Archive for category: Clinical

Ultrasound for Detection of Pneumothorax

16 Jun
June 16, 2014

Typically, the initial evaluation of blunt trauma patients involves a supine anteroposterior (AP) chest x-ray (CXR) which has a poor sensitivity for the detection of pneumothorax (PTX), and has been reported as low as 20% – 48%. Following the CXR computed tomography (CT) has been the standard for the diagnosis of pneumothorax. The use of ultrasonography to […]

Critical Care Horizons

11 Jun
June 11, 2014

Please welcome a new development in critical care publishing with the launch of a new open access critical care journal: CRITICAL CARE HORIZONS!!!  This will be a fresh, new, original voice in the critical care literature, offering thought provoking, cutting-edge commentary, opinion papers, plus state-of-the art review articles.

R.E.B.E.L. ECG of the Week: LBBB and STEMI

09 Jun
June 9, 2014

R.E.B.E.L. ECG of the Week

89 year old male with PMH of hypertension, stage 3 chronic kidney disease with chief complaint of shortness of breath. Several days ago patient had a laminectomy for radicular pain. He was doing fine post-operatively and began to develop gradual shortness of breath.  He had no complaints of chest pain, nausea/vomiting, fevers, diaphoresis, but did have some weakness.  There were no prior ECGs for comparison.

BP: 98/48 HR: 103 RR: 18 O2 on RA: 94% Temp: 38.6

JVD to the angle of the mandible
Bibasilar Crackles
Sinus Tachycardia
Bilateral lower extremity pitting edema

Labs: Na 125, K+ 4.2, Creatinine 2, BNP > 2500

ECG from triage is shown… Read more →

Left Ventricular Assist Device

29 May
May 29, 2014

The first left ventricular assist device (LVAD) was performed in 1984 and since that time there is an increasingly growing population of patients with LVADs.  This means ED physicians will be seeing more and more of these patients in the ED and should have a basic understanding of how these devices work and have an […]

Rivaroxaban for Treatment of Symptomatic Pulmonary Embolism

26 May
May 26, 2014

Typically, the treatment of acute pulmonary embolism consists of administration of unfractionated heparin or low molecular weight heparin (i.e. enoxaparin) overlapped with vitamin K antagonists (i.e. warfarin).  This can be a very effective treatment regimen, but also very complex.  New direct Xa inhibitors are being used more and more in clinical practice with prevention of venothromboembolism […]

Optimization WordPress Plugins & Solutions by W3 EDGE