EMDocs

JANUARY 11, 2024

Authors state early cath may be of benefit in those with no STEMI, but much of the more recent literature suggests this is more controversial. Statements: In ICUs where advanced cerebral monitoring is not in routine use, target an MAP >80 mm Hg unless there are clinical concerns or evidence of adverse consequences (82.6%, 19/23).

Critical Care 98

Critical Care E-9-1-1 OR ICU 98

Dr. Smith's ECG Blog

APRIL 20, 2018

If she had no risk factors, it is doubtful that she would have developed such extensive coronary artery disease as we see on the angiogram. I took part in her ICU care and she was extubated and stable to transfer to a stepdown unit after a few days. Her repeat ECHO showed an improving EF of 37%.

Coronary 40

Coronary STEMI EMS ACS 40

Dr. Smith's ECG Blog

JANUARY 6, 2023

Immediate and early percutaneous coronary intervention in very high-risk and high-risk Non-STEMI patients. The facility was not pressed to activate emergent transfer for PCI since the pain was improving and suggested we optimize pain control and admit to the Cardiac ICU. Lupu L, et al. mg/dL, K 3.5

ACS 52

ACS Coronary ICU STEMI 52

Dr. Smith's ECG Blog

DECEMBER 13, 2019

in the ICU but survived with excellent function. normal variant, not pericarditis) A Young Man with Sharp Chest pain (normal variant, not pericarditis) 24 yo woman with chest pain: Is this STEMI? The team was notified and they ordered a stat aortagram which showed type A aortic dissection from the aortic valve to the iliacs.

E-9-1-1 52

E-9-1-1 ACS Coronary CAD 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

Fortunately, he was extubated several days later in the ICU with intact baseline mental status and was discharged shortly thereafter to subacute rehab. His troponin I peaked at 97 ng/mL (very large MI!). His follow up ECHO the next day revealed an EF of 24% and a posterior wall motion abnormality. Herzog et al.

CAD 52

CAD OR ED ALS 52

Dr. Smith's ECG Blog

JULY 12, 2020

A CT was obtained later and showed appropriate positioning of the catheter: She was admitted to the ICU and the catheter was used several times to withdraw more fluid. There are too-numerous-to-count cases on Dr. Smiths ECG Blog in which emergency providers diagnosed acute pericarditis that was really acute coronary syndrome.

E-9-1-1 40

E-9-1-1 ED STEMI OR 40

EMDocs

OCTOBER 29, 2024

He was started appropriately on vancomycin and cefepime and accepted for ICU admission but remains in the ED due to boarding and bed lock. Left ventricular outflow tract obstruction in ICU patients. He has clinically deteriorated and required intubation. m/s)—problematic and elevated > 50 mm Hg (2.5 Curr Opin Crit Care.

E-9-1-1 98

E-9-1-1 ICU Epinephrine EMS 98

FOAMfrat

DECEMBER 4, 2024

In the EMS setting, the most common cardiogenic shock patient is most likely a STEMI. The ultimate goal is to optimize coronary perfusion pressure (CPP)—in other words, the amount of blood flow into the coronary arteries. When the heart is full, it puts pressure on the myocardium, compressing the coronary microvasculature.

Coronary 64

Coronary STEMI Epinephrine Critical Care 64