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ED Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.....
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4)    Reed MJ.  The ROSE (Risk Stratification of syncope in the emergency department) Study.  J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049  Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - April 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.....
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4)    Reed MJ.  The ROSE (Risk Stratification of syncope in the emergency department) Study.  J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049  Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - April 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

The Troubles at Cooper Continue, Lately Gruesomely, But Will Its Leadership and Governance Change This Time? - Part II: the History since 2005
In our most recent post, we noted the latest tragic, and gruesome development at Cooper Health System, the largest hospital system in southern New Jersey.  Months after the system CEO, John F Sheridan, and his wife Joyce were found dead after a fire in their home, local law enforcement concluded that Mr Sheridan murdered his wife, set fire to the house, then committed suicide.  It turns out this is just the latest, albeit possibly most tragic and grisly, troubling news from that health care system.Our last post summarized the history from 1978, including:-  Seven people, including the hospital system chief f...
Source: Health Care Renewal - April 3, 2015 Category: Health Management Tags: boards of trustees conflicts of interest Cooper Hospital/ UMC crime kickbacks legal settlements revolving doors Source Type: blogs

The Troubles at Cooper Continue, Lately Gruesomely, But Will Its Leadership and Governance Change This Time? - Part I: Historical Background
Allegations of Murder-Suicide by a Hospital System CEO This will be a hard series of posts to write. It wa triggered by the latest, and perhaps most gruesome chapter in the troubled history of the leadership of Cooper Health, the largest hospital system in southern New Jersey (known locally as South Jersey).  As reported by the Philadelphia Inquirer on March 28, 2015,Cooper University Health System CEO John P. Sheridan Jr. stabbed his wife to death, set their bedroom on fire, and then took his own life, authorities have concluded, closing a six-month investigation into the deaths that shocked New Jersey's political an...
Source: Health Care Renewal - April 1, 2015 Category: Health Management Tags: anechoic effect boards of trustees conflicts of interest Cooper Hospital/ UMC crime governance health care corruption hospital systems leadership Source Type: blogs

How do you shoot a troubled pacemaker ?
We have been taught right from first year cardiology residency  how to trouble shoot a pacemaker .It has been a real complex thing for us. Now looking  back ,all the troubles we took to understand seems to be redundant.Here is a summary of my thought process on the issue. It can be approached  with reference  to time, symptoms and ECG features.  With due respects to all those brainy hardworking   EP experts  , I have taken few academic liberties! Timing Within 24 hours -100% technical or procedural Issues , like lead dislodgement/Screws and nuts. Within 1-2 week – Again technical , Pocket issues , Infectio...
Source: Dr.S.Venkatesan MD - March 22, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology - Electrophysiology -Pacemaker Pace maker Tips and tricks atrial lead issues in ddd pacing best pacemaker tips and tricks capture failure pacemaker dc shock in pacing rhythm ddd vs vvi pacing intermittent pacemaker spikes pacema Source Type: blogs

I am confused sir , what is the hierarchy of medical advisories ?
In this era of synthesized evidence base,  one of my  intellectually aberrant  student asked  How can we indulge in  a popular coronary procedure   with  class 1 indication backed by level C evidence  ?   (As defined by  the seemingly invincible  guideline committee  of various  International cardiology organizations .) I told him , Institutional protocols are to be followed Guidelines are to be respected Recommendations are to be considered Please be reminded  all of the  above can be rejected  outright ! Finally , realise  Individual  decisions based on sound scientific understanding with zero non...
Source: Dr.S.Venkatesan MD - February 21, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology -guidelines Infrequently asked questions in cardiology (iFAQs) evidence based medicine guidelines vs recommendatios instituional protocols medical ethics Source Type: blogs

LITFL Review 168
Welcome to the 168th LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.The Most Fair Dinkum Ripper Beauts of the Week Those awesome Swedes. Not only do they host an excellent emergency ultrasound conference (SonoSweden), they livestream it free, and then save all the archives for all to see. That’s hours and hours of FREE ultrasound tutorial videos featuring Matt...
Source: Life in the Fast Lane - February 9, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Health Affairs Event Reminder: Biomedical Innovation
Biomedical innovation lengthens and enriches our lives through breakthroughs in medications and care, but it is has also been the leading source of health care cost growth over the past few decades. The February 2015 thematic issue of Health Affairs examines the topic from many perspectives. You are invited to join us on Thursday, February 5, at a forum featuring authors from the new issue at the W Hotel in Washington, DC. Panels will cover pharmaceuticals; biotechnology; medical devices; and accelerating, diffusing, and financing innovation. WHEN:  Thursday, February 5, 2015 9:00 a.m. – 12:30 p.m. WHERE:  W Hote...
Source: Health Affairs Blog - February 3, 2015 Category: Health Management Authors: Chris Fleming Tags: All Categories Biotech Health IT Innovation Policy Research Science and Health Technology HA_BiomedInnovation Source Type: blogs

Duke Cardiologist Robert Califf Named FDA Deputy Commissioner
FDA Commissioner Margaret A. Hamburg, M.D., on Tuesday appointed Robert Califf, M.D., a recognized global leader in cardiology and clinical research, as FDA Deputy Commissioner for Medical Products and Tobacco. In this position, Dr. Califf will be in charge of FDA’s Center for Drug Evaluation and Research, the Center for Biologics Evaluation and Research, the Center for Devices and Radiological Health, and the Center for Tobacco Products. He will also oversee the Office of Special Medical Programs in the Office of the Commissioner. “Dr. Califf will play a critical role in providing high-level advice and policy di...
Source: Policy and Medicine - January 28, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Some Older Hospitalized Heart Patients May Fare Better During Times Cardiologists Are Away Attending Their National Meetings?
<p><span style="line-height: 22.3999996185303px;">On December 22, 2014, </span><em style="line-height: 22.3999996185303px;">JAMA Internal Medicine</em><span style="line-height: 22.3999996185303px;"> published an article online titled “<a href="http://archinte.jamanetwork.com/article.aspx?articleid=2038979">Mortality and Treatment Patterns Among Patients Hospitalized With Acute Cardiovascular Conditions During Dates of National Cardiology Meetings</a>.” </span><span style="line-height: 22.3999996185303px;&#...
Source: blog.bioethics.net - January 8, 2015 Category: Medical Ethics Authors: Hayley Dittus-Doria Tags: Health Care Doctor-Patient Relationships Outcomes syndicated Source Type: blogs

Research and Reviews in the Fastlane 058
This study (n=60) randomized patients in the ED getting IV opioids to morphine (0.1 mg/kg) + placebo or morphine (0.1 mg/kg) + ketamine (group 1 0.15 or group 2 0.30 mg/kg). Patients in the ketamine arm had significantly decreased pain without significant adverse effects, although the group with the higher dose of ketamine had a seeming increase in side effects without added analgesic benefit. The literature is mounting that low dose ketamine has utility in the acute analgesia armamentarium but selecting the right population will likely be key (and more is not better). Recommended by: Lauren Westafer Further Listening: Cli...
Source: Life in the Fast Lane - November 20, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Education R&R in the FASTLANE Review Source Type: blogs

All For Gender Equality in Academic Medicine
This post is authored by Priya Kansal MD, FACC, director of the Women’s Heart Program at Salem Health in Oregon, and Bina Ahmed, MD, FACC, FSCAI, an assistant professor of interventional cardiology at the University of New Mexico School of … Continue reading → The post All For Gender Equality in Academic Medicine appeared first on ACC in Touch Blog.
Source: ACC in Touch Blog - November 14, 2014 Category: Cardiology Authors: Admin Tags: Membership Special Topics guest post Leadership/Professionalism women Source Type: blogs

Research and Reviews in the Fastlane 056
This article offers solutions in which he calls for a shift in the research mentality. The pearls: Focus on replication of research findings (and reward this) Broad collaboration and data sharing Altering the reward system for publication and academic advancement (i.e. reward not the number of publications but their impact; focus on the quality of peer review) Recommended by Lauren Westafer Resuscitation, Emergency MedicineSmekal D et al. CPR-related injuries after manual or mechanical chest compressions with the LUCAS™ device: A multicentre study of victims after unsuccessful resuscitation. Resuscitation 2014. PMID ...
Source: Life in the Fast Lane - November 4, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Cardiology Education Emergency Medicine Infectious Disease Intensive Care Neurology Neurosurgery R&R in the FASTLANE Resuscitation Wilderness Medicine acute coronary syndrome airway blood transfusion critical care ENT Review Source Type: blogs

LITFL Review 152
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. Welcome to the 152nd edition, brought to you by: Anand Swaminathan [AS] (EM Lyceum, iTeachEM) Brent Thoma [BT] (BoringEM and Academic Life in EM) Chris Connolly [CC] Chris Nickson [CN] ( iTeachEM, RAGE, INTENSIVE and SMACC) Joe-Anthony Rotella [JAR] Kane Guthrie [KG] Mat Goebel [MG] Segun Olusany...
Source: Life in the Fast Lane - October 14, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Review LITFL R/V Source Type: blogs

Research and Reviews in the Fastlane 051
Welcome to the 51st edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 10 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out...
Source: Life in the Fast Lane - October 6, 2014 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Cardiology Education Emergency Medicine Gastroenterology Infectious Disease Intensive Care Pre-hospital / Retrieval Respiratory Resuscitation critical care literature R&R in the FASTLANE recommendations Research an Source Type: blogs