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VEGAS BROWN, MD FAAEM FACEP

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EKG Pearl: Hyperkalemia and Peaked T Waves
Pearl: One of the earliest EKG changes in hyperkalemia is tall, peaked T waves, especially prominent in the precordial leads (V2–V4). As potassium levels rise further, P waves may flatten, QRS complexes widen, and eventually sine-wave patterns can develop, leading to cardiac arrest.
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EKG Pearl: Wellens' Syndrome
Pearl: Wellens' Syndrome is a sign of critical stenosis of the left anterior descending (LAD) artery and indicates a high risk for an extensive anterior wall myocardial infarction. It is characterized by: Deeply inverted or biphasic T waves in leads V2 and V3 Minimal or no ST elevation Normal or slightly elevated cardiac enzymes
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EKG Pearl: Brugada Pattern
Pearl: Brugada Syndrome is associated with a risk of sudden cardiac death due to ventricular arrhythmias. The classic Type 1 Brugada pattern shows: Coved ST-segment elevation ≥2 mm in ≥1 of leads V1–V3 Followed by a negative T wave No structural heart disease
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EKG Pearl: Pericarditis
Pearl: Acute pericarditis classically progresses through four stages on the EKG: Stage 1: Diffuse ST elevation and PR depression (especially in leads I, II, V3–V6) Stage 2: Pseudo-normalization of the ST segments Stage 3: T wave inversion Stage 4: Resolution of EKG changes
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Bedside cardiac ultrasound evaluation of a young male with chest pain
The Evil Twin: The Case of Heterotopic Pregnancy
Diagnosis of a Traumatic Lens Subluxation with Point-of-Care Ocular Ultrasound

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The Life of Vegas
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Question of the Day

What is the antidote for acute tylenol toxicity?

Answer

N-acetylcysteine
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34 health systems with strong finances
Here are 34 health systems with strong operational metrics and solid financial positions, according to reports from credit rating agencies Fitch Ratings and Moody’s Investors Service released in 2025. Note: This is not an exhaustive list. Health systems were compiled from credit rating reports. Ann & Robert H. Lurie Children’s... Read more
Published on: 2025-05-20
Source: Becker's Hospital Review
These Democratic governors are trying to curb health care for unauthorized immigrants
After expanding state Medicaid programs to cover people in the country without legal status, Democrats are considering changes that would reduce immigrant access.... Read more
Published on: 2025-05-20
Source: NPR
A pickled pepper maker knows exactly how hard it is to switch to natural food dyes
The MAHA movement loves the idea of getting rid of synthetic dyes in foods. But manufacturers face challenges that could drive prices higher.... Read more
Published on: 2025-05-20
Source: NPR
Protein for strength training? Vegan diet matches meat for muscle gains
If you're trying to build muscle, getting enough protein is a must. But does it matter if that protein comes from meat or plants? A new study overturns assumptions.... Read more
Published on: 2025-05-20
Source: NPR
How treatable is prostate cancer? A doctor reacts to Biden's diagnosis
Prostate cancer is one of the most common types of cancer in the U.S., and often treatable. One urologist says Biden has good options ahead — largely thanks to recent advances in research.... Read more
Published on: 2025-05-20
Source: NPR
Doctors urged to treat pain for IUD insertion and other procedures
A major medical group now recommends pain-blocking treatments for IUD insertion and other procedures amid a growing recognition that women's pain should be treated.... Read more
Published on: 2025-05-20
Source: NPR
New book alleges Biden aides hid his decline
Joe Biden has stage four metastatic prostate cancer.The former president made that announcement Sunday afternoon. It came just days before the publication of "Original Sin: President Biden's Decline, Its Cover-up and His Disastrous Choice to Run Again."An explosive book by journalists Jake Tapper and Alex Thompson. Original Sin chronicles what... Read more
Published on: 2025-05-20
Source: NPR
5 eating habits that can help you sleep better at night
What you eat during the day can affect how well you sleep at night. Sleep researchers explain the impact of diet, caffeine and alcohol on sleep health, and share a list of sleep-supporting foods.... Read more
Published on: 2025-05-20
Source: NPR
For the first time, the U.S. is absent from WHO's annual assembly. What's the impact?
In the wake of President Trump's decision to withdraw from the World Health Organization, the agency is holding its first major meeting. How will that affect WHO — and the United States?... Read more
Published on: 2025-05-20
Source: NPR
What it means to have prostate cancer today
Former President Biden's diagnosis spotlights both advances and challenges with the disease.... Read more
Published on: 2025-05-20
Source: NPR
Trump suggests without evidence that Biden delayed sharing his cancer diagnosis
President Trump was gracious on Sunday when former President Joe Biden announced his cancer diagnosis. But on Monday, Trump quickly pivoted to allege, without evidence, that there had been a cover-up.... Read more
Published on: 2025-05-20
Source: NPR
Health system bad debt piles up: 5 things to know
U.S. hospitals and health systems in many regions are seeing a sharp rise in uncompensated care, with new data showing big increases in bad debt and charity care deductions during the first quarter of 2025. “Disruptions in health insurance coverage can drive increases in bad debt and charity care deductions... Read more
Published on: 2025-05-19
Source: Becker's Hospital Review
Michigan Medicine joins Longitude Health: 4 notes
Ann Arbor-based Michigan Medicine has joined Longitude Health, marking the first new addition to the health system-led innovation collaborative since its creation in 2024.  Four things to know: 1. Four nonprofit systems launched Longitude Heath in October 2024 to tackle healthcare’s most pressing challenges by combining their resources and expertise.... Read more
Published on: 2025-05-19
Source: Becker's Hospital Review
Oregon hospital taps COO
James Roundtree, BSN, RN, was appointed COO of PeaceHealth Sacred Heart Medical Center at RiverBend in Springfield, Ore., effective June 2.  Mr. Roundtree will join RiverBend from Washington Regional Medical Center in Fayetteville, Ark., where he was vice president of surgical and cardiovascular services, according to a May 16 hospital... Read more
Published on: 2025-05-19
Source: Becker's Hospital Review
Children’s Hospital of Philadelphia CFO’s growth game plan
At Children’s Hospital of Philadelphia, Executive Vice President and CFO Sophia Holder is entering her fifth year in the role with pediatric growth opportunities on her mind, and a goal of continuing to drive access and innovation across the system.  Ms. Holder told Becker’s during a CFO+Revenue Cycle Podcast episode... Read more
Published on: 2025-05-19
Source: Becker's Hospital Review
A snapshot of the 2024 PEM MSc dissertations
In 2021, we welcomed our first cohort of doctors, nurses, and paramedics from across the world onto the PEM MSc. This online MSc is undertaken over three years and covers the full range of PEM presentations. In the final year, students use the skills they have learned in knowledge translation... Read more
Published on: 2025-05-19
Source: DONT FORGET THE BUBBLES
Ten More Things I’ve Learned From My Transgender Child
I walked down Karangahape Road to meet an old friend for dinner the other night.  For those unfamiliar with the so-called “K Road”, it’s a vibrant, bustling, noisy street in the heart of Auckland, a hub of diversity and colour.  When I was a kid, it was the strip club... Read more
Published on: 2025-05-16
Source: DONT FORGET THE BUBBLES
Apply Today: ACEP Now Is Recruiting Next Resident Fellow
ACEP Now is looking for its next resident to join our editorial team. The position is open... The post Apply Today: ACEP Now Is Recruiting Next Resident Fellow appeared first on ACEP Now.... Read more
Published on: 2025-05-15
Source: ACEP Now
Imaging in paediatric trauma- what’s new?
It’s the first week of your new placement in the Emergency Department of a Paediatric Major Trauma Centre. You’ve just finished discharging your third case of flu that day when the red phone rings – a 14-year-old child has been stabbed in the chest and is severely injured. The nurse... Read more
Published on: 2025-05-12
Source: DONT FORGET THE BUBBLES
Influenza, Muscle Pain, and an Elevated Serum Creatine Kinase
The best questions often stem from the inquisitive learner. As educators, we love—and are always humbled—by those... The post Influenza, Muscle Pain, and an Elevated Serum Creatine Kinase appeared first on ACEP Now.... Read more
Published on: 2025-05-10
Source: ACEP Now