Jack (EMNote)
@jackcfchong
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Creator of EMNote YouTube - free, focused, and facts.
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Joined May 2010
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Rapid sequence intubation.
See more teaching contents at:
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The ACLS bradycardia algorithm has been updated in 2020:
Atropine was increased from 0.5 mg to 1 mg. Give 1 mg for the first dose and then repeat every 3-5 minutes at the 1 mg dose.
The dopamine infusion rate was changed to 5-20 mcg/kg/min. The previous rate was 2-20 mcg/kg/min.
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The 1st-hour sepsis bundle:
1. Lactate.
2. Cultures.
3. Antibiotics.
4. Fluids.
5. Norepinephrine.
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Motor hand exam - quick tips!
- Ulnar nerve: "peace sign"
- Radial nerve: "thumbs up sign"
- Median nerve: "fist and OK signs"
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ECG cheat sheet.
More teaching contents:
ECG Quiz for ACLS and Clinical Practice.
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16 important ECG patterns that should not be missed.
More ECG lecture:
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Sgarbossa Criteria:
Used to diagnose infarction (score 3 or above) in LBBB:
- Concordant ST elevation > 1mm in leads with a +ve QRS (score 5).
- Concordant ST depression > 1 mm in V1-V3 (score 3).
Excessively discordant ST elevation > 5 mm in leads with a -ve QRS (score 2).
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The "4P's" that cause pinpoint pupils:
P: Pain killer - opioids/heroin
P: Phosphate - organophosphate
P: Pons - pontine hemorrhage
P: Pilocarpine - glaucoma eye-drop
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Management of hyponatremia.
Search YouTube for “EM Note”
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Medication choices of atrial fibrillation with rapid ventricular response.
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The Sepsis Guidelines emphasize on early administering broad-spectrum antibiotics, appropriate fluid resuscitation, measuring lactate, and initiating vasopressors if clinically indicated within the first hour of sepsis recognition.
See more teaching at:
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ST elevation not always STEMI.
Click this link to learn ECGs that mimic STEMI:
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Top 6 Teaching Videos:
1. Traumatic cardiac arrest:
2. ACLS Pretest:
3. ECG Quiz:
4. Airway Tips:
5. ACLS Megacode:
6. ACLS Rhythm Test:
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Needle decompression for treatment of tension pneumothorax.
Tension pneumothorax, bulla, and gastrothorax.
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Management of thyroid storm:
1. Glucocorticoids.
2. Iodines.
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Intravenous magnesium sulfate (MgSO4) appears to be an effective adjunct treatment for managing rapid atrial fibrillation (Afib/RVR) in the emergency department.
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Progressive changes of EVG and cardiac markers after STEMI.
ACLS Quiz:
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Mnemonic 4 Pediatric "tube" sizes!
1 x ETT = (age/4) + 4 (uncuffed)
2 x ETT = NG/ OG/foley size
3 x ETT = depth of ETT insertion
4 x ETT = chest tube size
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Common causes of scrotal pain include:
■ Testicular torsion.
■ Epididymitis.
■ Orchitis.
■ Torsion of appendix testis.
■ Incarcerated inguinal hernia.
■ Urolithiasis.
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BP control for emergency conditions. ■ More teaching contents at:
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ST segment depression in myocardial ischemia and differential diagnoses.
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Sepsis Management Tips:
1. Fluids (30 cc/kg).
2. Nnorepinephrine.
3. Steroids (for refractory shock).
4. Broad-spectrum antibiotics.
5. Packed RBCs (if Hb <7).
6. Source control (within 12 h).
7. Tidal volume 6 cc/kg.
8. MAP 65 mmHg, lactate normal.
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2024 Focused Update: Guidelines on Use of Corticosteroids.
DOI: 10.1097/CCM.0000000000006172
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Synchronized cardioversion and defibrillation in pediatric patients.
Synchronized Cardioversion:
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May occur in hemorrhagic pancreatitis or any other causes of retroperitoneal bleeding.
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Euglycemic DKA.
Euglycemic diabetic ketoacidosis (EDKA) can occur in both type 1 and type 2 diabetes mellitus, in association with the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors.
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Asthma management infographic.
Airway management tips:
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Kounis syndrome (KS) is a condition where acute coronary syndrome (ACS) occurs secondary to an allergic or hypersensitivity insult as a result of mast cell activation and release of inflammatory mediators, which leads to coronary artery vasospasm and/or plaque rupture.
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Cardiac arrest due to asthma.
More teaching contents at:
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BP targets for hypertensive emergency treatment.
Hypertensive Emergency Made Easy.
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Magnesium for Rapid Atrial Fibrillation.
Consider adding IV MgSO4 if rapid A-fib responses poorly to IV diltiazem.
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Steroids for Pneumonia.
For patients with severe CAP, and without contraindications to steroids, a course of hydrocortisone of 200 mg intravenous daily for 4 or 7 days, alongside antibiotics,showed a 6% mortality benefit.
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Updates available: For those who are preparing for the ACLS exam.
ACLS Training Video Playlist.
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Ramp Position for Intubation.
In the ramp position, the patient's head and upper back are elevated on a wedge or with blankets/pillows to achieve a straight alignment between the external ear canal and the sternal notch.
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Key findings to suggest cholecystitis:
- Gallstones.
- Sonographic Murphy's Sign.
- Thickened Gallbladder Wall >3mm.
- Pericholecystitic Fluid.
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Common types of anemia include iron-deficiency anemia, vitamin B12-deficiency anemia, hemolytic anemia, and aplastic anemia. If left untreated, anemia can lead to severe tiredness, pregnancy complications, and heart problems. Iron-deficiency anemia is the most common type.
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Brugada syndrome is a rare but potentially life-threatening heart rhythm condition that can cause fainting, seizures and sudden cardiac arrest. It is caused by a genetic mutation that affects the electrical activity of the heart.
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Respiratory emergencies.
10 Tips for Croup Management
Bronchiolitis
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Sympathetic Crashing Acute Pulmonary Edema (SCAPE) is different from fluid overload subacute pulmonary edema (FOSPE).
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