CHF exacerbations are common presentations in the Emergency Department. Here we review initial evaluation, diagnostics and management.
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Congestive Heart Failure
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How to Excel in Your 4th Year Clerkship
The data is out. Just published June 30th, 2015, in Academic Medicine (the Journal for the AAMC)(Benson, Stickle et al. 9000) is that 4th year students going into EM are much more likely to do away rotations during their 4th year than students going into other specialties. Also, the majority of 4th year medical students believe that one of the primary uses of the last year of med school is to successfully match in the residency of their choice.
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Journal Review
Utlity of Non-Invasive Cardiac Testing
In patients who present to the Emergency Department (ED) with chest pain whose initial evaluation does not reveal acute myocardial infarction, the American Heart Association (AHA) recommends non-invasive testing to provoke ischemia or to detect coronary artery disease (CAD) before or within 72 hours of their discharge. Such testing is believed to identify patients who might benefit from more invasive therapy,
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Core
Ebola Hemorrhagic Fever
Though rarely encountered outside endemic areas of West Africa, it is critical for Emergency Physicians to recognize Ebola.
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Journal Review
Prehospital Beta-Blockers in Anterior STEMI
Long-term oral beta-blocker use decreases mortality after myocardial infarction (MI). Our guidelines recommend initiation of this within 24 hours of acute MI. The benefit of IV beta-blockade is less clear. It is also unknown whether earlier beta blocker administration is better than delayed administration (within 24 hours).
-COMMIT Trial (2005): Early use of IV metoprolol in AMI decreases incidence of ventricular arryhthmias and reinfarctions,
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Core
Traumatic Ocular Injuries
Serious traumatic eye injuries are relatively uncommon but it is vital to recognize them and rapidly initiate management.
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Journal Review
Ultrasonography vs CT in Renal Colic
Abdominal CT is the most common initial imaging test ordered for suspected nephrolithiasis in the Emergency Department. This is largely due to its high sensitivity for the diagnosis of kidney stones and ability to assess for other high-risk diagnosis. However, CT scan results in exposure to ionizing radiation with related long-term cancer risk and a high rate of incidental findings.
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Journal Review
Non-Invasive Positive Pressure Ventilation for Pre-Hospital Respiratory Distress
Acute dyspnea is a common Emergency Department complaint; in 2003 this chief complaint comprised about 3.5% of more than 115 million emergency department visits nationwide. A subset of these patients will present in respiratory distress, which is associated with increased morbidity and mortality. Often it can be hard to determine the exact etiology of the shortness of breath in a timely fashion,
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