A man with chest pain off and on for two days, and " No STEMI " at triage.
Written by Kaley El-Arab MD, edits by Pendell Meyers and Stephen SmithA 61-year-old male with hypertension and hyperlipidemia presented to the emergency department for chest tightness radiating to the back of his neck that has been intermittent for the past day or two. Here is his triage ECG which was obtained at 20:34 during active pain.What do you think?This ECG was read as “No STEMI” with no prior available for comparison. It is true this ECG does not meet STEMI criteria (there is 1.0 mm STE in III, and possibly 0.5 mm in aVF), but there is clear evidence of OMI findings on this ECG. Leads II, III, and aVF hav...
Source: Dr. Smith's ECG Blog - June 19, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
Is it really depressing? Really living with chronic pain
Someone responded to my post Unpalatable truths about pain saying it was depressing. For a moment I thought – yeah, it is really. And then I reflected on my life living with, and working with people dealing daily with chronic, ongoing, persistent pain. It’s not inevitably miserable. Is there something wrong with me?
This, of course, set me to thinking maybe my pain isn’t as intense as others. Well – how would I know? I can’t give my pain a number out of 10. It’s just there and I can’t remember a time without any pain, so I can’t compare a 0 = no pain at all with anything ...
Source: HealthSkills Weblog - June 18, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Clinical reasoning Pain conditions Psychology Research Resilience/Health Science in practice Wellness pain management Therapeutic approaches Source Type: blogs
Can You Take Painkillers With Hypertension?
Conclusion
The crossroads of hypertension and painkillers is a complex and sensitive one.
While studies have highlighted potential risks, there are ways to navigate this maze safely.
It all comes down to individualized care, frequent communication with healthcare providers, and an active approach to managing your health.
With the right approach, relief from pain can be found—even within the parameters of managing high blood pressure.
Read also: Can Cold Medicine Raise Blood Pressure?
Reference
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), Published by American Heart Association in 2017. https://www....
Source: The EMT Spot - June 15, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs
Two ECGs texted to me in the same hour. What would you recommend?
Written by Pendell MeyersBoth of these cases were sent to me with no information other than adults with acute chest pain. What would be your response?Case 1:Case 2:What if I told you that Case 1 has an abnormal initial troponin, and Case 2 has a normal initial troponin? Case 1An elderly male presented with chest pain. His vitals were within normal limits except some mild hypertension. Here was his triage ECG:What do you think?I texted back: " I just see LVH with no signs of OMI " .I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict:You can subscribe for news and early access (via partic...
Source: Dr. Smith's ECG Blog - June 15, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
What's new in midwifery - 13th June 2023 (2)
Some new research. Most of this identified through McMaster ' s Evidence Alerts, so thanks to them. I have given links to the article (subscription, payment or librarian intervention may be needed to access the full article) or in some cases, the record in PubMed.Three relating toperinatal mental healthInternet delivered psychological interventions for reducing depressive, anxiety symptoms and fear of childbirth in pregnant women - a systematic review.An interactive childbirth education platform to improve pregnancy-related anxiety - an RCT.Another RCT, Effect of immediate referral vs a brief pr...
Source: Browsing - June 13, 2023 Category: Databases & Libraries Tags: midwifery Source Type: blogs
Unpalatable truths about pain
Recently I read a blog post about the way “Explain pain” had landed with a group of people in the general public. The point being made was that people found the ideas presented unpalatable. They didn’t agree with the points and they thought the ideas were dismissive of their experience.
Now I am a critic of any recipe-based approach to helping people. I am especially a critic of clinicians using something they’ve picked up on a weekend course, or out of a book, being applied holus bolus to an individual without nuance. There have been outrageous claims made about the effectiveness of giving some...
Source: HealthSkills Weblog - June 11, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Pain conditions Professional topics biopsychosocial pain management Therapeutic approaches Source Type: blogs
Can You Run In Marathons With Hypertension?
Marathons and hypertension: Understand the risks, learn how to stay safe while running, and explore alternative activities to keep your heart healthy and thriving.
Quick Summary
Marathons pose risks for individuals with hypertension: The intense physical exertion can lead to sudden increases in blood pressure, dehydration, irregular heart rhythms, and strain on the kidneys, potentially causing serious complications like heart attacks or strokes.
Safety measures for hypertensive individuals: If participating in a marathon, monitor blood pressure regularly, follow a supervised training regimen, stay hydrated, w...
Source: The EMT Spot - June 10, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs
Paving the Digital Roadmap for the Patient Journey
The following is a guest article by Patrick Reetz, Chief Product Officer at LinkLive
The pandemic was the catalyst for digital healthcare and transforming modern patient care. But it happened abruptly, leaving many challenges in its wake.
Dragged into this rapid shift, healthcare organizations adopted a plethora of communication endpoints without assessing their core attributes: adaptability, functionality, interoperability, effectiveness, and reliability.
Providers continuously pushed themselves to invest in new tools and solutions — with one overarching aim — to enhance the patient experience. But a digital tool does...
Source: EMR and HIPAA - June 9, 2023 Category: Information Technology Authors: Guest Author Tags: Clinical Communication and Patient Experience Health IT Company Healthcare IT Hospital - Health System Telemedicine and Remote Monitoring Care Coordination Care Management customer experience Data Silos Data-Collection Tools Digital Source Type: blogs
Unmasking the truth: the shocking reality of the opioid epidemic and who ’ s really to blame
An excerpt from Burden of Pain: A Physician’s Journey through the Opioid Epidemic. Glide your hand over a piece of velvet and you notice the smoothness. You feel its aggregated smoothness, not the individualized roughness of each fiber. Each fleeting fiber, a prick of truth, is nullified, synthesized, and then magnified into the silky fluency
Read more…
Unmasking the truth: the shocking reality of the opioid epidemic and who’s really to blame originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 7, 2023 Category: General Medicine Authors: Jay K. Joshi, MD Tags: Physician Pain Management Source Type: blogs
15 Symptoms Of Low Blood Pressure To Watch Out For
Conclusion
Low blood pressure, or hypotension, is often overshadowed by its counterpart, high blood pressure (hypertension), which receives more attention due to its perceived risks.
However, it’s crucial to recognize that low blood pressure can have significant impacts on overall well-being and various organ systems.
Fainting or loss of consciousness is a concerning symptom that may indicate a drop in blood flow to vital organs.
Chest pain suggests inadequate blood supply to the heart, while shortness of breath indicates reduced oxygen supply to the lungs.
Confusion or altered mental state can be a si...
Source: The EMT Spot - June 6, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure 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
Dangers And Risks Of High Blood Pressure
Conclusion
Despite its silent nature, high blood pressure gradually damages organs over time. The interconnectedness of the circulatory system means that all organs reachable by blood are at risk.
Hypertension can lead to critical complications such as heart enlargement, coronary artery disease, stroke, cognitive decline, erectile dysfunction, kidney disease, proteinuria, vision problems, and vascular damage.
The importance of proactive measures to manage and prevent these adverse effects is emphasized.
Regular blood pressure monitoring, adopting a healthy lifestyle, and working with healthcare professionals ar...
Source: The EMT Spot - June 1, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs
27 Dangers And Risks Of High Blood Pressure
Conclusion
Despite its silent nature, high blood pressure gradually damages organs over time. The interconnectedness of the circulatory system means that all organs reachable by blood are at risk.
Hypertension can lead to critical complications such as heart enlargement, coronary artery disease, stroke, cognitive decline, erectile dysfunction, kidney disease, proteinuria, vision problems, and vascular damage.
The importance of proactive measures to manage and prevent these adverse effects is emphasized.
Regular blood pressure monitoring, adopting a healthy lifestyle, and working with healthcare professionals ar...
Source: The EMT Spot - June 1, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs
Why doctors aren ’ t to blame for the U.S. opioid crisis [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes! Join us for an eye-opening episode as we discuss the truth behind the U.S. opioid crisis with our guest, patient advocate Richard A. Lawhern. Contrary to popular belief, doctors did not cause this crisis by over-prescribing opioid pain relievers to their patients. Instead, illegal
Read more…
Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST] originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - May 27, 2023 Category: General Medicine Authors: The Podcast by KevinMD Tags: Podcast Pain Management Source Type: blogs
Leading Change When “ Change ” Isn ’ t the Norm
“If there is one thing that will definitely change about our complex healthcare system, practices and behaviors aren’t one of these”
One comment I get whenever I talk about “learning organization” as a way for healthcare institutions to adapt to the new normal is this- “I really like the change concepts your saying, but what else can I do if many in my organization doesn’t embrace that change philosophy?”
Rina is a new resident physician assisting more senior residents attending and treating fractures at one healthcare institution. Yet to learn the finer details of cas...
Source: The Orthopedic Logbook - May 27, 2023 Category: Orthopaedics Authors: Remo Aguilar Tags: Healthcare Policy Leadership & Management Learning & Development Medicine change change leadership healthcare leadership leading change tranformational leadership Source Type: blogs
