Archive for category: Cardiovascular

Are we Missing Acute MIs with Clinical Risk Scores?

13 Apr
April 13, 2017

Background: In 2011, we saw 7 million patients in the emergency department (ED) complaining of chest pain. Most of these patients did NOT have an acute coronary syndrome (ACS) or an acute myocardial infarction (AMI). Missing an AMI is one of the biggest fears we have in the ED. By using validated risk scores, we can […]

Is the Future of Non-Invasive Hemodynamic Monitoring Here and Ready for Primetime?

06 Apr
April 6, 2017

Background: Many physicians struggle with monitoring accurate continuous blood pressures, cardiac output, and response to fluids in patient resuscitation. Also, due to the invasive nature of most methods presently available (i.e. arterial lines, etc) few patients get this monitoring. Ultrasound has been an amazing addition to our armamentarium, but many, I am sad to say, […]

Triage ECGs: Reducing Interruptions in a Busy ED

09 Mar
March 9, 2017

Background: Lets face it. All of us have been interrupted by the onslaught of triage ECGs for interpretation.  This constant flow of pink paper with black scribble causes frequent task switching, interrupts train of thought, and ultimately can lead to medical errors, which affects the patients in front of us.  On the other hand, it […]

February 2017 REBEL Cast: The All Hyperoxia Edition

20 Feb
February 20, 2017

Background: Many providers and health care workers place oxygen on patients as a way to overcome hypoxemia or for patient comfort. Also in STEMI patients, many of us have learned the mnemonic “MONA” to remember the treatments for acute coronary syndrome. MONA stands for morphine, oxygen, nitroglycerin, and aspirin. It is however important to remember […]

Outcomes After Aggressive Management of Recent-Onset Atrial Fibrillation in the ED

13 Feb
February 13, 2017

Background: Atrial fibrillation (AF) is one of the most common dysrhythmias encountered in the ED. The management of recent-onset AF and atrial flutter (AFl) in the ED continues to be debated. The discussion centers on whether patients with recent-onset AF should be rhythm controlled (e.g. converted back to sinus rhythm) or rate controlled only. This […]

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