Archive for category: Cardiovascular

The PEAPETT Trial: Half Dose tPA for PEA due to Massive Pulmonary Embolism

05 Jan
January 5, 2017

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Anyone who has run a code, knows that pulseless electrical activity (PEA) during cardiac arrest has a worse prognosis compared to patients with shockable rhythms.  In patients with suspected massive PE as the cause of their cardiac arrest the Advanced Cardiac Life Support (ACLS) and American Heart Association […]

December 2016 REBEL Cast: Obstructive Left Main Coronary Artery Disease

19 Dec
December 19, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketThe standard treatment for patients with obstructive left main coronary artery disease has typically been coronary-artery bypass grafting (CABG), however some newer trials have suggested that maybe drug-eluting stents may be an acceptable alternative to CABG in select patients. In this episode we will be reviewing the two most […]

Cardiac Arrest, Return of Spontaneous Circulation (ROSC) With No ST-Segment Elevation on ECG. Now What?

15 Dec
December 15, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: The American Heart Association/American College of Cardiology (AHA/ACC) give a Class I recommendation for activation of the cardiac catheterization lab in patients with out-of-hospital cardiac arrest (OHCA) whom ST-segment elevation myocardial infarction (STEMI) is present.  The evidence for early cardiac catheterization in patients after cardiac arrest, with ROSC […]

The REASON Trial: POCUS in Cardiac Arrest

08 Dec
December 8, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: For many emergency providers, POCUS has become a critical modality in the resuscitation of patients with cardiac arrest. The authors of this paper (The REASON Trial) state that <8% of all OHCA’s survive to hospital discharge; a dismal number.  We already know that shockable rhythms, early defibrillation, early […]

Treatment of Submassive Pulmonary Embolism (PE): Full Dose, Half Dose, or No Dose?

03 Nov
November 3, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketSubmassive pulmonary embolism (PE) is responsible for approximately 20% of all PEs.  Although the in-hospital mortality has been reported as about 5%, there is significant morbidity associated with this diagnosis such as chronic pulmonary hypertension, impaired quality of life, persistent right ventricular disfunction, and recurrent venous thromboembolism.  The literature […]

American College of Emergency Physicians (ACEP) Conference 2016

20 Oct
October 20, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketThis years ACEP 2016 conference took place in Las Vegas, NV from Oct 16th – 19th.  There was greater than 350 courses, labs, and workshops given throughout the week.  It was impossible to make all of these great lectures, but I was able to take away some very important […]

Beyond ACLS: Cognitively Offloading During a Cardiac Arrest

22 Sep
September 22, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketToday I am giving a talk at the 25th National Emergency Medicine Symposium by Kaiser Permanente in Maui, HI.  The focus of this talk was on how to cognitively offload our minds as we are running a resuscitation. ACLS provides us with a framework in treating adult victims of Cardiac Arrest […]

REBELCast: The PROCAMIO Trial – IV Procainamide vs IV Amiodarone for the Acute Treatment of Stable Wide Complex Tachycardia

15 Aug
August 15, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: In the ACLS guidelines stable Ventricular Tachycardia (VT) can be treated with either IV amiodarone or IV procainamide, as the drugs of choice. This has been given a class II recommendation, but there has not been a controlled prospective trial to base the use of one drug over […]

Macrolide Antibiotics, Prolonged QTc, and Ventricular Dysrhythmias

08 Aug
August 8, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: When it comes to treating community acquired respiratory tract infections, macrolide antibiotics (azithromycin, clarithromycin, and erythromycin) are a common choice of agent. In 2010, 57.4 million macrolide prescriptions were written in the U.S. with azithromycin being the most commonly prescribed individual antibiotic agent overall with ~51.5 million prescriptions (Hicks […]

Predicting Fluid Responsiveness by Passive Leg Raise (PLR)

23 Jun
June 23, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: The best way to resuscitate critically ill patients with fluids has been a hotly debated topic in the FOAMed and Critical Care worlds. Fluids are important to optimize stroke volume and distal tissue perfusion, however, the administration of excessive fluids for shock can increase a patient’s morbidity and mortality […]

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