EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. That’s where we’re at.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

Dr. Smith's ECG Blog

SEPTEMBER 17, 2023

COPD, Idiopathic PAH, acute or chronic PE, pulmonary valve stenosis, etc) 3) Conditions affecting RV myocardial contractility, such as ARVD or RV infarction The ECGs does not really show any signs of chronic RV dilation or hypertrophy. Any cause of pulmonary hypertension. Our THANKS to Dr. Magnus Nossen for sharing this case with us.

EKG/ECG 103

EKG/ECG COPD Wellness Shock 103

Taming the SRU

OCTOBER 1, 2023

It can be further divided into two types: primary--those that occur in generally healthy individuals without underlying lung disease, and secondary--those that occur in individuals with underlying lung disease such as COPD [1]. J Emerg Trauma Shock. Smoking is a known risk factor, as is cannabis use [2,5, 7-8]. Ann Emerg Med.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Dr. Smith's ECG Blog

FEBRUARY 28, 2020

This clinical information followed: "The patient had a COPD exacerbation with a prehospital SpO2 of 60%. Tachycardia is unusual in ACS unless there is cardiogenic shock or a second simultaneous pathology. Many patients with acute COPD exacerbations present with a similar heart rate. This is NOT Wellens. Is the patient hypoxic?

EKG/ECG 52

EKG/ECG COPD Documentation/Coding Shock 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. Authors' commentary: Cardiogenic shock in the setting of severe aortic stenosis. Fundamentally, cardiogenic shock is an issue of decreased cardiac output.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Dr. Smith's ECG Blog

JANUARY 5, 2020

This 60-something with h/o COPD and HFrEF (EF 25%) presented with SOB and chest pain. Here is the ECG: What do you think? Computer interpretation is below. Providers FORGET to “ U se t he O dds”. Q UESTION : Is there a d ifference between sinus rhythm with multiple PACs vs MAT?

EKG/ECG 52

EKG/ECG COPD Wellness Sepsis 52

EMDocs

APRIL 22, 2024

RV chamber size alone is not enough information to rule-in a PE as RV cavity enlargement can be visualized in other conditions such as pulmonary hypertension, RV infarct, COPD and cardiac arrest from multiple causes. 10,11 Vid 1. SubX4 Asystole RV > LV. SubX2 Asystole RV > LV. RV pressures > LV pressures.

Ultrasounds 82

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 82

Dr. Smith's ECG Blog

MARCH 12, 2018

This includes, but is not limited to, PE, asthma/COPD exacerbation, hypoxic vasoconstriction from pneumonia, acute pulmonary hypertension exacerbation. When there is tachycardia, the patient is in cardiogenic shock with very poor LV function on bedside echo. The T-waves simply look different in Wellens'. Here is an example of Wellens'.

EKG/ECG 40

EKG/ECG Radiology Radiology COPD 40

EM Ottawa

APRIL 4, 2024

Point-of-care ultrasound (PoCUS) is becoming a cornerstone tool in our assessment of patient presentations and is helping us guide our clinical management. This is also represented in the amount of literature that has been published on the use of PoCUS in 2023.

Ultrasounds 72

Ultrasounds Infectious Diseases COPD Shock 72

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Given her tachycardia and episodes of syncope, the patient was judged to be in compensated obstructive shock with very high risk of imminent decompensation. This patient’s pericardial effusion may likely be subacute given the size and echogenicity of the effusion (new blood is anechoic and this looks more isoechoic).

EKG/ECG 40

EKG/ECG Ultrasounds Documentation/Coding COPD 40

EMDocs

FEBRUARY 12, 2024

Louis); Marina Boushra, MD (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case Emergency Medical Services brings in a 62-year-old male with COPD in acute on chronic hypoxemic respiratory failure (usually on 3 L nasal cannula, now on non-rebreather at 15 L/min). is more likely to portend death (13, 14). Epub 2019 Dec 30.

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

Sensible Medicine

SEPTEMBER 22, 2024

In studies, and in practice, these people tend to be patients with COPD who have resting O 2 sats of < 88%. About 80% had either COPD or pulmonary fibrosis and the mean PaO 2 and O 2 sats were about 50mm Hg and 80%, respectively. What we have not really known is how much oxygen is enough. The enrolled patients were not well.

COPD 97

COPD Outcomes Hospitals Shock 97

RebelEM

MAY 15, 2024

Give appropriate fluids, vasopressors, and antibiotics.

Infectious Diseases 103

Infectious Diseases Administration Sepsis Anaphylaxis 103