Welcome to the third blog post in a series on subtle ECG findings in ACS. This post about mimics: benign early repolarization (BER) and the anterior STEMI. Each of these can mimic the other. The problem is that one of these diagnoses is deadly and the other is a normal variant.
Subtle ECG Findings in ACS: Part III Benign Early Repolarization vs. Anterior STEMI Read More »
What if you could identify a patient with complete coronary vessel occlusion almost immediately after it occurs, before the ST segments begin to elevate? What if you could pick up the very subtle, early MI? We know that early recognition and intervention improves outcomes in patients with coronary artery occlusion. Sometimes patients presenting with ACS are obvious. Sometimes it seems that the patient has read the textbook. However, more often than not, patients are not obvious, especially in the early stages of ACS. That is why we are concerning ourselves with subtlety.
Subtle ECG findings in ACS: Part II Hyperacute T-Waves Read More »
When it comes to ACS, some ECGs are obvious. This article is not about those ECGs. This article will be the first in a series of blog posts related to subtle ECG findings in ACS. In this post we will look at ECG findings associated with left main coronary artery disease and explore the significance of ST-segment elevation in the “forgotten lead”.
Subtle ECG Findings in ACS: Part I Left Main Coronary Artery Disease Read More »
Endophthalmitis is a rare, but clinically significant infection. It is often misdiagnosed due to the multitude of other ocular diseases that share similar presenting symptoms. It results from an infectious or non-infectious inflammatory process of the vitreous and aqueous humors. Missed or late diagnoses can have severe consequences, including permanent vision loss. The natural history of the disease thus necessitates a high degree of clinical suspicion in all patients, especially those at increased risk.
Endophthalmitis Highlights Read More »
Hemolytic uremic syndrome is a potentially deadly disease, comprised of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and acute kidney injury (AKI). This post evaluates the pathophysiology, evaluation, and management of HUS.
Hemolytic Uremic Syndrome (HUS): Pearls and Pitfalls Read More »
Does your choice of fluids for resuscitation in sepsis matter? Multiple studies have been performed to determine whether septic patients benefit from colloid versus crystalloid IV fluids, and other studies have specifically looked at the different kinds of fluids within those specific groups. Debate now exists as to which fluid will improve patient outcomes.
Fluid Choice in Sepsis: Does it matter? Read More »
A great deal of literature exists on sepsis and providing state of the art care in the ED. As EM physicians, we pride ourselves on resuscitating sick patients, and we are well aware that septic patients can rapidly decline clinically. Finding the source and providing appropriate antibiotics, adequate preload with IV fluids, and vasopressors if necessary are key components. The SIRS criteria are our first line of defense in the early identification of sepsis. But, it is important to recognize that just because a patient has multiple SIRS criteria, they may not actually be septic.
Mimics of Sepsis: What do ED Physicians Need to Know? Read More »
Salient critical care and trauma pearls as incorporated into a blunt trauma case
Popliteal Artery Injury from Blunt Trauma: A Trauma Case Read More »
Emergency physicians commonly care for poisoned patients. These exposures may be either intentional or unintentional. Salicylates are commonly found in many topical and over the counter preparations, yet salicylate toxicity is often overlooked and underestimated as a potential cause for illness in our patients. Below is a condensed quick-guide of common mistakes that emergency physicians may be making with respect to salicylate overdoses and how to fix them. The goals of care to take away from this article are prevention of intestinal absorption and CNS entry of salicylates, as well as drug elimination.
Pearls and Pitfalls of Salicylate Toxicity in the Emergency Department Read More »
We’ve all heard it at one point or another: “Man, I’d HATE to have to intubate THAT!” Typically, this sentence is used to describe a patient in an ominous, sphincter-tightening situation, or the patient with the obviously suboptimal airway.
You walk by the door to the Resuscitation Bay or Trauma Bay, see that the patient is in respiratory distress, and rapidly breeze through your airway mnemonics and ultimately come to the conclusion that this would be a scary airway. The airways of myths and legends, and where heroes are made.
The Scary Airway Series Part II: Mastering Obesity, Peds, and Burns Read More »
