Archive

Rebel Category: REBEL EM

Clinical Conundrum: Should a Troponin Routinely be Ordered in Patients with SVT?

Bottom Line Up Top: Troponins should not be routinely sent in patients presenting with SVT. Rarely, they may be necessary if the patient has concerning ischemic symptoms that persist after conversion to sinus rhythm. Clinical Scenario: A 44-year-old man presents …

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Cardiovascular

Rosh Review EM Scholar Monthly Question

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Orthopedics

POCUS in the ED: Is Confirmatory RUQ US Still Necessary?

Background: Point of care ultrasound (POCUS) has a demonstrated sensitivity of 89.8% and specificity of 88.0% for identification of cholelithiasis and has a proven negative predictive value for ruling out other acute biliary pathology such as acute cholecystitis.1  It is …

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Abdominal and GastroinstestinalProcedures and Skills

The PACER Trial: Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia

Background: Bleeding complications are an uncommon but potentially a significant risk during central venous catheter (CVC) placement. Thrombocytopenia is associated with increased bleeding complications but there is no good-quality evidence showing that prophylactic platelet transfusions decrease that risk. Previous studies …

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Hematology and OncologyProcedures and Skills

Clinical Conundrum: Does IM Ketorolac Provide Superior Pain Relief to PO Ibuprofen?

Clinical Scenario: A 34-year-old woman presents to the ED with back pain. After your history and physical, you conclude that the patient’s pain is muscular in origin and likely secondary to heavy lifting while moving apartments. You contemplate analgesic options …

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Trauma

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