Archive for category: Cardiovascular

Is This an Inferior STEMI or Pericarditis?

30 Nov
November 30, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: As emergency providers we must be smarter than our ECG machines. Many times subtle findings on ECGs are not read by the machine, but we must be the experts at making the distinction between findings that require emergent treatment versus more benign etiologies. One specific set of diagnoses […]

Does My Patient with Chest Pain Have Acute Coronary Syndrome?

23 Nov
November 23, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: We have already discussed the value of a good history in assessing patients with chest pain on REBEL EM. What is known about chest pain is that it is a common complaint presenting to EDs all over the world, but only a small percentage of these patients will […]

Why You Should More Than Consider a Vasopressin, Steroid, and Epinephrine (VSE) Cocktail

29 Oct
October 29, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketThe newly published 2015 AHA guidelines recommend that: “In IHCA, the combination of Vasopressin, Epinephrine, and Methylprednisolone and post-arrest Hydrocortisone as described by Mentzelopoulos et al. maybe considered; however, further studies are needed before recommending the routine use of this strategy (Class IIb, LOE C-LD)” Mentzelopoulos et al. [2][3] have […]

CPR in Out of Hospital Cardiac Arrest: Man vs Machine

26 Oct
October 26, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: In cardiac arrest, high quality, uninterrupted CPR is essential to help improve survival rates. In theory, mechanical CPR should provide CPR at a standard depth and rate for prolonged periods without a decline in quality, which should help improve survival and survival with good neurologic outcomes. There are […]

REBEL Cast Wee: Our Top 5 AHA 2015 Guideline Updates for CPR and ECC

22 Oct
October 22, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketIn case you have not heard or not read it on the twittersphere, the American Heart Association just released their 2015 Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) in Circulation. I am joined by Mr. Security, Matt Astin for this episode and we both read through […]

Catheter Directed Thrombolysis: The Magic Bullet for Submassive Pulmonary Embolism?

24 Sep
September 24, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: When evaluating therapeutic options for PE, there are three categories in my mind: Subsegmental, Submassive, and Massive. For simplicity sake lets just say subsegmental PEs get treated with anticoagulation and massive PEs get treated with thrombolysis. The submassive category is a bit trickier. For example the PEITHO trial […]

The REVERT Trial: A Modified Valsalva Maneuver to Convert SVT

14 Sep
September 14, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: In patients with cardiovascularly stable supraventricular tachycardia (SVT), the valsalva maneuver is recommended as an initial maneuver to help with cardioversion. The success rate of the valsalva maneuver alone is documented at 5 – 20%. The next option for patients who still remain in SVT is intravenous adenosine. […]

September 2015 REBELCast

07 Sep
September 7, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketWelcome to the September 2015 REBELCast, where Swami, Matt, and I are going to tackle a couple of topics in the world of Venous Thromboembolism (VTE). Seems like we are hearing more and more about VTE in terms of workup, management, etc. Lets face it, diagnosing someone with a pulmonary embolism […]

Beyond ACLS – POCUS in Cardiac Arrest

20 Aug
August 20, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketAs we have discussed in previous posts, the care of patients with cardiac arrest is a key skill for Emergency Providers. ACLS provides a foundation for care but is rife with shortcomings including, but not limited to, reliance on outdated data and inability to adapt in the face of […]

REBEL Cast Wee: Early Cardiac Catheterization in OHCA Survivors with Non-STEMI

03 Aug
August 3, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: We know that cardiac arrest is a devastating disease and that it occurs in approximately 400,000 Americans each year. In the few patients who achieve return of spontaneous circulation (ROSC) and survive past the pre-hospital stage, mortality rates range from 50 – 60% depending on which sources you […]

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