Don't Forget the Bubbles

NOVEMBER 29, 2023

This article is based on: Mayberry, H., Intensive Care Research , 1 (3-4), pp.60-64. A retrospective cohort analysis of the ED portion of the National Hospital Ambulatory Medical Care Survey from 2006 to 2009 in the US revealed that less than one-half of patients undergoing ETI in the ED received sedative drugs while in the ED.

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REBEL EM

MAY 27, 2024

Given that these two treatment options operate via different physiologic mechanisms, the author of this study postulates that MVM and IV adenosine could be combined synergistically to convert PSVT with better success rates than either treatment individually and with better safety profiles. Article: Xiao, L., Qiu, S., & Zhang, Q.

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Don't Forget the Bubbles

MAY 6, 2024

With millions of journal articles published yearly, it is impossible to keep up. Our team has scoured the literature, so you don’t have to—or it might spark an interest in reading the full article. Article 1: Positive urine cultures without pyuria Wang ME, Jones VG, Kane M, et al. 2024;24(1):111-118.

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REBEL EM

MAY 25, 2023

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. NEJM 1994. [2] Richards JE et al.

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Dr. Smith's ECG Blog

JUNE 17, 2024

Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. C Examination notable for diaphoresis, 1+ bilateral lower extremity edema, regular heart rate and rhythm, and no signs of respiratory distress with normal breath sounds. What do you think? In fact, Kosuge et al. Stein et al.

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Don't Forget the Bubbles

JULY 17, 2023

We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. You will find the list is broken down into four sections: 1.Reviews Reviews and opinion articles Point-of-care ultrasound in pediatric nephrology. 2023 Jun 1.

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Don't Forget the Bubbles

MAY 8, 2024

We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. You will find the list is broken down into four sections: 1.Reviews Reviews and opinion articles Approach to simple kidney cysts in children. 2024 Apr 9.

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EMDocs

MAY 11, 2024

A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis?

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Don't Forget the Bubbles

SEPTEMBER 16, 2023

We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. You will find the list is broken down into four sections: 1.Reviews Reviews and opinion articles Forgotten Pediatrics: 8 Disturbing Windows on the Past.

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Don't Forget the Bubbles

AUGUST 4, 2024

We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. The Journal of Pediatrics published an article on education interventions to reduce diagnostic errors in burned or bruised patients suspected of abuse. Pediatrics.

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Don't Forget the Bubbles

FEBRUARY 5, 2024

We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Paediatric advocacy still has a long road ahead… You will find the list is broken down into four sections: 1.Reviews 2024 Jan 1;43(1):e11-e13. 2024 Jan 9.

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Dr. Smith's ECG Blog

JULY 14, 2023

A 40-something with persistent Ventricular Fibrillation presented after attempted prehospital resuscitation A 40-something with no previous cardiac history presented to the ED in persistent Ventricular Fibrillation after attempted prehospital resuscitation. Finally, head-up CPR (which was not used here), makes for better resuscitation.

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REBEL EM

JULY 3, 2023

Background: Atrial fibrillation and atrial flutter with rapid ventricular rate (AF/AFL with RVR) are the most common subtypes of SVT, comprising a large number of ED visits in aging populations. Article: Rossi N et al. The inclusion of p-values in Table 1 might lead to misinterpretation or improper use of statistical significance.

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ACEP Now

JANUARY 14, 2024

Many common presentations to the emergency department (ED) are related to drug interactions that are commonly missed and largely preventable. 1-3 We may be unaware of potentially dangerous drug interactions when we order and prescribe medications in the ED. 2008;178:1563-9. 2020;10(1):18964. Rev Invest Clin.

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REBEL EM

MAY 8, 2023

Paper: Smith JA, Secombe P, Aromataris E. 2 additional articles were identified from reference lists. 95% Confidence Interval) Strengths: The study addresses a patient-centered clinical question that is relevant to ED practice. 2 additional articles were identified from reference lists. J Trauma Acute Care Surg.

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REBEL EM

FEBRUARY 21, 2024

Clinical Scenario: A 34-year-old woman presents to the ED with back pain. Reviewing every study would be tedious and, fortunately, we’ve got a great review article on the topic. Schwartz and colleagues performed an ingenious trial ( Schwartz 2000 ) Enrolled 64 ED patients with acute pain. Can J Emerg Med 2007; 9(1): 30-2.

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EMDocs

OCTOBER 30, 2023

” – Musings of an American ED resident in July 2022 when US healthcare was affected simultaneously by supply chain issues from GE Healthcare (contrast media) and Abbott Laboratories (Similac baby formula). The primary aim of this article is to examine the clinical insights derived from scarcity and its consequences.

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This Podcast Will Kill You

NOVEMBER 7, 2023

For every article about the risks of sun exposure or a guide to sunscreens, you don’t have to look far to find one about the health benefits of sunshine or a how-to for achieving the best tan. Manne, eds. New England Journal of Medicine, 355(1), pp.51-65. Nature reviews Disease primers, 1(1), pp.1-20. and Sharon L.

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REBEL EM

AUGUST 28, 2023

Clinical Scenario: A 34-year-old woman presents to the ED with back pain. Reviewing every study would be tedious and, fortunately, we’ve got a great review article on the topic. Schwartz and colleagues performed an ingenious trial ( Schwartz 2000 ) Enrolled 64 ED patients with acute pain. Can J Emerg Med 2007; 9(1): 30-2.

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Dr. Smith's ECG Blog

SEPTEMBER 27, 2019

. == MY Comment by K EN G RAUER, MD ( 9/27/2019 ): == As suggested by the title of this Blog post — confirmation of the diagnosis in this case was made not by ECG — but instead by chest aorta CT ! For clarity — I’ve put these first 2 tracings together in Figure-1. Figure-1: The first 2 ECGs in this case ( See text ).

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REBEL EM

JULY 18, 2022

TXA has become the standard practice in the ED based on small RCTs, though larger trials have not demonstrated the same benefit ( REBEL EM review ). 2013 Sep;31(9):1389-92. Medications and cotton pledgets for each arm were packed in blinded boxes by a research nurse outside the ED. Am J Emerg Med. Epub 2013 Jul 30.

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Dr. Smith's ECG Blog

MAY 5, 2022

Submitted and written by Destiny Folk MD , peer reviewed by Meyers, Smith, Grauer, McLaren A man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. On arrival in the ED, he was hypotensive with a systolic blood pressure in the 70s. What is it?

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Don't Forget the Bubbles

JULY 5, 2023

See this helpful summary article for more info. 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. with thanks A 15-month-old Kenyan boy presents to ED with right hand swelling.

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Dr. Smith's ECG Blog

DECEMBER 13, 2019

On review of systems the patient reported back pain for approximately 1 week which he was treating with NSAIDs with minimal relief. I’ve excerpted in Figure-1 , relevant paragraphs from a 2017 ESC ( European Society of Cardiology ) article on this subject by Xanthopoulos & Skoularigis ( ESC: Vol. 15-9/6/2017 ).

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Dr. Smith's ECG Blog

JANUARY 30, 2019

The article is edited by Smith. The pattern of STE and STD reminded us of Brugada Type 1 morphology. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. Patients that develop a Type 1 pattern without any precipitating or provoking factors have a risk of SCD of 0.5-0.8% per year.

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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. Appelbaum E, Batt R. References Pomorski C. The death of Hahnemann Hospital.

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Dr. Smith's ECG Blog

NOVEMBER 30, 2022

mm of ST segment elevation, V2 and V3 have 1 mm of elevation, v4 has 2 mm of elevation and v5 around 1.5 In a recent article (J Electrocardiol this year, see reference below), peak trop onin I levels in takotsubo presenting with ST Elevation were median 1.02 Reference on Troponins: Xenogiannis I, Vemmou E, Nikolakopoulos I, et al.

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Dr. Smith's ECG Blog

MAY 19, 2022

Written by Pendell Meyers, edits by Smith and Grauer A man in his late 20s with history of asthma presented to the ED with a transient episode of chest pain and shortness of breath after finishing a 4-mile run. At the time of evaluation in the ED, his symptoms were resolved. He typically runs 4 to 8 miles per day.

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FOAMfrat

JULY 1, 2023

In fact, Herbstritt 2012, identified that there was "no significant difference to time to intubate, intubating conditions, or intubating success rate when using 1 to 1.2 mg/kg Rocuronium versus 1 to 1.5 mg/kg of Succinylcholine during RSI in an ED setting." [1] mg/kg Rocuronium versus 1 to 1.5 E1, March 01, 2012.

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Dr. Smith's ECG Blog

NOVEMBER 12, 2020

This is a 30-something healthy patient presented with COVID pneumonia who presented to the ED. Here they are: Learning Points: 1. 4 Unfortunately, this article provides no electrocardiographic, echo, or angiographic data, so it is not certain that these high levels were in the absence of acute MI. He was moderately hypoxic.

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Dr. Smith's ECG Blog

FEBRUARY 8, 2015

Vittinghoff, E. Metoprolol and atenolol are overwhelmingly beta-1 cardioselective. Beta-1 blockade decreases inotropy and chronotropy and has no vasoconstrictive effects. The prohibition against beta blockade in cocaine toxicity, causing "unopposed alpha" stimulation, needs to be re-examined. is intuitive, and not surprising.

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Dr. Smith's ECG Blog

SEPTEMBER 4, 2016

Important Learning Point: "STEMI" is defined by millimeter criteria (1 mm in limb leads), which this does not meet. True Positive ST elevation in aVL vs. False Positive ST elevation in aVL Case 1. Medics recorded 2 ECGs, one before and one after sublingual NTG, and both are similar to the first ED ECG. Why did I say this?

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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. 10% of patient’s have an ED visit within 30 or 90 days following THA. 9=11 70% monomicrobial, 25% poly-microbial, 5% culture-negative. 2020 Sep 30;5(9):558-567.

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Don't Forget the Bubbles

OCTOBER 4, 2023

We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Reviews and opinion articles Pathophysiology of primary hypertension in children and adolescents. Arch Dis Child Fetal Neonatal Ed. 2023 Sep 1:113720.

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Don't Forget the Bubbles

AUGUST 30, 2023

This series of DFTB articles aims to increase awareness of the Choosing Wisely ® recommendations. Each article will take a deeper dive into each recommendation’s supporting evidence and practical implications. The parents of 9-month-old Josie bring her into the Emergency Department with coryzal symptoms and difficulty breathing.

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EMDocs

DECEMBER 18, 2023

On arrival to the ED, her blood pressure is 84/36 mmHg with a heart rate of 110 beats per minute. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician. This was based on studies that demonstrated qSOFA was more specific but less sensitive than its counterparts (Table 1).

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Don't Forget the Bubbles

SEPTEMBER 20, 2023

This series of DFTB articles aims to increase awareness of the Choosing Wisely ® recommendations. Each article will take a deeper dive into each recommendation’s supporting evidence and practical implications. Up to 70% of children diagnosed with constipation in the ED have had an AXR. 2012;161(1):44–50.e502.

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