Archive for category: Cardiovascular

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

15 Dec
December 15, 2016

Background: 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 and no STEMI is a bit […]

The REASON Trial: POCUS in Cardiac Arrest

08 Dec
December 8, 2016

Background: 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 bystander CPR, and ROSC in the […]

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

03 Nov
November 3, 2016

Submassive 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 suggests that systemic thrombolytics can improve […]

American College of Emergency Physicians (ACEP) Conference 2016

20 Oct
October 20, 2016

This 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 clinical pearls that I wanted to […]

Beyond ACLS: Cognitively Offloading During a Cardiac Arrest

22 Sep
September 22, 2016

Today 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 (CA) or other cardiopulmonary emergencies. This […]

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