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Grand Rounds Recap 6.19.2024

Taming the SRU

Other medical interventions include PPIs, octreotide, erythromycin, and blood transfusion as needed. Blood transfusion may be useful in patients with penetrating trauma, although we must acknowledge when efforts are futile. Early endoscopy is key to both diagnosis and therapeutics.

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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

ECG: Evaluate for ischemia, right heart strain. Simple blood transfusion should be considered early in the hypoxemic patient with advancement to red cell exchange transfusion if there are clinical features of severe pathology or evidence of progression despite initial simple transfusion.

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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

ECG: Evaluate for ischemia, right heart strain. Blood transfusion Reduces the overall proportion of HbS. Overestimates arterial oxygen saturation. Up to 3x less accurate in black patients. When the clinical picture does not match the SpO 2 , get an ABG. Use a co-oximeter to measure different types of Hb.

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EM@3AM: Amniotic Fluid Embolism

EMDocs

Answer : Amniotic fluid embolism Epidemiology: Incidence of 1:15,200 to 1:53,400 1 7% occur during labor Causes approximately 14% of all maternal peripartum death in United States Current fatality rate 13-60% 1-4 Risk factors: Advanced maternal age, amniocentesis, cesarean delivery, eclampsia, medical induction of labor, placental pathology, diabetes, (..)

EMS 110
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Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated.

Dr. Smith's ECG Blog

This ECG was done in a middle aged woman who was in a motor vehicle collision in which her vehicle "T-boned" another, so there was trauma to the anterior chest. She had multiple rib fractures as well as serious hemorrhage and underwent massive transfusion. ng/mL, and an ECG was recorded: There are no P-waves visible.

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REBEL Core Cast 88.0 – Hypocalcemia

RebelEM

Treat moderate to severe symptoms and any EKG changes with IV calcium salts Always search for and treat the underlying cause of hypocalcemia REBEL Core Cast 88.0 – Hypocalcemia Click here for Direct Download of the Podcast Definition: A serum calcium level < 8.5

EKG/ECG 52
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What does the ECG show in this patient with chest pain, hypotension, dyspnea, and hypoxemia?

Dr. Smith's ECG Blog

Here is his triage ECG: What do you think? A prior ECG was available for comparison: There is sinus rhythm here; the QRS is the same We can see that the QRS is essentially the same as prior. For clarity in Figure-1 — I've reproduced and labeled the 2 ECGs in today's case. Figure-1: I've labeled the 2 ECGs in today's case.

EKG/ECG 52