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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis Sickling leads to vascular occlusion, end-organ ischemia, and decreased RBC lifespan, which, in turn, leads to pain crisis, acute anemia, sequestration, infection, and acute chest syndrome (ACS.) times maintenance.

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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis. Ultrasound Sensitivity 88-100%, specificity 68-94% LR+ of 14.6 (95% Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Look for B lines, consolidation, pleural effusion. times maintenance.

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Tachycardia must make you doubt an ACS or STEMI diagnosis; put it all in clinical context

Dr. Smith's ECG Blog

More often, tachycardia with ST segment abnormalities (elevation or depression) is due to an underlying illness (PE, sepsis, hemorrhage, dehydration, hypoxia, respiratory failure, etc.). Large volume fluid resuscitation was undertaken. The patient was suffering from severe dehydration, possibly with sepsis. The K returned at 6.9

EKG/ECG 52
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Elective Placement With The Air Ambulance: Reflective Account and Top Tips

Mind The Bleep

There were however some investigations used that you would not typically see in a ward A-E, such as thoracic ultrasound to rule out traumatic injuries. There were multiple patients where the only intervention from the team was stopping resuscitation.

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Orofacial Infections

Mind The Bleep

Investigations Bedside Observations Where there is an abscess with pus formation, the temperature will be swinging up and down Capillary blood glucose if diabetic Laboratory Venous blood gas if haemodynamically unstable Full blood count C-reactive protein Blood cultures if patient haemodynamically unstable Pus swab if discharging pus present for MC&S (..)

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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

EKG/ECG 40
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EM@3AM: Crush Injury

EMDocs

neurologic damage and thrombosis) 20,21 Resuscitation Lactated ringers > Normal saline due to reduced need for urinary alkalinization 22 Place foley and target urine output >300 mL/hr Electrolyte abnormalities Hyperkalemia: Obtain an ECG Stabilization: Calcium gluconate 2 g over 5-10 min.

EMS 86