Answer from Rhythm Nation- February 2020 Answer: Spontaneous coronary artery dissection (SCAD) Interpretation: Rate: 60/min Rhythm: sinus Axis: Normal Intervals: Normal ST-T-Q: STE in lead III, aVF. STD I, aVL; Wellens type A pattern in V1 and V3, short/symmetric T wave inversions in V2, V4, V5. Biphasic T waves in Read more…
You hear the red phone ring as you are about to take a bite out of your sandwich in CCT. The notification is for a patient being brought in for “VT.” You ask the dispatcher if EMS is performing CPR, and they tell you that the patient is awake and Read more…
This article is reposted from The American Journal of Emergency Medicine. Introduction The coronavirus disease 2019 (COVID-19) pandemic has caused a total of nearly 300,000 deaths worldwide [1]. Pediatric patients PCR-postive for SARS-CoV-2 present differently than adults with 40% either asymptomatic or with URI symptoms and commonly have pharyngeal erythema Read more…
Ted Segarra, MD & Nicole Anthony, MD The New 2020 GINA Asthma treatment guidelines[1] are out! Our focus will be on Adults & Adolescents 12+ years. The biggest change to our practice in the ED is that we will no longer be sending these patients home with short-acting beta-agonist (SABA)-only PRN Read more…
Note: The cases discussed in this post happened before COVID-19. Given that D-Dimer may be elevated in patients with COVID-19, the pretest probability of PE in your patient population may be elevated at this time. Thus, the assumptions derived from Kohn et al’s paper highlighted in this post may not Read more…
A 58-year-old male is rolled into the critical care area of your ED with the complaint of crushing, midsternal chest pain that began one hour before presentation. The nurse tells you he has a history of hypertension and hyperlipidemia but is currently not on any medications. You look at the Read more…
Introduction As far as dangerous causes of chest pain go, acute aortic syndromes (aortic dissection, intramural thrombus, and penetrating aortic ulcer) can present a real diagnostic dilemma. They’re rare (with a prevalence of around 2-4 per 100,000 individuals), seem to present in a myriad of ways, and are invariably life-threatening. Read more…
Which aortic dissections need surgery? Although it is not the ED team’s decision whether to take a patient with dissection to the OR, it is vitally important for us to be familiar with the indications, so we can effectively advocate for our patients as needed. Management of aortic dissections differs Read more…
As some of you may have heard, COVID-19 is a thing. We’ve covered it in-depth, here. Fortunately, there’s a cure. President Trump touted it himself and therefore it must be true. So good – so, so good that this will all be over by Easter. Could this be true? Let’s Read more…
Last Updated: 4/29/2020 By: Noah Berland MD, Andrea Greene MD, Suvam Neupane MD, and Julian Watson MD Reviewed By: Robert Allen MD and Monisha Dilip MD Introduction This post is meant to be an easily digestible and up-to-date article. The post is broken up into multiple parts, and we have Read more…