May 15, 2019

Essentials of Emergency Medicine 2019 is taking place at the Cosmopolitan Hotel/Casino in Las Vegas, NV. I was asked to give five lectures on varying topics and wanted to share what was discussed at each of these sessions.  If you haven't been to Essentials of Emergency Medicine, you need to add this conference to your list of conferences to attend.  The organizers pride themselves in discussing the latest practice-changing research and have meticulously designed content to maximize enjoyment and retention. In my humble opinion this conference is the quintessential medutainment extravaganza that applies learning theory principles, with amazing speakers, to provide you with the latest and greatest for clinical practice.

May 14, 2019

 

Essentials of Emergency Medicine 2019 is taking place at the Cosmopolitan Hotel/Casino in Las Vegas, NV. I was asked to give five lectures on varying topics and wanted to share what I discussed at each of these sessions.  If you haven't been to Essentials of Emergency Medicine, you need to add this conference to your list of conferences to attend.  The organizers pride themselves in discussing the latest practice-changing research and have meticulously designed content to maximize enjoyment and retention. In my humble opinion this conference is the quintessential medutainment extravaganza that applies learning theory principles, with amazing speakers, to provide you with the latest and greatest for clinical practice.

May 13, 2019

Background: Post-ROSC care is a multifaceted endeavor that includes targeted temperature management (TTM), vital-organ support, and treatment of the underlying cause of arrest. One of the most common causes of cardiac arrest is acute coronary syndrome.  Current European and American guidelines recommend immediate coronary angiography with PCI in patients who present with cardiac arrest due to STEMI. However, in patients with cardiac arrest who do not have STEMI, the role of immediate coronary angiography is still up for debate.  The ACC/AHA published a statement in July of 2015 (Covered on REBEL EM) that proposed an algorithm to stratify cardiac arrest patients who are comatose on presentation for emergent coronary angiography and possible PCI. 

April 22, 2019

Background: Syncope and presyncope are common presenting complaints to the Emergency Department. Orthostatic vital signs are often included in the ED evaluation of syncope to assess for volume depletion despite their poor performance characteristics as previously discussed. In particular, it is important to understand that older adults often have abnormal orthostatic vitals at baseline,  due to numerous causes including medications, despite having a normal physiologic state (Ooi 1997, Aronow 1988). In spite of the evidence, orthostatic vital signs measurements continue to be recommended by the AHA/ACC/HRS guidelines (Shen 2017) and occupy valuable provider and nursing time.

March 14, 2019

Background: Chest pain is a complaint commonly seen in the emergency department.  Getting a good history is an essential part of working up patients with chest pain, as the history may guide us to be concerned for the cause of life-threatening chest pain including, pulmonary embolism, aortic dissection, tension pneumothorax, or acute coronary syndrome. In regard to acute coronary syndrome, many of us learned that the classic description of ischemic chest pain was chest pressure radiating to the left arm.  But as sometimes is the case, classic teachings are based on antiquated evidence and simply not correct.
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