February, 2022

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ECG Cases 28 Approach to Atrial Fibrillation

Emergency Medicine Cases

Jesse McLaren explains his AFIB mnemonic for approach to atrial fibrillation that involves 4 questions: 1. Is it atrial fibrillation? 2. If it is atrial fibrillation and there is rapid ventricular response, is it fast from a secondary cause? 3. If it is atrial fibrillation with a rapid ventricular response without a secondary cause, what is the intervention?

ED 130
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SGEM#360: We Care a Lot – The EmPATH Study

The Skeptics' Guide to EM

Date: February 21st 2022 Reference: Kim et al. Emergency psychiatric assessment, treatment, and healing (EmPATH) unit decreases hospital admission for patients presenting with suicidal ideation in rural America. AEM February 2022. Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England).

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Episode 43: Resuscitative TEE with Felipe Teran

Critical Care Scenarios

The hows, whys, logistics, and applications of focused, bedside transesophageal echocardiography performed by critical care and EM providers, with Felipe Teran, assistant professor of emergency medicine at Weill Cornell and director of the Resuscitative TEE Project. Takeaway lessons As a rule, resuscitative TEE is performed in patients with a secured airway.

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ECG of the Week 16 February 2022 Interpretation

EMergucate

The following ECG is from a 52 year old male with a history of bipolar mood disorder and cardiomyopathy. He presents to ED complaining of increasing shortness of breath and leg swelling.

ED 130
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Prehospital Emergency Care Podcast Ep. 110

Prehospital Emergency Care Podcast

Happy February from the PEC podcast crew! Even though Punxsutawney Phil's shadow predicted another 6 weeks of winter, the PEC podcast team is happy to keep you company while you're keeping warm. In this episode, we cover the Prehospital Emergency Care Journal Volume 25 Number 5 where we cover manuscripts like: Impact of a Standardized EMS Handoff Tool on Inpatient Medical Record Documentation at a Level I Trauma Center Documentation of Child Maltreatment by Emergency Medical Services in a Natio

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Episode 82: Dr. Remle Crowe on Stroke and Burnout

The Overrun Podcast

Remle Crowe is a statistics rockstar. Her primary areas of research in EMS include burnout, and how to improve performance in our industry. There's a lot to cover, and a lot we discussed, so everything is listed below. Take some time to listen to the episode and read all the studies linked below. It'll make your practice better. Promise. August 2017 Prehospital emerg.

EMS 52
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JJ 20 Outpatient Medications for COVID-19

Emergency Medicine Cases

In this Journal Jam podcast we dig deep into the science of FDA-approved outpatient medications for COVID with 3 critical appraisal masters: Dr. Andrew Morris, Dr. Rohit Mohindra and Dr. Justin Morgenstern. What is the evidence for the neutralizing monoclonal antibody medications like Sotrovimab? The nucleoside analogs like Remdesivir and Paxlovid? The inhaled corticosteroids like Budesonide and Ciclesonide?

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TIRBO #4: Hope

Critical Care Scenarios

Why an assumption in your training should be to call for assistance, but expect it will never arrive. Plan to manage problems yourself. Let help surprise you—otherwise hope becomes your plan. Why an assumption in your training should be to call for assistance, but expect it will never arrive. Plan to manage problems yourself. Let help surprise you—otherwise hope becomes your plan.

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ECG of the Week – 23rd February 2022

EMergucate

The following ECG is from an 82 year old man with metastatic mesothelioma on immunotherapy treatment with a background of … Continue reading →

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The MICHELLE Trial: Anticoagulation Post-Discharge in Patients Hospitalized Secondary to COVID-19

Silk City Blog

Background:Patients diagnosed with COVID-19 have an increased risk of thromboembolic events, including pulmonary embolism and deep vein thrombosis (DVT). In addition, COVID-19 patients with increased coagulation parameters such as D-dimer, fibrin degradation products, prothrombin time, and activated partial thromboplastin time are at higher risk of morbidity and mortality.

ICU 52
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Finding Feedback

Medic Mindset

Ginger Locke speaks to the topic of Feedback. In this recording from University of Washington’s Grand Rounds, she explains that paramedics are not getting enough feedback. She outlines theories for why it is so scare, what we can do about it, and how feedback might look in the future. A really great conversation about feedback on Rob Orman’s Stimulus podcast.

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This ECG was interpreted as completely NORMAL by the computer: What about it is THE critical finding??

Dr. Smith's ECG Blog

A 40 something otherwise healthy man presented with substernal chest pain. It had occurred once 3 days prior and resolved without any medical visit. He had a triage ECG at time zero: Here is the computer interpretation (Normal) This was the Veritas algorithm. What do you think? This ECG is DIAGNOSTIC of acute LAD Occlusion. The T-waves are hyperacute, but most important, the minimal ST Elevation is accompanied by Terminal QRS Distortion , or at least nearly so.

STEMI 52
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SGEM#359: Meet Me Halfway on the Duration of Antibiotics for Non-Severe Pediatric Community-Acquired Pneumonia

The Skeptics' Guide to EM

Date: February 7th, 2022 Reference: Williams et al. Short- vs standard-course outpatient antibiotic therapy for community-acquired pneumonia in children: the scout-cap randomized clinical trial. JAMA Pediatrics 2022 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Case: A three-year-old boy presents to the emergency department (ED) with fever […] The post SGEM#359: Meet Me Halfway on the Duration of Antibiotics for Non-Seve

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TIRBO #3: Weaning vs Titration

Critical Care Scenarios

When do interventions need to be “weaned”? Stop using this word when you don’t mean it! Titrate, target to effect, but only wean when there is a physiologic dependence. When do interventions need to be “weaned”? Stop using this word when you don’t mean it! Titrate, target to effect, but only wean when there is a physiologic dependence.

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ECG of the Week – 9th February 2022 – Interpretation

EMergucate

Interpretation: Note: Lead V6 missing – ECG not fully interpretable Rate: 60bpm – 300bpm Rhythm: Biphasic p II, III; can be normal.

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EMT Spotlight: Elizabeth Gray, Field Training Officer

On Time Medical Transportation

Elizabeth sheds light on becoming an EMT, training new employees, staying safe during a pandemic, and learning from talented people around you.

EMT 52
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Is This Even Legal?

EMS 20/20

On this weeks episode a very sick patient is taken to the hospital. but do issues of patient abandonment arise when a Paramedic refused to be the primary provider? Listen to this weeks call and find out if Spencer and Chris can close the case. On this weeks episode a very sick patient is taken to the hospital. but do issues of patient abandonment arise when a Paramedic refused to be the primary provider?

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Tasty Morsels of Critical Care 057 | Myasthenia Gravis

Emergency Medicine Ireland

Welcome back to the tasty morsels of critical care podcast. Today we’re looking at a small section of Oh Chapter 58 covering myasthenia gravis. I don’t think I’ve ever looked after a true myasthenic crisis in the ICU. Likely because. Read More » Welcome back to the tasty morsels of critical care podcast. Today we’re looking at a small section of Oh Chapter 58 covering myasthenia gravis.

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Time of ECG and Coronary Angiography in ROSC

Emergency Medicine Education

Very interesting study in patients who got ROSC and had an ECG. Patients with an ECG before 7 minutes after ROSC had more false positive ECG findings in favor of STEMI vs 8-33 minutes and more than 33 minutes.

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Lightning rounds #12: Co-managing patients in a surgical ICU

Critical Care Scenarios

Brandon and Bryan talk about the practicalities of communication, collaboration, and compromise in a surgical ICU, when the surgical and critical care teams are both involved, one is the “primary” team on paper, but everyone needs to be heard. Brandon and Bryan talk about the practicalities of communication, collaboration, and compromise in a surgical ICU, when the surgical and critical care teams are both involved, one is the “primary” team on paper, but everyone needs to be heard.

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Imaging Case of the Week 492

EMergucate

The following pelvic x-ray is from a 2 year old febrile child who is refusing to weight bear on right … Continue reading →

EMS 130
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Episode 3: Thinkin' about stuff w/ Ginger Locke

The EMS Show

Austin-based EMS Educator and friend Ginger Locke joins Mike and Ritu as we discuss thinking and decision-making in EMS. We barely scratched the surface.leaving you wanting more.we are sure of that. Appreciate you subscribing to our channel and our podcast, wherever you may listen!

EMS 40
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(Please) Free CO2

EMS 20/20

A crew find a patient that rapidly deteriorates, prompting quick action. Baffling monitor readings are the result, so the Chris and Spence bring in back up: Nicole Johnson, a seasoned ICU RN and host of the Found Down podcast join the team to figure out some crazy numbers in one of our biggest episodes yet! A crew find a patient that rapidly deteriorates, prompting quick action.

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Occlusion/reperfusion through 6 ‘normal’ ECGs

Dr. Smith's ECG Blog

This is written and contributed by Jesse McLaren (@ECGCases), with comments and edits by Smith, and commentary by Ken Grauer (@EKGPress) An 80 year-old female presented with weakness and a fall, with normal vitals and no injuries. The ECG was labeled ‘normal’ by the computer (Marqette 12SL), later confirmed by the cardiologist. What do you think? There’s normal sinus rhythm, normal conduction, normal axis, normal R wave progression, and normal voltages.

STEMI 40
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The Dangerous Cold

Silk City Blog

Listen while PGY-3 emergency medicine resident at St Joseph's Regional Medical Center, Dr. Scott Wilder discuss environmental emergencies with a focus on hypothermia.

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TIRBO #2: Procedural handedness

Critical Care Scenarios

When should you place a line or perform other procedures using your left (or non-dominant) hand? Brandon reflects on a few situations. When should you place a line or perform other procedures using your left (or non-dominant) hand? Brandon reflects on a few situations.

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Imaging Case of the Week 494 Answer

EMergucate

The chest x-ray shows triangular peripheral based pleural opacity with apex towards the hilum. This is Hampton’s hump.

EMS 130
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Episode 3: Thinkin' about stuff w/ Ginger Locke

The EMS Show

Austin-based EMS Educator and friend Ginger Locke joins Mike and Ritu as we discuss thinking and decision-making in EMS. We barely scratched the surface.leaving you wanting more.we are sure of that. Appreciate you subscribing to our channel and our podcast, wherever you may listen!

EMS 40
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Never Tell Me The Odds!

EMS 20/20

In an-almost-Valentines-Day special, the guys pick a part a call that has some unusual possibilities for symptoms that started during unusual circumstances that results in an unusual diagnosis. Can the guys shed any light on this unusual episode? In an-almost-Valentines-Day special, the guys pick a part a call that has some unusual possibilities for symptoms that started during unusual circumstances that results in an unusual diagnosis.

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Hypothermia at 18 Celsius in V Fib arrest: CPR, then ECMO rewarming, for 3 hours, then Defib with ROSC. Interpret the ECG.

Dr. Smith's ECG Blog

A middle-aged man was found outside in the cold in full arrest in ventricular fibrillation. Chest compressions and ventilation were begun. On arrival, CPR was continued and core temperature was measured at 18° C (64.4° F). The patient was put on Extracorporeal Life Support in the ED 3 hours after initial resuscitation, the core temp was 30° C and the patient was defibrillated with a single attempt.

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A Shameless Toxic Alcohol Ingestion

Silk City Blog

Listen while Dr.

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Ep 165 Getting Sued in Emergency Medicine – Practical Tips

Emergency Medicine Cases

How many civil actions against Emergency Physicians does CMPA handle and what have been the outcomes? What are the 4 aspects of medical negligence and the anatomy of a legal action against physicians in Canada? What are the 3 stages of civil action in a medicolegal law suit in Canada? How should you respond when you are served with a medicolegal action?

ED 130
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Imaging Case of the Week 491 Answer

EMergucate

The chest x-ray shows The chest x-ray is technically inadequate, having been performed in the resuscitation area.

EMS 130
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ECG of the Week – 9th February 2022

EMergucate

75yo M who presents with chest pain and shortness of breath. Interpret the ECG How would you treat this patient?

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Imaging Case of the Week 495

EMergucate

The following knee x-rays are from a 15 year old with knee pain & swelling after a twisting injury.

EMS 130
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Imaging Case of the Week 494

EMergucate

The following chest x-ray is from an adult patient with right sided chest pain. What can be seen?

EMS 130
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ECG of the Week 16 February 2022

EMergucate

The following ECG is from a 52 year old male with a history of bipolar mood disorder and cardiomyopathy. He presents to ED complaining of increasing shortness of breath and leg swelling.

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