Thanks to Dr. Freedman for today’s Morning Report! Part 1: ECG Findings of Hypokalemia First some definitions: Mild: K < 3.5 mmol/L Moderate: K < 3.0 Severe: K < 2.5 ECG Changes: Typically appear at ~2.7 Increased amplitude and duration of P wave PR prolongation T wave Read more…
Dr. Grock presents today’s Morning Report! The Case: 65 M h/o HTN, CHF w/ EF 25% with AICD presents s/p 3 shocks. Appears well. ECG: LBBB unchanged without any other scariness. What do you do? (IV/O2,Cards for device interrogation, Check lytes (ca, k, mag), (cbc?/Trop?)) Cards interrogates: three runs of Read more…
It seems like only yesterday, I was writing about the silliness of some order set (link) with a one-click stop for amylase, lipase, and ketones. Now, for another. In some hospitals, a single, “cardiac markers” click orders troponin I and a CK with a reflex to CK-MB. Two tests in Read more…
Cardiac Tamponade and Pericardiocentesis Summary by Dr. Kaycie Corburn Presented by Dr. Sally Bogoch The Case: 60 yo M PMH metastatic lung cancer, HTN, DM, former smoker presents to the ED with acute onset shortness of breath. Vitals in triage revealed tachypnea and tachycardia. Initial work-up revealed low voltage on EKG, Read more…
Congratulations Dr. Adesina! and thanks for the Morning Report! Management of Submassive (Intermediate Risk) PE Massive PE (high risk): acute PE causing hemodynamic instability and hypotension, pulselessness, or profound bradycardia Submassive PE (intermediate risk): hemodynamically stable PE w/ right ventricular dysfunction (RVD) or myocardial necrosis. Low Read more…
Hey Thanks to Dr. Grock for today’s Morning Report! Case 1: 75 year old female with pmhx DVT no longer on Coumadin, recent radical mastectomy currently on chemo/rad for breast cancer presents after long flight with pleuritic chest pain and shortness of breath. She is tachycardic, tachypnic, and hypoxic. Read more…
EMS notification. 115 year old female in cardiac arrest. ACLS in progress. Estimated time of arrival: 5 minutes. Your stomach groans. Upon EMS arrival, you learn that she comes from a nursing facility and has end-stage dementia; she is bed-bound, contracted and non-verbal. Maybe she’s got a PEG tube or Read more…
Thanks to Dr. Kong for presenting today’s Morning Report!
Quick case: It’s 3am. A 55yM, with a pmhx of chubbiness, DM, HTN is brought in by EMS after being found down. He is pulse-less, with an initial rhythm of ventricular fibrillation. He is shocked appropriately and exquisite ACLS is performed. He regains pulses 20 minutes after EMS arrival…Now Read more…
The debate on the treatment of circulatory shock is over(-ish?). Ever since the NEJM put out its big RCT on the treatment of all-comer shock[i], we know that norepinephrine is the vasopressor of choice. Septic, cardiogenic….doesn’t matter. Norepinephrine is superior to dopamine. Bummer, right? Choice of vasoactive agent was so Read more…