Dr. Smith's ECG Blog

OCTOBER 15, 2023

Submitted by anonymous, written by Pendell Meyers I was at triage when this ECG was presented to me. What do you think? Here's what the Queen of Hearts thinks: Note that the Queen has "HIGH" confidence that this is OMI. As noticed by the AI, if the patient presented with chest pain , then even this subtle ECG is diagnostic of OMI. Specifically , this ECG is diagnostic of acute LAD OMI, with hyperacute T waves likely in V3 and V4, very small but abnormal STE in V2-V4 (because of its there is a lo

ACS 100

ACS ED STEMI OR 100

First 10 EM

OCTOBER 15, 2023

In the massive hemorrhage deep dive, I mentioned that there were a number of large trials in the works that would further define practice. One of those trials – CRYOSTAT-2 – was just published, and adds important information about the role of empiric fibrinogen administration (in the form of cryoprecipitate) in trauma patients. The paper […] The post CRYOSTAT-2: Empiric cryoprecipitate in traumatic massive hemorrhage appeared first on First10EM.

EMS 95

EMS 95

ACEP Now

OCTOBER 15, 2023

There is no shortage of evidence regarding the harms of opiate use and misuse. With this in mind, prescriptions for opiates have been dropping in the United States, but were still dispensed at a rate of 43.4 prescriptions annually per 100 persons in 2020. 1 The emergency department remains an important frontier for work in judicious prescribing, but opiate analgesia remains a valuable tool for the initial treatment of a variety of presentations.

Emergency Department 52

Emergency Department Naloxone ALS OR 52

EMT City

OCTOBER 15, 2023

Hi! I recently took the PAT for AMR and I failed because I was too short and I couldn't get the stretcher high enough to get it back into the ambulance. Everything else I could do just fine and the test was honestly easier than I thought it was going to be, but when I went to put the stretcher back in the ambulance, I couldn't. I can lift it just fine, so I don't think weight is the issue, but I was wondering if anyone had any advice for my retest in a few months.

Ambulance 40

Ambulance 40

ACEP Now

OCTOBER 15, 2023

A 37-year-old female was walking home from grocery shopping when she had an encounter with a stray pit bull. For obvious reasons, all history was obtained via emergency medical services and Cleveland police. They were called to the scene to find her with a blood pressure of 135/85, pulse of 110 beats per minute, and respiratory rate of 26 per minute.

Emergency Medical Services 52

Emergency Medical Services OR ED Emergency Department 52

ACEP Now

OCTOBER 15, 2023

The treatment of diabetic ketoacidosis (DKA) is, in many ways, unchanged: intravenous fluids, electrolyte repletion, insulin, and treatment of any precipitating factors. However, as with many treatments, there has been substantial de-escalation in intensity of therapy over time. Historically, patients were given a bolus of intravenous insulin followed by an insulin infusion.

ICU 104

ICU ALS ED Emergency Department 104