Don't Forget the Bubbles

MAY 6, 2024

Article 1: Positive urine cultures without pyuria Wang ME, Jones VG, Kane M, et al. Clinical Course of Children 1 to 24 Months Old With Positive Urine Cultures Without Pyuria. 2024;24(1):111-118. of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) Arch Dis Child Fetal Neonatal Ed. Giannoni, E.,

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Don't Forget the Bubbles

DECEMBER 16, 2024

Coverage of the 6-in-1 vaccine measured at 12 months of age in England for Q4 2023 to 2024 Source: ONS under the Open Government License v3.0 Young infants and immunosuppressed individuals are particularly at risk of severe disease, resulting in significant morbidity and associated mortality rates of 1-3 per 1,000 cases.

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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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Don't Forget the Bubbles

FEBRUARY 26, 2024

A 6-year-old known asthmatic presents to ED with a two-day history of cough and coryza, worsening wheeze and work of breathing over the last day. 2007 Jan 1;25(1):6-9. uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2019. Beers SL, Abramo TJ, Bracken A, Wiebe RA. Frontiers in Pediatrics.

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Dr. Smith's ECG Blog

JUNE 30, 2023

Queen: #1: NOT OMI, HIGH CONFIDENCE Queen: #2: NOT OMI, HIGH CONFIDENCE ECG 1 Interpretation: there is terminal T-wave in V3-V6. LEARNING POINT : 1. Smith and Meyers containing thousands of tracings with documentation of cardiac catheterization results. in ECG #1 ). These were texted to me only with "chest pain."

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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."

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Dr. Smith's ECG Blog

JANUARY 30, 2019

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 incidence of SCD in this cohort [1].

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ACEP Now

FEBRUARY 11, 2024

1,2 In the emergency department (ED), the focus of treatment is pain control and immobilization unless there is a clear indication for surgery, such as open fractures, skin tenting, or neurovascular compromise. Gently inject 1 to 2 cc of anesthetic to hydrodissect the clavipectoral fascia from the clavicle. for the ED clinician.

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Don't Forget the Bubbles

MARCH 11, 2024

A 4-month-old boy presents to the paediatric ED. New York, USA: The International Society for Pediatric Neurosurgery, 2024 (Accessed January 9, 2024). link] Mitchell, E. Recommendations for sudden infant death syndrome prevention: a discussion document. Pediatric Annals, 52(1), e10–e17. Bialocerkowski, A.

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Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Right atrial diastolic collapse is the earliest sign, but the patient needs to have right atrial collapse for at least 1/3 of the cardiac cycle which can be difficult to identify with ultrasound. Beck’s triad only happens all 3 together in approximately 1/3rd of patients. 2013 Sep;26(9):965-1012.e15. She has already had syncope.

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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. of adults over the age of 55).

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EMDocs

JULY 3, 2023

Louis); Alex Koyfman, MD (@EMHighAK); Marina Boushra, MD (EM-CCM Attending, Cleveland Clinic Foundation) Case A 62-year-old male with past medical history of hypertension (HTN), hyperlipidemia (HLD), and prior cerebrovascular accident (CVA) presents to the emergency department (ED) via ambulance. What additional workup is necessary in the ED?

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EMDocs

FEBRUARY 12, 2024

As the only respiratory therapist in the ED has been paged and is starting BiPAP for this patient, an overhead call for two incoming trauma alerts from a multivehicle collision sounds. Importantly, the comparison between an ABG and VBG is site-specific, as illustrated below (Table 1) (1, 3-6).

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Dr. Smith's ECG Blog

APRIL 8, 2015

Summary of ED Approach to Syncope Please excuse the formatting problems, which I have not been able to fix! Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. Palpitations preceding syncope (highest value on EGSYS score) 9. Abnormal ECG – looks for cardiac syncope.

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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. fold increased odds of mortality, respectively. Internal medicine journal.

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ACEP Now

OCTOBER 9, 2023

Physicians should document the interpreter’s name and identification number if available in the patient’s chart. 9 Being bilingual is often not enough to be a medical interpreter, which requires precision, experience, and knowledge of medical jargon, as well as culturally specific idioms and phrases. 2022;105(1):62-73.

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Pediatric EM Morsels

FEBRUARY 2, 2024

In one ED study, ALL cases of missed travel-related illness did not have a documented travel history in their ED note , whereas 90% of the identified travel-related illnesses had a provider documented travel history (Greenky 2022) Those who are visiting friends and relatives (VFR) are typically at highest risk.

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REBEL EM

NOVEMBER 11, 2024

What They Did: Investigators performed a retrospective cohort study in the Emergency Department at the University of Michigan between July 1, 2014 through December 31, 2018. Comorbidity Index : Higher in the cefepime group (median 2 vs. 1). 9 Instrumental Variable Analysis? Sex : More males in piperacillin-tazobactam (57.1%

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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. with thanks A 15-month-old Kenyan boy presents to ED with right hand swelling. Blood culture is pending.

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Don't Forget the Bubbles

AUGUST 10, 2023

Descriptive Terms When describing injuries of the hand for documentation or referral purposes it is important to know the terminology that is widely in use in order to convey an accurate description to others. A 4-year-old boy is brought to ED with his father. The annular, cruciate and oblique ligament of the hand.

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ACEP Now

FEBRUARY 19, 2025

In contrast to traditional teams that have the luxury of time for their members to build rapport, teams in the emergency department (ED) change every day. 1,2 As Edmondson described, ED teams disband almost as quickly as they are assembled. Harvard professor Amy C. 4 Can AI Help with Teaming? 4 Can AI Help with Teaming?

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Core EM

JANUARY 16, 2025

While this guide isnt exhaustive, its designed by residents, for residents, to provide practical tips and foundational knowledge thats crucial in the fast-paced, high-stakes environment of the ED. Introduction Airway management is a critical ED skill to master. fiber optic through the nose). Just the uvula but not the pillars, class 2.

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Don't Forget the Bubbles

NOVEMBER 5, 2023

Arch Dis Child Fetal Neonatal Ed. Xylitol for the prevention of acute otitis media episodes in children aged 1-5 years: a randomised controlled trial. Parental physical disease severity and severe documented physical child abuse: a prospective cohort study. 2023 Oct 9. 2023 Oct 9. Soydan E, et al.

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EMDocs

NOVEMBER 6, 2024

What are important clinical features differentiating strychnine and tetanus toxicity to aid with diagnosis? How does the clinical management of strychnine and tetanus differ? Site of action of strychnine and tetanus. red X = target of strychnine = target of tetanus Adapted from: Stephan J. Neurotransmitter. 2015;2:10-14800/nt. doi:10.14800/nt.491

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EMDocs

JANUARY 6, 2025

ED Evaluation Transport to the ED from the refugee reception center takes 1 hour. Labs Laboratory workup in the ED is notable for a leukocytosis of 41,000/L, hemoglobin of 6.5 g/dL, thrombocytopenia of 96 10 9 /L, prothrombin time (PT) of 16.1 1 By the end of 2023, 117.3 of the global population.

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