

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EMDocs

FEBRUARY 7, 2024

Despite a plateau in overall union membership of around 10% in 2023 1 , major labor actions shook the U.S. January 23, 2024. 2023 October 9. 2012 Feb 1;4(1):127-57. Essex R, Weldon SM, Thompson T, Kalocsányiová E, McCrone P, Deb S. 2013 Dec;14:1-0. 2022 Nov 9. October 16, 2023. Retrieved from: [link].

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