It is understood that chronic conditions such as hypertension, coronary artery disease, heart failure, hypertrophic cardiomyopathy, and valvular disease (just to name a few) are risk factors for the development of atrial fibrillation. However, in the ED it is important that we are aware of the acute triggers of atrial fibrillation, some of which are associated with significant morbidity and mortality.
How do you safely disposition your low-risk chest pain patients? This week for his Critically Appraised Topic, Dr. Michael Coletta investigated the safety and accuracy of accelerated diagnostic protocols for low-risk chest pain patients presenting to the ED.
Pericardiocentesis is a rarely performed, but potentially life-saving procedure. Commerical models are prohibitively expensive, but students and residents (and critical care fellows) still need to learn the mechanics, ideally with an ultrasound compatibile model. This week's post gives a step by step guide towards making a cheap, easy to fabricate phantom based on this fantastic paper published in the Journal of Emergency Medicne 2012: https://www.ncbi.nlm.nih.gov/pubmed/21925818
It’s another busy shift in the Emergency Department and you are seeing the third patient of the day in atrial fibrillation with rapid ventricular response. You think to yourself, “simple plan and disposition: stabilize, start on a diltiazem infusion, anticoagulate and admit to cardiology, right?” Well before you proceed with this well accepted approach, consider an alternative management strategy where you can even discharge the patient home!