Category Archives: SMARTEM

Pseudoaxiom – epinephrine in the digits

By Will Fleischman, MD Please refer to SMARTEM Axiom – noun – A statement or proposition that is regarded as being established, accepted, or self-evidently true. Pseudoaxiom – A false axiom passed down as anecdote, tradition, or simple repetition from … Continue reading

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Pediatric UTI

By Kei Ko, MD Please refer to SMARTEM Part I Original date: Jan. 23, 2011 1993 – Practice guidelines published and it suggested <3 month age group, a full sepsis workup and <1 month admitted with iv abx, and 1-3 … Continue reading

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SMART SAH: A Picture is Worth a Thousand LPs

By Will Fleischman, MD Please refer to SMARTEM Overview: Headaches and SAH: Headache is chief complaint for 3% of ED visits 3-4% with grossly normal neuro exam will have serious pathology roughly 1% SAH according to Perry et al, CJEM … Continue reading

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Coronary CT’s for low-risk chest pain patients in the ED

By Will Fleischman, MD Refer to SMARTEM General comments Coronary CT and coronary angiography are anatomical tests and say nothing of the clinical significance of whatever it finds. And angiography has been made the gold standard without ever having been … Continue reading

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SMARTEM Thrombolytics for Stroke

By Will Fleischman, MD Thrombolytics for Stroke http://smartem.org/podcasts/smart-thrombolytics-acute-stroke General facts: Stroke morbidity/mortality varies widely depending on age/gender/race. Mortality rate is about 8% for ischemic stroke, and 40% for hemorrhagic stroke. 50% have some hemiparesis 6 months out; 1/3 can’t walk … Continue reading

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SMART EM: Testing

By Will Fleischman, MD http://smartem.org/podcasts/smart-testing-back-basics Testing happens constantly during the clinical encounter and includes clinical impression, HPI questions, lab tests etc. These elements all have defined diagnostic properties, i.e. sensitivity, specificity. But how do we use these diagnostic properties to … Continue reading

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SMARTEM: Updates

By William Fleishman MD, edited by David Newman MD                                                               … Continue reading

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SMART Stress Testing

by William Fleishman MD This is a little bit of a behemoth lecture and summary –  but well worth it. Stress Test: A test to determine whether a patient has myocardial ischemia during tachycardia   Exercise stress: looking for ECG … Continue reading

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SMARTEM: Cardiac arrest – Pharmacotherapy Part 2

By Will Fleischman, MD & Kei Ko, MD SMART Cardiac Arrest: Pharmacotherapy Part 2: Pharmacotherapy Hallelujuah!: AHA 2010 guidelines admit that there is no evidence of benefit from drugs Stiell study: phased in ACLS bundles including advanced airway management, epinephrine, atropine, … Continue reading

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SMARTEM: Cardiac arrest – Pharmacotherapy Part 1

By Will Fleischman, MD & Kei Ko, MD SMART Cardiac Arrest: Pharmacotherapy Part 1: A Modern History of Cardiac Arrest Treatment With the advent of electricity in the early 20 th century, and the problematic electrocution of line workers, ConEd partners … Continue reading

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