Dr. Smith's ECG Blog

NOVEMBER 14, 2023

Learning Point: 1. 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. How Would YOU Interpret the Serial Tracings in Figure-1? So they looked into the patient's chart.

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Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

I texted this ECG with no information to Dr. Smith, who immediately said: "If CP, then anterior OMI until proven otherwise." 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

An ECG was texted to me (Smith) without any clinical information: What did I say? This clinical information followed: "The patient had a COPD exacerbation with a prehospital SpO2 of 60%. 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.

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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. By contrast with today's case — I offer this tracing from a 60-year old woman with dyspnea and the ECG in Figure-1 showing LBBB conduction every-other-beat. link] Shvilkin et al. mm, and T-wave inversion in lead III is only 2.5

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Dr. Smith's ECG Blog

DECEMBER 13, 2019

Written by Pendell Meyers A man in his late 40s with several ACS risk factors presented with a chief complaint of chest pain. On review of systems the patient reported back pain for approximately 1 week which he was treating with NSAIDs with minimal relief. 15-9/6/2017 ). There is no more than minimal PR segment depression.

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Dr. Smith's ECG Blog

NOVEMBER 30, 2022

The fire department, who operate at an EMT level in this municipality, arrived before us and administered 324 mg of baby aspirin to the patient due to concern for ACS. mm of ST segment elevation, V2 and V3 have 1 mm of elevation, v4 has 2 mm of elevation and v5 around 1.5 Learning Points: 1. What do you think? V1 has 0.5

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Dr. Smith's ECG Blog

NOVEMBER 12, 2020

Here they are: Learning Points: 1. 7 These 3 studies, as well as 1 smaller meta-analysis, 6 and another small study, 8 make it clear that troponin is associated with increased severity and mortality in COVID when adjusted for multiple other variables. Am J Med [Internet] 2017;130(12):1431–9.e4. Available from: [link] 2.

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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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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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AAEM RSA

DECEMBER 3, 2020

1 His description of cases of life-threatening infections in the perineal, genital or perianal regions were thought to be idiopathic in previously healthy men. 3-5 Fournier gangrene is a type of necrotizing soft tissue infection, which can be categorized into four types based on the infectious organism involved and other features (Table 1).

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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. It's complicated, but they derived a score based on these variables: 1. h/o heart disease (+1) 3. Troponin greater than 99th percentile (+1) 5.

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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

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., Sharkey, S.,

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Dr. Smith's ECG Blog

MARCH 3, 2025

The status of the patients chest pain at this time is unknown : EKG 1, 1300: There is sinus tachycardia and artifact of low and high frequency. I suspect pulmonary edema, but we are not given information on presence of B-lines on bedside ultrasound, or CXR findings. She arrived to the ED with a nonrebreather mask. Management?

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ACEP Now

FEBRUARY 19, 2025

Although technology like electronic health records (EHRs) were initially introduced as tools for improving team communication and streamlining information sharing, they have instead often isolated ED teams, siloing clinicians, who are hunched over keyboards rather than communicating at the bedside. References Edmondson AC.

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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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