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Is your persistent cough more than a cold? Understanding micro-choking.
These days, everybody is coughing. The resurgence of COVID, RSV, and flu has overwhelmed emergency rooms and hospitals this early winter. But not all coughs are viral. If you recently visited a family member for the holidays and noticed a persistent cough after dinner, you may have witnessed not a viral illness but what’s known Read more… Is your persistent cough more than a cold? Understanding micro-choking. originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 27, 2024 Category: General Medicine Authors: Tags: Conditions Pulmonology Source Type: blogs

A 40-something with 2 hours of new active chest pain and new T-wave inversion
A 41-year-old male who presents to the emergency department with chest pain. Patient reports approximately 2 hours prior to arrival he developed a sharp chest pain that radiates into his left arm and left lower leg. Describes the radiating pain as numbness/tingling.  No shortness of breath. No recent travel. No cough. No cardiac history. Here is his ECG:He had a previous ECG on file, from many years prior:What do you think?There is new T-wave inversion in inferior leads and V3-V6.  This is recorded during pain.  The faculty physician thought this is highlylikely to be ACS.  ...
Source: Dr. Smith's ECG Blog - February 14, 2024 Category: Cardiology Authors: Steve Smith Source Type: blogs

Noisy, low amplitude ECG in a patient with chest pain
Written by Colin Jenkins. Colin is an emergency medicine resident beginning his critical care fellowship in the summer with a strong interest in the role of ECG in critical care and OMI. Edits by Willy Frick.A patient in their 40s with type 1 diabetes mellitus and hyperlipidemia presented to the emergency department with 5 days of “flu-like” illness. They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chest pain. They denied fever, cough, dyspnea, and sick contacts. They described the chest pain as severe, crushing, and non-radiating. It was not wo...
Source: Dr. Smith's ECG Blog - January 15, 2024 Category: Cardiology Authors: Willy Frick Source Type: blogs

Medical and legal aspects of codeine cough syrup [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes! Join us for an insightful podcast discussion with L. Joseph Parker, a research physician. In this episode, we delve into the fascinating world of promethazine with codeine cough syrup, its medical applications, diversion risks, and the legal complexities surrounding its prescription. Explore the history, Read more… Medical and legal aspects of codeine cough syrup [PODCAST] originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - November 13, 2023 Category: General Medicine Authors: Tags: Podcast Pain Management Source Type: blogs

Codeine cough syrup: a controversial classification
Did you know that promethazine with codeine cough syrup had a high risk of diversion and high risk of addiction? I didn’t. From my experience, this is the only effective prescription cough medicine available. Sure, you can prescribe what is essentially over-the-counter dextromethorphan. But be ready when the patient throws a fit because that’s what Read more… Codeine cough syrup: a controversial classification originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 13, 2023 Category: General Medicine Authors: Tags: Meds Medications Source Type: blogs

Ragweed allergy peaks during college football season
Not only is it kickoff time for college football season, but it’s also prime time for fall allergies. For the 50 million Americans who suffer from ragweed allergy, the late summer and early fall signal the onset of runny noses, sneezing, congestion, cough, itchy watery eyes, and in more severe cases, sinus infections and asthma Read more… Ragweed allergy peaks during college football season originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - September 2, 2023 Category: General Medicine Authors: Tags: Conditions Allergies & Immunology Source Type: blogs

A middle-aged man with acute chest pain.
A 50-something male had onset of chest pain 1 hour prior to ED arrival.  It is constant, 9/10, left-sided CP that radiates into left arm and jaw. Endorses some associated SOB, but denies back pain, fever, cough, chills, leg swelling, or other new symptoms. Has never had this before. Takes metoprolol for HTN. Here is the triage ECG:What do you think?This was not identified as OMI by either the conventional algorithm nor the triage faculty physician.Smith: I think leads V3 and V4 are highly concerning, and all but diagnostic, for acute LAD occlusion.  I would activate the cath lab, or at least look f...
Source: Dr. Smith's ECG Blog - September 1, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

Bonus Features – July 23, 2023 – Number of people impacted by data breaches up 56% compared to last year, CMS keeps temporary telehealth expansion in 2024 Medicare fee schedule, and more
This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job. News and Studies The 2024 Medicare Physician Fee Schedule Proposed Rule from CMS would continue many of the public health emergency telehealth flexibilities, such as an expanded definition of telehealth practitioners, continued...
Source: EMR and HIPAA - July 23, 2023 Category: Information Technology Authors: Brian Eastwood Tags: Health IT Company Healthcare IT Regulations AliveCor American Telemedicine Association Amwell ATA AVIA Black Book Research Bren Webster CenTrak Cerner CMS eClinicalWorks eCW Force Therapeutics Fortified Health Security He Source Type: blogs

Angiotensin II Receptor Blockers (ARBs) For High Blood Pressure: Types, Side Effects, Drug Interactions
Conclusion Cardiovascular disease (CVD) has become a leading cause of death globally, necessitating the adoption of preventive measures, early detection, and effective management strategies. Hypertension, a significant risk factor for CVD, requires active management to mitigate associated risks. Angiotensin II Receptor Blockers (ARBs) have emerged as a favored choice among healthcare professionals due to their effectiveness and unique benefits. ARBs offer several advantages compared to other blood pressure medications. They effectively control blood pressure, protect vital organs such as the heart and kidneys, ...
Source: The EMT Spot - July 11, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

ACE Inhibitors For High Blood Pressure: Types, Side Effects, Drug Interactions
Conclusion In conclusion, the rising utilization of blood pressure medications reflects a growing awareness of the importance of managing hypertension for overall health. ACE inhibitors, among other drug classes, are widely used due to their effectiveness in lowering blood pressure and providing additional benefits for heart and kidney health. It’s essential to consult your doctor before starting or adjusting ACE inhibitor treatment to ensure personalized care and monitor for potential side effects or drug interactions. Taking ACE inhibitors as prescribed, following consistent dosing schedules, and attend...
Source: The EMT Spot - July 9, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

Rationing Health Care
Lately we ' ve touched upon the absurd cost of medical services in the U.S. -- we spend twice as much as the next biggest spender and three or four times as much as others -- and we ' re less healthy for it. There are a few reasons for this, but here I ' m going to touch the third rail.In the United States, in contrast to other nations, if the FDA approves a treatment, insurance has to pay for it. The FDA does not consider cost, but only whether there is evident of clinical benefit that outweighs risks or (non-financial) harms. The definition of benefit and harm, and how to value them, is of course far from obvious, but we...
Source: Stayin' Alive - July 7, 2023 Category: American Health Source Type: blogs

The rising threat of lung cancer in Asian American female nonsmokers
“It’s adenocarcinoma,” said the voice on the other end of the phone. I couldn’t believe it. “Lung cancer? Me? How could that be? I’ve never smoked!” Shock, disbelief, and disappointment filled all the nooks and crannies of my mind and heart. In January 2021, I went to my PCP after developing a nagging dry cough Read more… The rising threat of lung cancer in Asian American female nonsmokers originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 3, 2023 Category: General Medicine Authors: Tags: Conditions Oncology/Hematology Source Type: blogs

A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!
 Written by Pendell MeyersA woman in her 30s with minimal past medical history presented simply stating she was " feeling unwell. " Her symptoms started suddenly about 48 hours ago, but had continued to worsen, including epigastric discomfort, nausea, cough, and dyspnea and lightheadedness on exertion. She denied chest pain and denied feeling any palpitations, even during her triage ECG:What do you think?Despite otherwise normal vital signs, she was appropriately triaged to the critical care area of the ED.She was awake, alert, well perfused, with normal mental status and overall unremarkable physical exam except for ...
Source: Dr. Smith's ECG Blog - June 3, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

How digital care solutions are changing the game for patients with long COVID, diabetes, and Crohn ’ s disease
“Ever since I had COVID, it always smells like something’s burning,” explained a patient suffering from symptoms of long COVID. This burning smell has plagued her for more than three months and is coupled with fatigue, difficulty breathing, and a persistent cough. Long COVID recently joined other diagnoses, such as diabetes and Crohn’s, as one Read more… How digital care solutions are changing the game for patients with long COVID, diabetes, and Crohn’s disease originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 16, 2023 Category: General Medicine Authors: Tags: Conditions Primary Care Source Type: blogs

AI Front and Center at 2023 eClinicalWorks Health Centers Summit
Product enhancements based on the application of artificial intelligence (AI) featured prominently at the recent 2023 Health Centers Summit (HCS2023) hosted by eClinicalWorks. CEO Girish Navani showcased new AI powered search capabilities, AI-generated patient summaries, and next-step recommendations. The company also debuted a new macro feature and AI-assisted appointment reminders designed to improve no-shows. HCS2023 is an annual event specifically for eClinicalWorks’ community health centers and Federally Qualified Health Centers (FQHCs). These healthcare organizations have unique needs and challenges that are differ...
Source: EMR and HIPAA - May 9, 2023 Category: Information Technology Authors: Colin Hung Tags: Administration Ambulatory Clinical EMR-EHR Healthcare IT Appointment Reminders Carequality ChatGPT CommonWell Community Health Centers eClinicalWorks FQHC Girish Navani HCS2023 Large Language Models No Shows PRISMA Source Type: blogs