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Episode 14: Thoracotomy

PHEM Cast

Injury; 2006 (37): 1-19. Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. World Journal of Emergency Surgery; 2006: 1:4. EMJ; 2005: 22-24. Hunt et al. Emergency thoracotomy in thoracic trauma: a review. Clay et al. Rhee et al.

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Big Labs, Little People

Pediatric Emergency Playbook

We could use it to track treatment , and see if we can clear the lactate; decreased lactate levels are associated with a better outcome in adults. Myopericarditis in Children: Elevated Troponin I Level Does Not Predict Outcome. for the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents.

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Why we need continuous 12-lead ST segment monitoring in Wellens' syndrome

Dr. Smith's ECG Blog

It is well documented with continuous 12-lead monitoring that acute re-occlusion is frequently asymptomatic. Eur Heart J 2001;22:1997–2006. Silent ischemia as a marker for early unfavorable outcomes in patients with unstable angina. Here is the most recent documentation that T-wave inversion does indicate reperfusion: [link] 6.

EKG/ECG 52
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Intubation

PHEM Cast

Guidance documents College of Paramedics Statement on Intubation, available here. The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. Annals of Emergency Medicine 2006; 47(6):548-555 Lewis SR, Butler AR, Parker J, Cook TM, Smith AF. Tracheal intubation. 20(12);681-686.

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You Diagnose Pericarditis at your Peril (at the Patient's Peril!)

Dr. Smith's ECG Blog

The medicine note documents that the patient had worsening pain with lying flat and relief with leaning forward. Also, the ST elevation has diminished as myocardium infarcts Outcome and comments by the source of the case: "The following morning the cardio consult service saw the patient. "In 2 comments : 1. Grauer K.

EKG/ECG 52
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Episode 21- Updates and Controversies in the Early Management of Sepsis and Septic Shock

EB Medicine

Since this 2006 study, other studies have had mixed results - with studies showing increased odds of death with delays in abx administration and others showing only a benefit in those with septic shock with or without hypotension with no benefit to those without shock. But this isn’t limited to the air. vasopressin.

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Acute OMI or "Benign" Early Repolarization?

Dr. Smith's ECG Blog

Cardiology consult note written around that time documents that "Pain improved with NTG, morphine in ED but still present." Comparative early and late outcomes after primary percutaneous coronary intervention in st-segment elevation and Non–St-segment elevation acute myocardial infarction (from the Cadillac trial). Stuckey, T.,

EKG/ECG 134