article thumbnail

Ultrasound Diagnosis of Necrotizing Soft Tissue Infections

Core EM

The definitive treatment of a necrotizing soft tissue infection is surgical debridement and removal of the necrotic tissue. It is a rapidly progressing infection that moves along fascial planes, often evading the immune system. This is a tricky diagnosis that can often be inconspicuous, so clinical gestalt is key.

E-9-1-1 246
article thumbnail

What makes a T-wave Hyperacute? And: 30 Examples of Hyperacute T-waves, 10 in each of 3 myocardial territories.

Dr. Smith's ECG Blog

In Figure-1 — Since this patient is having new CP, this T wave disproportionality in 4 of the limb leads by definition represents hyperacute T waves that mandate prompt cath. The early HATW model correctly identifies the HATWs in the inferior leads. Figure-1: ECG from the August 26, 2009 post in Dr.

STEMI 135
professionals

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

SGEM#462: Spooky Scary Access – IV or IO for OHCA

The Skeptics' Guide to EM

The current evidence has not given a definitive answer as to which type of access is best for OHCAs. Recent randomized trials are now evaluating whether the speed and reliability of IO access provide significant benefits over the traditional IV route. Most EMS providers are choosing the proximal tibial as their go-to IO access.

article thumbnail

SGEM#453: I Can’t Go For That – No, No Narcan for Out-of-Hospital Cardiac Arrests

The Skeptics' Guide to EM

This has led to variability in EMS protocols, with some agencies including naloxone in their cardiac arrest protocols while others do not specifically recommend it, highlighting a gap in definitive guidance [6].

Naloxone 251
article thumbnail

Episode 204: Necrotizing Fasciitis

Core EM

Definition A rapidly progressive, life-threatening infection of the deep soft tissues. Surgical Consultation Early surgical exploration is often the definitive diagnostic step. Not definitive but can guide suspicion. High mortality and morbidity underscore the need for vigilance.

article thumbnail

Episode 197: Acute Agitation

Core EM

Hosts: Jonathan Kobles, MD Brian Gilberti, MD [link] Download Leave a Comment Tags: Agitation , psychiatry , Toxicology Show Notes Background/Epidemiology • Definition and Scope : Agitation encompasses behaviors from restlessness to severe altered mental states.

article thumbnail

A young man with palpitations.

Dr. Smith's ECG Blog

My response: "Definitely not polymorphic VT. Definitely atrial fibrillation. Here is the post cardioversion ECG: Definite pre-excitation (delta waves due to accessory pathway, "bypass tract"). Probably WPW but is very slow for atrial fib withWPW. I would just cardiovert electrically."

ALS 133