Dr. Smith's ECG Blog

MARCH 10, 2025

Our data corroborate that immediate management of a patient with a normal automated triage ECG reading is not modified by real-time ED physician ECG interpretation." The ED physicians ECG interpretation of her first ECG was ST elevation in II-aVF and V5-V6,()concave, no reciprocal changes. CJEM 2025 March 10 3.

STEMI 89

STEMI OR Coronary Emergency Department 89

ACEP Now

MARCH 9, 2025

As hospital boarding, increased emergency department (ED) volumes, and complexity of patients have increased, so have wait times. 1 When space is limited, patients medical history is rarely protected from the vision or hearing of other patients and guests in the ED. The sensitivity of the details of an ankle sprain may seem minor.

Emergency Department 95

Emergency Department ED ALS OR 95

The FllightBridge ED

FEBRUARY 3, 2025

Have a new kid with you today? Spend a minute with them on differential diagnosis development. The tool I use to teach this and develop…

52

52

The FllightBridge ED

FEBRUARY 3, 2025

Have a new kid with you today? Spend a minute with them on differential diagnosis development. The tool I use to teach this and develop…

52

52

The FllightBridge ED

FEBRUARY 3, 2025

Have a new kid with you today? Spend a minute with them on differential diagnosis development. The tool I use to teach this and develop…

52

52

The FllightBridge ED

FEBRUARY 3, 2025

Have a new kid with you today? Spend a minute with them on differential diagnosis development. The tool I use to teach this and develop…

52

52

The FllightBridge ED

FEBRUARY 3, 2025

Have a new kid with you today? Spend a minute with them on differential diagnosis development. The tool I use to teach this and develop…

52

52

ACEP Now

OCTOBER 9, 2024

However, when a patient walks through the door, they want to know there are resources available for that ED to delivery high quality care.” ACEP’s ED Accreditation Program (EDAP) is the next step in ACEP’s robust suite of Accreditation programs. EDAP has been more than a year in the making, and launch is expected around Spring 2025.

Emergency Department 52

Emergency Department Emergency Medical Services ED OR 52

ACEP Now

JUNE 14, 2024

And the Board approved a new clinical policy, “Critical Issues in the Management of Adult Patients Presenting to the ED with Seizures,” rescinding the 2014 clinical policy with same title. 17-23, 2025 in Orlando, Florida. To build on that momentum, the Board approved hosting ACEP Accelerate on Jan.

ED 52

ED EMS OR 52

GEDC

APRIL 12, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2025 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) proposed rule. This is a proposed measure, not to be set in place until Fall 2024.

Operating Room 52

Operating Room Emergency Department ED OR 52

REBEL EM

AUGUST 22, 2024

The protocol involved collaboration between the ophthalmology service, ED, and stroke service, including neurology and neuroendovascular teams. Outside eye care providers could refer patients directly to the ED for expedited evaluation. 2020;51(7):2018-2025. 25 patients (42%) had confirmed retinal artery occlusion (RAO).

ALS 85

ALS ED OR EMS 85

ESO

APRIL 19, 2024

Due to this, it’s important for the industry to develop strategies for better supporting psychiatric patients while avoiding unnecessary ED visits and secondary EMS transports. Save the date for Wave 2025 featuring ESO Training Academy!

MIH 105

MIH EMS Paramedic Firefighter 105

ESO

SEPTEMBER 5, 2024

Their feedback represent ed over 957 incidents overall and provided a ton of information to help iron out some of the initial wrinkles. The group consist s of fire departments, fire authorities, fire and rescue, and more , represent ing metropolitan, suburban , and small rural populations with wide-ranging technological capabilities.

CAD 59

CAD Mobile Integrated Health PSAP Community Paramedicine 59

Dr. Smith's ECG Blog

MARCH 27, 2025

Nurse notes: the silent scream of the heart The emergency nursing notes document the patient complaining of chest pain refractory to nitro, with a rising trop: 2200: ECG shown to ED MD 0020: repeat ECG shown to ED MD, patient complain of midsternal chest pain 0520: nitro x 3. Chest pain still persists. Cardiology aware.

STEMI 80

STEMI Coronary ACS OR 80

Pediatric EM Morsels

MARCH 7, 2025

TXA has been mentioned previously on PEM Morsels in the following contexts: Post Tonsillectomy Hemorrhage , Hemophilia in the ED , Von Willebrand Disease , Epistaxis in Children , Hereditary Angioedema , Hemoptysis in Children , Hyphema , and even in Neonatal Subgaleal Hemorrhage. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.Available

E-9-1-1 231

E-9-1-1 ALS OR EMS 231

ACEP Now

SEPTEMBER 13, 2023

Starting in 2025, $200 million will be devoted annually to increase reimbursement rates to emergency physicians. They will have training in conflict resolution and de-escalation, and have the ability to physically restrain unruly patients, family members, or other individuals in the ED. Read more details at acep.org/puerto-rico-win.

Emergency Department 40

Emergency Department Critical Care ED OR 40

EMDocs

JULY 17, 2023

and is poorly tolerated by patients with obstruction, it should not be a routine part of the ED evaluation for LBO unless it is critical for another diagnosis on the differential. 2021;13(9):2025. Bowel Perforation: ED Presentations, evaluation and management. He reports distension and the sensation of fullness. Adv Cancer Res.

E-9-1-1 98

E-9-1-1 ED Operating Room ALS 98

Don't Forget the Bubbles

MARCH 21, 2025

March 2025 doi.org/10.1016/S2213-2600(25)00074-8 The Kids THRIVE study was a pragmatic, multicentre, international, open-label, randomised clinical trial, spanning ten hospitals across Australia, New Zealand, and Switzerland. Recruitment took place across ten PICUs, one NICU, and four EDs in Australia, New Zealand, and Switzerland.

ICU 108

ICU Critical Care ED OR 108

REBEL EM

JUNE 5, 2023

These statistics make the ED a crucial treatment initiation point to prevent further morbidity and mortality from opioid overdoses. The benefit of accessibility, availability, and safety of buprenorphine compared to methadone makes it a viable option for opioid use disorder treatment initiation in the ED. PMID 33392580.

Naloxone 95

Naloxone ED Overdose Emergency Department 95

EMDocs

OCTOBER 27, 2023

Case: A 65-year-old male with a history of atrial fibrillation presents to the ED with shortness of breath, fever and palpitations. 6 This means a $608 annual out-of-pocket price tag for many patients headed home from your ED after new-onset atrial fibrillation or DVT diagnosis. This was a very significant change to how the U.S.

ED 96

ED OR EMS 96

ESO

APRIL 19, 2024

Due to this, it’s important for the industry to develop strategies for better supporting psychiatric patients while avoiding unnecessary ED visits and secondary EMS transports. Save the date for Wave 2025! Within the past year, they rose to the 2 nd most commonplace 911 call for most agencies, making up almost 10% of call volume.

EMS 105

EMS Paramedic Critical Care STEMI 105

ACEP Now

SEPTEMBER 3, 2024

25 Wesley Barnett had heard disturbing stories about the firm staffing his hometown critical-access ED as he was nearing the end of residency at the University of Kentucky, so he founded an independent physician group to try to take back the contract. Accessed August 24, 2025. JAMA Health Forum. 2022:3(9):e222886. 2023;382:e075244.

E-9-1-1 113

E-9-1-1 ALS OR Emergency Department 113

The Skeptics' Guide to EM

APRIL 1, 2025

Date: April 1, 2025 This is another SGEM Xtra. I was asked to give a public lecture for the Gateway Centre of Excellence in Rural Health. The topic was the zombie idea that emergency department crowding is due to non-urgent patients.You can click on this LINK and get a PDF copy of my slides.

ED 279

ED Emergency Department 279

The Skeptics' Guide to EM

APRIL 19, 2025

Reference: Kareemi et al Artificial intelligence-based clinical decision support in the emergency department: a scoping review.AEM April 2025. Date: April 15, 2025 Guest Skeptic:Dr. Few have been rigorously tested in the ED, and even fewer have demonstrated improvements in patient outcomes or clinician workflow.

OR 178

OR Emergency Department ED ALS 178

The Skeptics' Guide to EM

APRIL 5, 2025

JAMA Pediatrics, October 2024 Date: February 12, 2025 Dr. Brandon Ho Guest Skeptic: Dr. Brandon Ho is a graduating pediatric emergency medicine fellow at Childrens National Hospital in Washington DC and soon to be attending physician at Seattle Children's. Case: You are approached by the medical director of your emergency department (ED).

Emergency Department 211

Emergency Department ED ALS OR 211

The Skeptics' Guide to EM

MARCH 1, 2025

AEM Feb 2025 Date: February 27, 2025 Guest Skeptic:Dr. Case: A 57-year-old woman presents to the emergency department (ED) with pleuritic posterior chest/back pain, shortness of breath, and left leg swelling. Reference: Bannelier et al.

Allergic Reaction 189

Allergic Reaction ALS Emergency Department ED 189

The Skeptics' Guide to EM

MARCH 8, 2025

December 2023 Date: February 7, 2025 Dr. Lauren Rosenfeld Guest Skeptic: Dr. Lauren Rosenfeld is a PGY-3 emergency medicine resident at George Washington University. Case: A five-day-old girl is brought to the emergency department (ED) for fever by her parents. Her mother had an uneventful pregnancy and delivery. Will it hurt?

OR 178

OR ALS Emergency Department ED 178

The Skeptics' Guide to EM

FEBRUARY 22, 2025

2022 Date: February 21, 2025 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Vice Chair of Critical Care Medicine at Mayo Clinic Arizona. Case: A 62-year-old male presents to the Emergency Department (ED) with fever, confusion, and shortness of breath.

Critical Care 151

Critical Care ICU ALS Emergency Department 151

ACEP Now

FEBRUARY 11, 2025

Journal Research Looks at Physician Coverage in the ED A new study published in JACEP Open , one of ACEPs peer-reviewed publications, asked the question, Is at least one attending physician (not resident) on duty in the ED 24 h/d? The research found that approximately 1 in 13 EDs in the U.S.

ED 52

ED 52

American Burn Association

APRIL 15, 2025

Categories Advocacy Burn News MAC Spotlight Media Member Services Member Spotlight Organization News Prevention Quality Care Research Return to News & Activities The 2025 American Burn Association (ABA) Annual Meeting in Phoenix was a remarkable gathering of over 2,200 burn care professionals worldwide.

Life Support 59

Life Support EMS ED 59

American Burn Association

MARCH 26, 2025

Also, media can meet with ABAs new CEO, Ed Dellert. The event will bring together burn care professionals from around the globe to share cutting-edge research, clinical practices, and innovations in burn care. at the Phoenix Convention Center, Ballroom Lobby, near the event registration before the exhibit opens to attendees.

Frozen Plasma 109

Frozen Plasma Plasma Firefighter ED 109

EMDocs

APRIL 19, 2025

2025 Feb;85(2):122-131. Source Cephalosporins for Outpatient Pyelonephritis in the Emergency Department: COPY-ED Study. 2025 Mar;85(3):240-248. 2025 Mar 3:S0196-0644(25)00060-5. Source Development of a Clinical Risk Score to Risk Stratify for a Serious Cause of Vertigo in Patients Presenting to the Emergency Department.

Overdose 50

Overdose Emergency Department ED OR 50

EMDocs

JANUARY 1, 2025

Pain Management of Common Chief Complaints in the ED This post from Nikhil B. Jafar Mahmood provides you with key components of pain management in the ED. Stay tuned for 2025! EM@3AM: Retroperitoneal Hematoma Iosif Davidov covers retroperitoneal bleeding in this EM@3AM. Bhana, Clarence Kong, Mani Hashemi, and S.M.

Critical Care 75

Critical Care EMS ED OR 75

Dr. Smith's ECG Blog

JANUARY 28, 2025

Written by Hans Helseth A 34 year old man with no known medical history presented to the ED after an hour of chest pain. out of 10 at onset, but on presentation to the ED, reported that the pain had improved to 4.5. The patient waited another three hours in the ED until the cath lab was ready to accept him.

STEMI 105

STEMI ED ACS Emergency Department 105

Dr. Smith's ECG Blog

APRIL 21, 2025

Here is her initial ED ECG: Here is a prior ECG available from months ago: No alternans. Although alert on arrival in the ED she was markedly hypotensive and appeared critically ill. In Figure-1 Ive reproduced the initial ECG recorded in the ED. Figure-1: The initial ECG in the ED. This is electrical alternans.

ED 81

ED Emergency Department EMS ALS 81

Dr. Smith's ECG Blog

MARCH 1, 2025

A 50 something male presented in the evening to ED for evaluation of chest pain that started at 1600. Here are the troponins while the patient is in the ED, with persistent pain: Even if you don't believe the ECG, it should have been clear from the very first troponin that this is acute MI.

OR 121

OR Heart Attack STEMI Coronary 121

Dr. Smith's ECG Blog

FEBRUARY 10, 2025

normal glucose, and mild acute on chronic renal failure (Creatinine from 140 to 170 umol/L), and the following ECG, and they were sent to the ED. The patient was seen three hours later in the ED, with triage vitals showing BP 50 and BP 106/60. ED labs showed a repeat K of 6.6 Labs showed a non-hemolyzed potassium of 6.2,

ALS 118

ALS ED OR ICU 118