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The Critical Pulmonary Embolism Patient

Background: Previously, I had given a talk on the use of thrombolytics in submassive PE in 2016. This year, I had the privilege of speaking at ACOEP 2017 again with an update on the critical pulmonary embolism patient. This post ...

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Thoracic and Respiratory

The Death of MONA in ACS: Part IV – Aspirin

Background: Aspirin is the most widely used antiplatelet agent in acute coronary syndromes.  The bulk of the evidence for this came from the second international study of infarct survival (ISIS-2) published in the Lancet in 1988.

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Cardiovascular

The Death of MONA in ACS: Part III – Nitroglycerin

Background: Nitroglycerin is a first line agent in the treatment of ACS. The physiologic basis for it’s use rests on it’s ability to promote coronary vasodilation resulting in increased blood flow to the coronary arteries . Nitroglycerin, is typically given ...

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Cardiovascular

The Death of MONA in ACS: Part II – Oxygen

Background: The first report for supplemental oxygen for angina was in 1900, and since then oxygen therapy has been a commonly used treatment of patients with ST-Elevation Myocardial Infarction (STEMI).  The reason for this is the belief that supplemental oxygen ...

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Cardiovascular

The Death of MONA in ACS: Part I – Morphine

Background: Morphine is a commonly used medication in acute coronary syndromes (ACS) to help relieve pain which in turn can help reduce sympathetic tone.  Over the past few years however, there has been some concern raised about the drug-drug interactions ...

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Cardiovascular

Acetaminophen vs. Diclofenac vs. Combo for Acute MSK Pain

Background: Acute, minor musculoskeletal injuries (i.e. non-fracture or dislocations) are frequently seen in the Emergency Department. Aside from ruling out a more severe injury, management often focuses on pain relief or mitigation of pain. Though many analgesic agents exist, acetaminophen ...

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Orthopedics

NSTEMIs Are Not All the Same

Background: Acute coronary syndrome (ACS) is a true spectrum of disease: STEMI, NSTEMI, Unstable Angina (UA), and Stable Angina (SA).  The history and physical plus ECG help us to differentiate patients with STEMI from NSTEMI.  Classically, STEMI represents complete occlusion ...

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Cardiovascular

REBEL Cast Episode 41: Research From the Past Year – Resuscitation

Welcome back to Episode 41 of REBEL Cast. In this episode, we will be discussing some studies from the past year that caught our attention in the area of resuscitation. Again, this 3 part series will be dedicated to discussing ...

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The ADvISED Trial: A Novel Clinical Algorithm for the Diagnosis of Acute Aortic Syndromes

Background: Acute Aortic Syndromes (AAS) are life threatening cardiovascular emergencies that are the bane of every emergency physician’s existence.  They are diagnostic challenges due to the clinical presentation being highly non-specific.  Computed tomography angiography (CTA), Transesophageal Echocardiography (TEE), and Magnetic ...

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Cardiovascular

REBEL Cast Episode 40: Research From the Past Year – Pain Control

Welcome back to Episode 40 of REBEL Cast. We have taken some time off but don’t worry, we are back.  In this episode, we will be discussing some studies from the past year that caught our attention, dealing with pain ...

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Trauma
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