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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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Question of the Day

What is the antidote for acute tylenol toxicity?

Answer

N-acetylcysteine
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Keeping it Peachy
Acute behavioural disturbance (ABD) includes agitation, violence, self-harm or delirium. Acute Behavioural Disturbance is not a diagnosis or syndrome, but rather a clinical manifestation with diverse presenting characteristics and potential aetiologies. It may result in risk of self-harm, harm to staff and to others and may require medical intervention to... Read more
Published on: 2025-08-11
Source: DONT FORGET THE BUBBLES
Pediatric Bloody Diarrhea: Recognition, Management of STEC Infection
When a child presents with bloody diarrhea, it could be more than a simple bug. Are you prepared to recognize the signs of STEC and prevent fatal HUS? The post Pediatric Bloody Diarrhea: Recognition, Management of STEC Infection appeared first on ACEP Now.... Read more
Published on: 2025-08-11
Source: ACEP Now
AI Scribes Enter the Emergency Department
Could AI scribes be the answer to ED physician burnout? This new tech is already cutting charting time, but what are the risks and rewards? The post AI Scribes Enter the Emergency Department appeared first on ACEP Now.... Read more
Published on: 2025-08-11
Source: ACEP Now
ACEP Member Uses ED, Military Training To Set Standards at FEMA
FEMA CMO Dr. Andre Pennardt explains how his military and emergency medicine career prepared him for a leadership role in disaster medicine. The post ACEP Member Uses ED, Military Training To Set Standards at FEMA appeared first on ACEP Now.... Read more
Published on: 2025-08-11
Source: ACEP Now
The Disappearing Doctor: Challenging the Provider Paradigm
Using "provider" instead of "doctor" or "physician" devalues the profession and erodes professional identity. It's time to reclaim the title. The post The Disappearing Doctor: Challenging the Provider Paradigm appeared first on ACEP Now.... Read more
Published on: 2025-08-11
Source: ACEP Now
The 93rd Bubblewrap x Southampton Children’s Paediatric ED
Have you been keeping up with the literature? The Bubble Wrap team have. The post The 93rd Bubblewrap x Southampton Children’s Paediatric ED appeared first on Don't Forget the Bubbles.... Read more
Published on: 2025-08-04
Source: DONT FORGET THE BUBBLES
What’s in The Drug Pipeline These Days?
A unique aspect of emergency medicine is being on the front lines of clinical care. We are... The post What’s in The Drug Pipeline These Days? appeared first on ACEP Now.... Read more
Published on: 2025-08-04
Source: ACEP Now
Bubble Wrap PLUS – August 2025
Time to look at what has been published in this month's Bubble Wrap Plus with Anke Raaijmakers and Prof .Jaan Toelen The post Bubble Wrap PLUS – August 2025 appeared first on Don't Forget the Bubbles.... Read more
Published on: 2025-08-04
Source: DONT FORGET THE BUBBLES
Implementation Science in Paediatric Intensive Care
Turning Knowledge into Practice for Critically Ill Children  What is the problem?? Each year, Paediatric intensive care units (PICUs) and transport teams in the UK provide lifesaving care for approximately 19,000 children. Mortality has remained static in recent years at around 3%. However, PICUs often face demand which exceeds supply.... Read more
Published on: 2025-07-28
Source: DONT FORGET THE BUBBLES
An Overview of Chest Trauma in Children
Chest trauma in children can result in serious injuries and poor outcomes. Managing chest injuries in children can be challenging, but being prepared makes all the difference. This overview will guide you through the key steps in assessing and managing paediatric chest trauma, with practical tips to help you stay... Read more
Published on: 2025-07-21
Source: DONT FORGET THE BUBBLES
What's behind the rise in wearable health tracking devices
NPR's Ailsa Chang talks with Adam Clark Estes of Vox about his new story out titled: "I Covered my body in health trackers for 6 months. It ruined my life."... Read more
Published on: 2025-06-15
Source: NPR
Ancient miasma theory may help explain Health Secretary Robert F. Kennedy Jr.'s vaccine moves
Health Secretary Robert F. Kennedy Jr. apparently embraces the outdated "miasma theory" of disease instead of the widely accept "germ theory" of disease, which may help explain some of the actions he's been taking.... Read more
Published on: 2025-06-15
Source: NPR
More than 400 CDC staff may be called back to work after being laid off in April
Laid off workers were told their notices of an upcoming reduction in force were "revoked." Officials didn't explain why HHS appeared to be restoring hundreds of jobs it previously called duplicative.... Read more
Published on: 2025-06-15
Source: NPR
Could humans' unique nasal 'fingerprints' give us information about our health?
Take a big inhale through your nose. Now, exhale. Breathing may seem simple, but it's controlled by a complex brain network. Each inhale gives the human brain information about the external world. And now, a new research paper in the journal Current Biology suggests that humans have unique breathing patterns,... Read more
Published on: 2025-06-15
Source: NPR
A doctor fired by RFK Jr. from the national vaccine advisory board speaks out
Health Secretary Robert F. Kennedy Jr. fired all the people serving on a national vaccine advisory board. NPR's Ayesha Rascoe speaks to Edwin Asturias, one of the doctors who was sacked.... Read more
Published on: 2025-06-15
Source: NPR
People told my dad not to bother educating his 4 daughters. He didn't listen
On Father's Day, Esther Ngumbi thinks of the sacrifices her Kenyan dad made to ensure that not only his son but his four daughters got an education. He'd say, "I choose to educate you, my girls."... Read more
Published on: 2025-06-15
Source: NPR
Advice for trying GLP-1 drugs for weight loss from a doctor who's been there
Former FDA chief Dr. David Kessler says the new weight-loss drugs are a powerful tool to fight obesity. But they come with pitfalls. Here's his tips for how to use them successfully.... Read more
Published on: 2025-06-15
Source: NPR
RFK Jr. sent Congress 'medical disinformation' to defend COVID vaccine schedule change
A document circulated to members of Congress misinterprets studies and cites debunked research, scientists say. It could influence congressional perceptions of vaccine safety.... Read more
Published on: 2025-06-14
Source: NPR
An AIDS orphan, a pastor and his frantic search for the meds that keep her alive
In the wake of U.S. aid cuts, Pastor Billy is reminded of his twin sister's death from AIDS. He doesn't want 9-year-old Diana, who's HIV-positive, to meet the same fate.... Read more
Published on: 2025-06-14
Source: NPR
RFK Jr. replaced everyone on the CDC's vaccine panel. Here's why that matters
It plays a big role in deciding which vaccines kids and adults get routinely, what's covered by insurance and which shots are made available free to low-income kids.... Read more
Published on: 2025-06-14
Source: NPR