ALiEM

SEPTEMBER 15, 2023

A 64-year-old Caucasian male with a history of alcohol use disorder and tobacco use disorder presents with painless bilateral hand contractures that have been worsening for the past several months. He denies any recent trauma, fever, chills, or decreased sensation. The patient works as a construction worker. Physical Exam Vitals : BP 143/83 ; HR 94; RR 18; T 98.6°F; O2 saturation 98% on room air Musculoskeletal : He has bilateral palmar contractures proximal to the fourth digits.

OR 152

OR 152

Dr. Smith's ECG Blog

SEPTEMBER 15, 2023

I came to work one day and one of my partners said, "Hey, Steve, we had a STEMI this afternoon!" I said, "Cool, can I see the ECG?' Of course he said: "Yes, it was a 60 year old diabetic with Chest pain." So he showed me the ECG recorded in triage: What did I say? "That is not a STEMI. That is Arterial Pulse Tapping Artifact (APTA)." He said: "What?

STEMI 129

STEMI Coronary 129

EMDocs

SEPTEMBER 15, 2023

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter. Originally published at JournalFeed , a site that provides daily or weekly literature updates. Follow Dr. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: How to Spot Ischemia in RBBB Patients Spoon Feed In non-ischemic right bundle branch block (RBBB) ECGs, we expect discordant ST depression and T wave inversions in leads V1-V3.

Emergency Medical Services 61

Emergency Medical Services Coronary Emergency Department EMS 61