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Acute LAD occlusion in the setting of Right Bundle Branch Block and Left Anterior Fascicular Block. Case Review: [link] Key features of Right Bundle Branch Block: In general, there is no ST elevation throughout the 12 Lead ECG. RBBB has expected slight ST depression, with T wave inversion, in V1-V3 when discordant to a positive R' wave. A possible normal variant is lateral ST elevation (i.e., I/aVL/V5/V6) with bulky T waves when subsequent to a large, slurred S wave.
In this main episode podcast on ED risk stratification and workup of the febrile infant, recorded at the CAEP 2022 Conference in Quebec City with Dr. Brett Burstein and Dr. Gary Joubert, we answer such questions as: Which febrile infants require lumbar puncture? How accurate is procalcitonin in identifying low risk febrile infants? What is the difference between serious bacterial infection (SBI) and invasive bacterial infection (IBI) and why is this important in the work up of the febrile infant
Researchers at UCLA have developed a fingertip sensor that can rapidly provide data on the levels of lithium in the body. Used as a treatment for bipolar disorder and depression, lithium requires very accurate and sensitive dosing, with too little providing no therapeutic benefit but slightly too much potentially leading to unwanted side-effects. At present, the most common method to assess lithium levels involves a blood draw and subsequent lab testing, which is inconvenient and cumbersome.
New onset chest discomfort with demonstrable Hyperacute T waves that went undetected by EMS, EM, and cardiology. Case review presentation: [link] Learning Objectives Hyperacute T waves are disproportionately large in comparison to their paired QRS, and represent Grade I Sclarovsky-Birnbaum ischemia. Diffuse / global ST depression is consistent with subendocardial ischemia (supply-demand mismatch) when maximal in Leads II and V5.
Continuing the discussion from last Lightning Rounds about presenting at conferences, Brandon and Bryan chat about writing for peer-reviewed journals: why, how, and the process from choosing co-authors to choosing journals to navigating the submission. Continuing the discussion from last Lightning Rounds about presenting at conferences, Brandon and Bryan chat about writing for peer-reviewed journals: why, how, and the process from choosing co-authors to choosing journals to navigating the submis
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Continuing the discussion from last Lightning Rounds about presenting at conferences, Brandon and Bryan chat about writing for peer-reviewed journals: why, how, and the process from choosing co-authors to choosing journals to navigating the submission. Continuing the discussion from last Lightning Rounds about presenting at conferences, Brandon and Bryan chat about writing for peer-reviewed journals: why, how, and the process from choosing co-authors to choosing journals to navigating the submis
It's back to the basics! Take a seat and relax as the maestro, Tom Bouthillet, guides us through a stepwise approach to assessing Left Bundle Branch Block-- especially in the nefarious context of Occlusive Myocardial Infarction.
Date: August 23rd, 2022 Reference: Schoenfeld et al. “Just give them a choice”: Patients’ perspectives regarding starting medications for opioid use disorder in the ED. AEM August 2022 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. […] The post SGEM#374: Bad Habits – Medications for Opioid Use Disorder in the Emergency Department fir
Historically, many patients admitted with congestion due to heart failure have been treated with furosemide monotherapy. However, a strategy of furosemide monotherapy has numerous drawbacks: Furosemide tends to stimulate production of dilute urine, leading to a greater amount of water loss than sodium loss. Predominant loss of water may cause loss of volume from the […].
Background: The Calcium for Out-of-Hospital Cardiac Arrest (COCA) trial was a randomized, placebo-controlled, double-blind trial of calcium compared to placebo in OHCA. COCA found no improvement in sustained ROSC but, rather, a trend towards harm for their primary outcome. Additionally, there were non-statistically significant trends toward lower survival and lower survival with good neurologic outcomes in patients receiving calcium at 30 to 90 days.
I know that this is a long-shot with the volume of traffic on here anymore, but what the hell, I'll ask. Does anyone know of a source for obtaining the ring that goes around diaphragm bell of the Classic II? I don't need an entire kit. I just need to replace the ring. Thanks.
SORRY FOR THE DELAY! BLAME CHRIS! The guys review a call with a patient that needs just a touch of magic to a large neck wound. Was the crew able to cast the right spell? Listen and find out! SORRY FOR THE DELAY! BLAME CHRIS! The guys review a call with a patient that needs just a touch of magic to a large neck wound. Was the crew able to cast the right spell?
Background: The use of ketamine and etomidate for induction in rapid sequence intubation is heavily debated. The Ketased Trial (Jabre 2009) reported no significant difference between the two induction agents. However, recently the National Emergency Airway Registry reported ketamine is associated with more-frequent hypotension than etomidate in critically ill patients (Mohr 2020).
Answers: PH = 7.24 that is moderate acidaemia. HCO3 = 16 mmol/L, so we have metabolic acidosis. Next, we need to calculate the anion gap and the compensation.
I’ve recently been turned onto Van Neistat’s YouTube channel. Van, the older brother of Casey Neistat, is a true pleasure to watch – he’s the DIYer’s DIYer and his style is untainted by modern social media. He’s the best of the Gen X cohort without the pretension or cynicism. In his video meditating on the nature of burnout , he described slow burnout in terms of a motor with the cylinders breaking down one at a time.
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