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Another deadly triage ECG missed, and the waiting patient leaves before being seen. What is this nearly pathognomonic ECG?

Dr. Smith's ECG Blog

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. The patient was upgraded to the ICU for closer monitoring. looked at consecutive patients with PE, ACS, or neither.

E-9-1-1 139
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Amiodarone Versus Digoxin for Acute Rate Control of Atrial Fibrillation in the Emergency Department

REBEL EM

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). 2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). Am J Emerg Med. Am J Emerg Med.

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A man in his 60s with syncope and ST depression. What does the ECG mean?

Dr. Smith's ECG Blog

A man in his 60s with a history of severe alcohol use disorder and epidural abscess on long-term ciprofloxacin presented to the emergency department after an episode of syncope while standing in line at a grocery store. Moreover, the Queen is only supposed to be used with a high pretest probability of ACS/OMI.

Overdose 124
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A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

She presented to the emergency department after a couple of days of chest discomfort. Ischemia from ACS causing the chest discomfort, with VT another consequence (or coincidence)? The pacing rate was increased without clinical improvement and the patient was transferred to the ICU for closer monitoring/treatment.

Coronary 119
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Beyond Ketamine: When to use Facilitated Intubation in the ED

EMDocs

Despite the risk of hypotension and bradycardia, propofol has been shown in the ICU setting to be a safe and effective monotherapy intubation agent for hemodynamically unstable patients (19). References: Heffner AC et al. Incidence and factors associated with cardiac arrest complicating emergency airway management. J Emerg Med.

ED 86
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Diagnostic Errors, Revisited: Where Do We Go Wrong, and How Can We Change?

ACEP Now

It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergency department (ED). After developing encephalopathy and hypoxemic respiratory failure, the patient was transferred to the ICU. Ann Emerg Med. JAMA Intern Med.

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Penetrating chest trauma

Don't Forget the Bubbles

They found NO difference in drain failure rates ( 11% pigtail vs 13% chest tube P=0.74), total daily volume drained or length of ICU stay between groups. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality. c) Or, do both? Trauma Surg Acute Care Open.

E-9-1-1 139