Archive for category: Cardiovascular

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 […]

Beyond ACLS: Pre-Charging the Defibrillator

24 Mar
March 24, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketPost Written By: Sam Ghali (Twitter: @EM_RESUS) In cardiac arrest care there has been a lot of focus over the years on limiting interruptions in chest compressions during CPR. In fact, this concept has become a major focus of the current AHA Guidelines. Why? Because we know interruptions are […]

Is ST-Segment Elevation in Lead aVR Getting Too Much Respect? with Amal Mattu

14 Mar
March 14, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketLead aVR is a commonly ignored lead and I have even heard of it referred to as the Rodney Dangerfield of ECG leads as it gets no respect. I have anecdotally heard many EM physicians activate the cath lab for STE in lead aVR and many cardiologists say that […]

Management and Disposition of Low Risk Chest Pain

18 Feb
February 18, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketChest Pain (CP) is a very common complaint seen in emergency departments around the world.  In the US specifically  anywhere from 8 – 10 million patients present to the ED complaining of CP.  Many use liberal testing strategies to prevent missing acute coronary syndrome (ACS) or other major adverse […]

Five ECG Patterns You Must Know

04 Feb
February 4, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: The electrocardiogram (ECG) is one of the most useful diagnostic studies for identification of acute coronary syndrome (ACS) and acute myocardial infarction (AMI). The classic teaching is ST-segment elevation myocardial infarction (STEMI) is defined as symptoms consistent with acute coronary syndrome (ACS) + new ST-segment elevation at the […]

Cardiocerebral Resuscitation: Hands-Only CPR

21 Jan
January 21, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketOne of the major reasons contributing to dismal survival rates in out-of-hospital cardiac arrest (OHCA) is the lack of bystander initiated cardiopulmonary resuscitation (CPR). Even though the majority of OHCA is witnessed, only 1 in 5 patients will receive bystander initiated CPR [1].  Survey studies have shown that bystanders […]

Modified Sgarbossa Criteria: Part Deux

11 Jan
January 11, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Left Bundle Branch Block (LBBB) on the ECG makes accurate recognition of ST-Elevation Myocardial Infarction (STEMI) rather difficult. The 1996 and 2004 American College of Cardiology/American Heart Association (ACC/AHA) STEMI guidelines recommended immediate reperfusion therapy for patients with potentially ischemic symptoms and new, or presumed new, LBBB. In […]

The Role of TEE in Cardiac Arrest

04 Jan
January 4, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Sudden cardiac arrest has very poor outcomes; less than 11% of patients in cardiac arrest in the Emergency Department survive to discharge from the hospital. The management of cardiac arrest is algorithmic because providers have limited tools at their disposal and limited knowledge of the patient’s past medical […]

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