A young man with persistent palpitations
Written by Pendell MeyersA teenager was playing basketball when he suddenly developed palpitations and lightheadedness. He presented soon afterward at the Emergency Department with ongoing symptoms. Mentation and blood pressure were normal. He had no chest pain or shortness of breath. Heart rates on the monitor fluctuated from 180-250 bpm.Here is his triage ECG:What do you think?The ECG shows an irregularly irregular polymorphic wide complex rhythm, with some R-R intervals as short as approximately 220 msec or even less. But it is not disorganized enough to be polymorphic ventricular tachycardia. The rhythm is therefo...
Source: Dr. Smith's ECG Blog - February 16, 2024 Category: Cardiology Authors: Pendell Source Type: blogs
From pain management to Port au Prince: a doctor ’ s journey in disaster relief
As medical doctors, we think we can help alleviate physical suffering in almost any situation. When the 2010 earthquakes shattered Haiti’s capital, I felt compelled to help. I had extensive pain management experience and training as a physiatrist. I thought I was ideally suited to lend a hand. At the time, this all seemed obvious.
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From pain management to Port au Prince: a doctor’s journey in disaster relief originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 15, 2024 Category: General Medicine Authors: Francisco M. Torres, MD Tags: Physician Emergency Medicine Source Type: blogs
Monocyte Population Differences with Age Following Bone Fracture
The innate immune system is involved in tissue maintenance and regeneration. That includes populations of monocytes, circulating innate immune cells in the bloodstream that enter damaged tissue to become macrophages. Monocytes are somewhat easier to catalog and study than is the case for macrophages. The former can be found in a blood sample, while the latter require a tissue sample. Researchers tend to follow the incentives attending the cost and availability of data, and thus we have examples like today's open access paper, in which the authors focus on circulating monocytes in the context of bone fracture.
You mi...
Source: Fight Aging! - February 14, 2024 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
A Few #HealthPolicyValentines
Happy Valentine’s Day to all of you! May your lives be filled with love this day. In the world of health IT and healthcare policy, this is the day we love to share our love (and some disdain) for healthcare in what we call #HealthPolicyValentines. Be sure to check out our coverage of previous #HealthPolicyValentines as well as some that we found interesting this year below. We hope you’ll enjoy a nice break this Valentine’s day.
Roses are red, violets are blue
CMS’s plan to abruptly migrate Medicare/Medicaid research to the expensive VRDC
Will be bad for researchers and bad for health polic...
Source: EMR and HIPAA - February 14, 2024 Category: Information Technology Authors: John Lynn Tags: Healthcare IT #healthpolicyvalentines Fun Friday Health Policy Personal Musings Valentine's Day 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
Can we finally say goodbye to opioids? There may be new pain relief on the horizon.
In an article I recently wrote about a new calcium channel-blocking medication that could be effective in treating central chronic pain, I mentioned that medications like lidocaine block sodium channels to prevent the transmission of pain through the peripheral nervous system. I also said that these medications have limited use, usually just in the ER,
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Can we finally say goodbye to opioids? There may be new pain relief on the horizon. originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 13, 2024 Category: General Medicine Authors: L. Joseph Parker, MD Tags: Meds Pain Management Source Type: blogs
Let ’ s Think of Patient-Centered Care, Not Value-Based Care
This article explores some fundamental changes that could accompany this shift in terminology, revolutionizing how we handle data and patient interventions.
Engagement For Life
We know that maintaining health is an endeavor that takes years, even decades. A successful endeavor must survive the departure of clinicians who have built relationships with the patient, as well as the patient’s own geographic moves, changes of provider, and changes of insurance. Treatment recommendations should also be tailored to the psychology of each patient.
Is there a message in this exhortation for people working with data and healt...
Source: EMR and HIPAA - February 13, 2024 Category: Information Technology Authors: Andy Oram Tags: Analytics/Big Data C-Suite Leadership Communication and Patient Experience Health IT Company Healthcare IT Hospital - Health System Interoperability Chronic Care Management Patient Centered Care Patients Society for Participatory Medic Source Type: blogs
Career Guide In Digital Health And Healthcare AI
It seems like every other day, someone reaches out to us – aiming their questions at Dr. Meskó, our lead researcher – seeking career advice. Now, let’s set the record straight: doling out career guidance isn’t exactly what we do. Yet, here we are, writing this article. Why? Even though we’re not career advisors, we’re right in the thick of the digital health and healthcare AI world. From this spot, we have a good overview of what you need to get into these booming fields.
So, while we might not be career counselors, here are our two cents on which direction to take –...
Source: The Medical Futurist - February 13, 2024 Category: Information Technology Authors: Andrea Koncz Tags: TMF Source Type: blogs
poem
ConsultationThe patient came to see me for a consultation. He said his doctor had referred him. But he didn ’t know why. Just that it was critical that he see me as soon as possible. He wasn’t experiencing any pain. His weight had been steady. He denied fevers, sweats, rashes or catarrh. He hadn’t noticed any bulges, lesions, lumps or viscous secretions. He ate well and trimmed his nails. Drank only occasionally. Most mornings he woke at dawn and worked out. He seemed a paragon of robust middle age health. I had a busy day, many more patients to see and then a couple add-on cases after clinic, but I didn’t wa...
Source: Buckeye Surgeon - February 13, 2024 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs
Vomiting, Diarrhea, and " Bubbles in my Chest "
A 60-something complained of vomiting, diarrhea overnight, and " bubbles in my chest " that started just prior to calling 911.He had this ECG recorded prehospital:Smith interpretation:There are hyperacute T-waves in III and aVF, and reciprocal STD in aVL with a reciprocally inverted T-wave in aVL. There are also hyperacute T-waves in V3 and V4. There is STD in V1 and V2. So it appears to be diagnostic of OMI, but it is hard to figure out what exact territory and artery. It could be a proximal RCA with both inferior OMI, posterior OMI (pulling ST down in V1/V2), and RV OMI causing large ischemic...
Source: Dr. Smith's ECG Blog - February 12, 2024 Category: Cardiology Authors: Steve Smith Source Type: blogs
Circling back to supported self-management
I’ve been writing a bit about supported self-management over the last few months. Partly because it’s topical given that medications and exercise offer very small reductions in pain and disability, and people do have lives outside of swallowing a pill and doing 3×10 reps! And partly because it is what we end up doing. It is the bulk of what people living with pain use to have lives.
Self-management refers to a broad range of strategies people with pain use in their daily lives to help them live well. I’m aware of the multiple definitions that exist for self-management, and that the level of agreem...
Source: HealthSkills Weblog - February 11, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping strategies Pain conditions Professional topics Research Science in practice biopsychosocial Health self-management Source Type: blogs
Not all patients are on disability
A recent conversation with my sister inspired me to write this post. She is a physical therapist who often rants about how patients with chronic pain or chronic illness don’t work and are just on disability. I know she’s far from the only health care provider with the same belief. She and her coworkers spend
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Not all patients are on disability originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 11, 2024 Category: General Medicine Authors: Benita Talati Tags: Conditions Patients Primary Care Source Type: blogs
See What PM Cardio Digitization can do with this ECG
This was a patient with chest pain. The ECG was faxed to a cardiologist. But it was very difficult for him to see.He showed this to me the next day.I told him that he could make it legible AND get an OMI diagnosis from the Queen of Hearts and sent this ECG to the Queen right before his eyes:She correctly rules out OMI:And the outcome was Not OMI (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - February 11, 2024 Category: Cardiology Authors: Steve Smith Source Type: blogs
The Payment Integrity Game-Changer: Generative AI
The following is a guest article by Dr. Musheer Ahmed, Founder and CEO at Codoxo
New Generative AI Use Cases are Emerging, Including to Transform Healthcare Payments, it’s up to the Industry to Embrace Adoption for Next-Level Cost Containment Outcomes
The healthcare system in America is confronted with significant challenges, including a steep rise in healthcare expenditures. In 2023, healthcare costs are projected to surge by almost 6%. A vast majority of healthcare workers are reporting job burnout. While these and other obstacles may seem insurmountable, we are already seeing how advancements in technology — partic...
Source: EMR and HIPAA - February 9, 2024 Category: Information Technology Authors: Guest Author Tags: Administration AI/Machine Learning Ambulatory Health IT Company Healthcare IT Hospital - Health System Revenue Cycle Management Codoxo Dr. Musheer Ahmed Generative AI Healthcare ChatGPT Healthcare Costs Healthcare Generative AI P Source Type: blogs
Chest pain with anterior ST depression: look what happens if you use posterior leads.
Don ' t forget to watch theWebinar: Smith and Pendell Meyers interpret ECGs for OMI or not OMI on Monday Feb 12 at 11 AM U.S. Central time. Register here:https://zoom.us/webinar/register/7617067094184/WN_LMN0vPb1Rz-HZu12K-QuYQWritten by Jesse McLarenA 65 year old
with a history of atrial flutter, CABG and end-stage renal disease on dialysis presented
with 3 days of fluctuating chest pain, which was ongoing at triage. What do you
think? Do you need posterior leads?There ’s atrial
flutter with controlled ventricular response, a non-specific intra-ventricular
conduction delay, borderline right axis, normal R wave...
Source: Dr. Smith's ECG Blog - February 9, 2024 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
