The Facebook group EM Docs, launched in April 2013, was started by a small group of friends and has become a forum to discuss common and uncommon issues and situations that emergency physicians face. It exploded in size and posting volume in October 2015 when it changed the settings to allow current EM Docs group members to invite their colleagues to its discussions. It’s empowering to have colleagues come together to share the joys and challenges of emergency medicine. Emergency physicians are fiercely passionate trailblazers with high expectations of themselves and others and are always advocates for patients.

As the EM Docs numbers have grown, the group has shared articles, crowd-sourced difficult cases, encouraged colleagues not to be bullied by attorneys, enjoyed emotional support after pediatric codes and full-moon shifts, laughed at one another’s sarcastic dark humor, shared success stories, and sent words of support with virtual pats on the back to say, “I’ve been there” when a colleague had a rough shift.

The discussions range from absurd and silly to life-changing because EM physicians can see this range on every shift and in their own lives. When a member gets a little out of line, other members declare a “meme war” (ie, they post “too numerous to count” funny captioned photos) until enough comic humor makes everyone forget the controversial post.

In this column, I plan to highlight and summarize some of the conversations for those who aren’t on Facebook. However, if you want to be included in the conversation, ask a colleague to add you. Chances are someone in your department is on EM Docs. There are currently more than 6,200 of us, representing every state and some countries outside the United States. I’ll maintain the privacy of the group, so there won’t be personal attribution or details provided in this column. I will, however, summarize the most interesting/impactful posts.

A Few Helpful Discussions

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Figure 1. ECG with a complete right coronary artery occlusion that was a STEMI equivalent with Sgarbossa criteria in a symptomatic patient.
PHOTO: TRENT STEPHENSON, DO.

Sgarbossa criteria: Remember that Sgarbossa criteria applies to paced rhythms as well as left bundle branch block (LBBB). Figure 1 shows an ECG with a paced rhythm that was an ST elevation myocardial infarction (STEMI) equivalent with Sgarbossa criteria in a symptomatic patient. Three criteria are included in Sgarbossa criteria:

• ST elevation ≥1 mm in a lead with a positive QRS complex (ie, concordance): 5 points
• ST depression ≥1 mm in lead V1, V2, or V3: 3 points
• ST elevation ≥5 mm in a lead with a negative (discordant) QRS complex: 2 points

≥3 points = 90 percent specificity of STEMI (sensitivity of 36 percent)