30 May 2019

May 30, 2019

Written by REBEL EM

Background: Syncope, defined as a transient loss of consciousness with spontaneous and complete recovery to pre-event status, is a common emergency department (ED) presentation. Recently, we have discussed the lack of clinical utility in distinguishing syncope from near-syncope in terms of outcomes. In that discussion, we concluded: “In older adults (> 60 years of age), near-syncope appears to portend an equal risk of death or serious clinical event at 30 days when compared to syncope. These two entities should be considered as one when decisions are made in terms of evaluation in the ED.” While we argue for evaluation and disposition to be the same, we don’t address what the best disposition or plan is. While it is common to admit older patients with syncope/near-syncope from the ED, admission doesn’t inherently yield better outcomes.

Medical Categories: Cardiovascular
0 Likes
23 May 2019

May 23, 2019

Written by REBEL Crit
Background: The clinical importance of immediate coronary angiography, with subsequent percutaneous coronary intervention (PCI) in OHCA patients without STEMI is a matter of debate.  We have already covered the COACT trial on REBEL EM, but this is a second study, the pilot phase of the DISCO trial, assessing immediate vs delayed coronary angiography in patients with OHCA and without STEMI on ECG.
Medical Categories: Cardiovascular, Resuscitation
1 Like
20 May 2019

May 20, 2019

Written by REBEL EM
Background: Atrial fibrillation (AF) is a common cardiac dysrhythmia encountered in the emergency department (ED), affecting 2.7 million - 6.1 million Americans annually. Hospitalizations with AF as the primary diagnosis total >467,000 annually. AF is associated with a 5-fold increased risk of ischemic stroke, a 3-fold increase in risk of heart failure, and a 2-fold increased risk of mortality. (1) Previous RCTs comparing outcomes of rhythm-control using antiarrhythmics with rate-control in patients with AF failed to show a benefit of rhythm control on mortality. (2,3) However, for some patients, rhythm control improves symptoms and is associated with a better quality of life. (4) Given that up to 70% of AF terminates spontaneously within 24 hours, can we adopt a delayed, or wait-and-see (WAS), approach to AF in the ED and avoid early cardioversion? (5).
Medical Categories: Cardiovascular
1 Like
15 May 2019

May 15, 2019

Written by REBEL EM
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.
Medical Categories: Cardiovascular, Neurology, Thoracic and Respiratory
0 Likes
14 May 2019

May 14, 2019

Written by REBEL EM

 

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.

Medical Categories: Cardiovascular, Infectious Disease
2 Likes
en English
zh-CN Chinese (Simplified)en Englishfr Frenchde Germanit Italianpt Portugueseru Russianes Spanishtr Turkish
0