A patient presents in ventricular tachycardia with a blood pressure of 90 systolic. He is diaphoretic and complaining of chest pain. You decide to attempt electrical cardioversion and it fails. You attempts again....and again....and again....without success. You realize this is no ordinary VT...this is electrical storm. Read on for pearls on how to deal with this frightening and deadly condition.
Ever wonder if all of your patients presenting with recent onset (<48 hrs) atrial fibrillation and a rapid ventricular response really need to be admitted? Is there evidence of a safe and effective treat and street algorithm that EM physicians can employ? Read on for a review of the Ottawa Aggressive Protocol for rapid afib that enables discharge of 97% of patients!
This post is a a summary of a portion of Dr Byrne's airway talk from last month's ResusEM conference at the Cooper Medical School of Rowan University. New techniques for preoxygenation before intubation can help to prolong time to desaturation and make this potentially dangerous procedure safer than ever!
A college baseball player presents to your ED with right arm pain, which is worse with elevation of his arm (especially while throwing baseball) and has progressively worsened over past two weeks. He comes to your ED because of increased arm swelling and numbness in arm over past two days. Could this be thoracic outlet syndrome??
Intubation has traditionally been performed with patients in the full supine position. Recent data suggests that elevation of the head of the bed may be more effective during preoxygenation before intubation. Check out this summary of a paper from Anesthesia that put this idea to the test!