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SGEM#460: Why Do I Feel Like, Somebody’s Watching Me – CHARTWatch to Predict Clinical Deterioration

The Skeptics' Guide to EM

Date: October 28, 2024 Reference: Verma et al. Case: The Chief of Emergency Medicine (EM) at a large urban hospital recently approached the AI Committee at Unity Health, intrigued by the CMAJ article describing the apparent success of CHARTWatch in detecting early signs of patient deterioration. Reference: Verma et al.

ICU 274
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US Probe: Velocity Time Integral (VTI) in Sepsis Management

EMDocs

Fluid responsiveness should always be interpreted in the context of a patient’s fluid tolerance, however, evaluation of this is beyond the scope of the current article. Consider reviewing the EMDocs article on the VEXUS exam for further information on the ultrasound guided evaluation of fluid tolerance. Zhai S, Wang H, Sun L, et al.

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Does the literature support medications for stable, monomorphic ventricular tachycardia?

EMDocs

Long and Koyfman (3) wrote up an excellent review article looking at multiple trials trying to figure out what medication would be best (if any) for the treatment of stable monomorphic ventricular tachycardia. Now lets walk through them quickly: Ho et al (4) looked at termination of VT in 15 min or hemodynamic deterioration.

ALS 75
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Elbow Dislocations

REBEL EM

Commentary on an article by Marc Schnetzke, MD, et al.: “Determination of Elbow Laxity in a Sequential Soft-Tissue Injury Model. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 28846302 O’Driscoll SW. How Do Elbows Dislocate?: A Cadaveric Study” J Bone Joint Surg Am.

E-9-1-1 99
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Compassionate Care for Neurodivergent Patients in the Emergency Dept.

ACEP Now

9 As Stowers points out in his article debunking neurodiversity myths: Consider that some individuals are auditory learners, while others prefer visual methods. Maenner MJ, Warren Z, Williams AR, et al. 12 Each person has their unique approach to learning and understanding, and we adapt and use techniques that suit us best.

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How much epinephrine is sufficient?

Emergency Medicine Education

Garcia et al. Link to article How much epinephrine is enough? published a retrospective study in AJEM discussing cumulative epinephrine dosage in cardiac arrest.

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Airway Considerations in Prehospital Cardiac Arrest

ACEP Now

From the articles cited above, a theme begins to emerge: Early placement of the airway, along with first-pass success, are important considerations. References Dyson K, Bray JE, Smith K, et al. Wang HE, Schmicker RH, Daya MR, et al. Benger JR, Kirby K, Black S, et al. Benger JR, Lazaroo MJ, Crout M, et al.