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EMS personnel found him seated on a bench, uncomfortable, but without gross distress. MICU transport was unremarkable. A third, and final, EMS 12 Lead ECG was recorded: The precordial ST segments (even Leads I/aVL, as well) have reverted to a dramatically depressed state. But the lesion is still active!
All intubations were performed on hospitalized patients, limiting application to the ED population. In contrast, patients in the ketamine arm had higher rates of MICU admissions. A highly specialized airway team was utilized for intubation, likely unavailable in many institutions. The significance of 7-day survival is unclear.
The Case An 88-year-old woman with a history of dementia, major depressive disorder, and hyperlipidemia presented to the ED via EMS after a near syncopal episode. The ED team emergently notified cardiology and loaded her with aspirin, ticagrelor, and heparin. High-sensitivity troponin peaked at 61 and BNP was normal.
An EM Residents Guide to Basic Airway Management Authors: Justin Rice, MD Sagar Desai, MD Eunice Monge, MD William Chiang, MD Preface: Airway management is one of the most critical skills in emergency medicine, yet it can be one of the most challenging to master. Introduction Airway management is a critical ED skill to master.
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