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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REBEL EM

JULY 18, 2022

When simple maneuvers fail, we proceed to topical agents such as lidocaine with epinephrine, oxymetazoline, anterior nasal packing, and electrical or chemical cauterization. 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 ).

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Dr. Smith's ECG Blog

JANUARY 19, 2020

On arrival in the ED, she was profoundly hypotensive, nearly obtunded, and bradycardic. At about 30 minutes after presentation, the patient had acceptable vital signs with the TVP and low dose epinephrine drip. Another ECG was obtained during pacing: Mostly paced rhythm with PVCs (#3, #6, #9, #12). mm STE with 9.5

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ACEP Now

NOVEMBER 14, 2023

One of the most hair-raising presentations to the emergency department (ED) can be massive hemoptysis with respiratory failure. or 9 size endotracheal tube to allow for bronchoscopy and/or endobronchial blocker placement whenever necessary. These patients are at imminent risk of respiratory failure.

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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. He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Here they are: Learning Points: 1. He was moderately hypoxic.

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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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EMDocs

JANUARY 4, 2024

1 In addition to intentional overdoses, there are multiple case studies of abuse (ingestion, insufflation, injection). QRS > 100 msec can give sodium bicarbonate 1-2 mEq/kg IV boluses. 9-12 Do not use this prophylactically in bupropion overdoses. Other Norepinephrine or epinephrine are preferred vasopressors when needed.

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Don't Forget the Bubbles

MAY 8, 2024

You will find the list is broken down into four sections: 1.Reviews Arch Dis Child Fetal Neonatal Ed. 2024 Apr 9. Arch Dis Child Fetal Neonatal Ed. Associations of excessive internet use, sleep duration and physical activity with school absences: a cross-sectional, population-based study of adolescents in years 8 and 9.

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ACEP Now

NOVEMBER 7, 2023

A 67-year-old man presents to the emergency department (ED) in cardiac arrest. Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. On ED presentation, he is unresponsive and the monitor shows ventricular fibrillation. 2018;13(9):e0204169. Margey R, Browne L, Murphy E, et al.

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EMDocs

JANUARY 20, 2024

She describes the pain as left-sided, non-radiating, and 9/10 in severity. Answer: Takotsubo Cardiomyopathy 1-18 Background: Also known as transient apical ballooning syndrome, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, stress cardiomyopathy, Gebrochenes-Herz syndrome, and broken-heart syndrome.

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EMDocs

OCTOBER 29, 2024

A 43-year-old male with a history of mitral valve regurgitation s/p valvular replacement, hypertension, hyperlipidemia was evaluated in the ED for septic shock secondary to a pyelonephritis with a renal abscess. Chu CK, Delia E, Mograder A, Dwyer EM. 2017;45(1):12-20. 2015;7(9):E365-E369. J Saudi Hear Assoc. J Thorac Dis.

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Dr. Smith's ECG Blog

FEBRUARY 20, 2025

This is what the providers in the ED understood on patient arrival: Patient called 911 for syncope, then had witnessed PEA arrest after medics arrived. Resuscitated with chest compressions, epinephrine. including epinephrine, and there was ROSC. Not a shockable rhythm. Resuscitation was begun with chest compressions, etc.,

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EMDocs

JANUARY 22, 2025

In the ED, he develops recurrent respiratory depression and hypoxia to 80%. 1 Most heroin in the United States actually contains fentanyl and fentanyl analogs. Naloxone reverses the analgesic, respiratory, sedative , and miotic e ffects of opioids. 6 Image 1: Structure of naloxone. How long should they stay in the ED?

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