Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

Ongoing pain noted throughout all documentation, but after nitro drip and prn morphine, "pain improved to 2/10." References: 1) See this study showing an association between morphine and mortality in Non-STE-ACS: Meine TJ, Roe M, Chen A, Patel M, Washam J, Ohman E, Peacock W, Pollack C, Gibler W, Peterson E.

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Dr. Smith's ECG Blog

FEBRUARY 28, 2020

Some providers were worried about ACS because of this ECG. My answer alleviated their concern for ACS and no further workup was done for ACS. 4 important features that indicate acute right hear strain: 1. looked at consecutive patients with PE, ACS, or neither. Tachycardia (or nearly) 2. Poor R-wave progression 4.

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Dr. Smith's ECG Blog

FEBRUARY 16, 2019

It is true that other documents occasionally describe "abnormal ST segment elevation" in the posterior leads (commonly accepted criteria is 0.5 mm in just one lead V7-9), but as far as I can tell all of these documents specifically avoid calling this condition STEMI and specifically avoid using any terminology similar to "STEMI equivalent."

STEMI 52

STEMI E-9-1-1 ACS OR 52

EMDocs

JANUARY 11, 2024

The neurologic section was divided into (1) brain oxygenation, perfusion, edema, and intracranial pressure (ICP); (2) seizures and the ictal-interictal continuum (IIC); and (3) sedation and analgesia. Reference: Hirsch KG, Abella BS, Amorim E, et al; American Heart Association, Neurocritical Care Society. 2023 Dec 1.

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Critical Care E-9-1-1 OR ICU 97

EMDocs

FEBRUARY 12, 2024

Introduction Arterial blood gas (ABG) or venous blood gas (VBG) testing is used to assess the pH and systemic carbon dioxide tension in patients, and, therefore, provide a more complete picture of their acid-base status than an isolated basic metabolic panel (BMP) (1). However, ABGs have many drawbacks compared to VBGs.

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Emergency Department E-9-1-1 ED ICU 98

AAEM RSA

DECEMBER 3, 2020

Introduction: While cases of genital gangrene were documented as early as 980 CE, the condition we know today as FG was coined in the 1880’s by French venerologist, Jean Alfred Fournier. 2018;48(9):1157-1160. 2020;26(1):8-17. 2018;8(1):88. 2016;4:1-3. Internal medicine journal. Filippone LM. Clin Microbiol Infect.

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

Dr. Smith's ECG Blog

APRIL 8, 2015

Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. Palpitations preceding syncope (highest value on EGSYS score) 9. Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful.

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

Don't Forget the Bubbles

JULY 5, 2023

Figure 1: Clinical manifestations and long-term consequences of sickle cell disease Training and education on sickle cell disease: Training and education are crucial to improve morbidity and mortality. Investigations : Bloods show Hb of 8 g/L, White cell count 13x 10 9 /L, Platelets 570 x10 9 /L, CRP 35mg/L.

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Dr. Smith's ECG Blog

FEBRUARY 12, 2025

When the Queen has some suspicion of OMI, she asks if the patient has ACS Symptoms. The emergency physician does cautiously (correctly) note that the ECG meets STEMI criteria in V3 and V4, but goes on to document absence of ACS symptoms. Pendell Meyers , Aaron E. PEARL #2: The above said Remember the rule of "N = 1".

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STEMI E-9-1-1 ACS Coronary 82

Dr. Smith's ECG Blog

MARCH 8, 2025

1:45, case start To orient you to this screen, the top is obviously ECG waveforms. 1:51, diagnostic RCA angiography At this point, the patient very clearly has a diagnosis of OMI, especially since we visualized embolism within the PDA. & Falk, E. Papadopoulou, E., link] Falk, E., Bossone, E., Galiuto, L.,

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ACEP Now

FEBRUARY 19, 2025

AI started to make its mark in the ED by maximizing the efficiency of certain tasks like patient triage, clinical presentation diagnosis, mortality prediction, clinical decision making, and operational workflow management (see Figure 1). References Edmondson AC. Edmondson AC. 2024;184(9):1125-1127. 2014;3(4):1.

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EMDocs

JANUARY 6, 2025

ED Evaluation Transport to the ED from the refugee reception center takes 1 hour. g/dL, thrombocytopenia of 96 10 9 /L, prothrombin time (PT) of 16.1 1 By the end of 2023, 117.3 million people had been forcibly displaced, representing 1 in 69 individuals or 1.5% seconds (normal 30-40 seconds), creatinine of 3.11

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ED E-9-1-1 ALS Emergency Department 75