This post discusses the presentation, diagnosis and management of abdominal aortic aneurysm.
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Abdominal Aortic Aneurysm
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The Perfect Game
I love sports; I’m the type of guy who opens up ESPN.com on his laptop before The New York Times or CNN every morning. I can most definitely name the last ten NBA MVPs faster than all of the PERC criteria. That being said, I am probably more parts “mathlete” than athlete. But that doesn’t mean I haven’t thought about which fellow stars would make up my entourage,
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Journal Review
Intensive Blood Pressure Lowering in Intracerebral Hemorrhage (ATACH-2 Trial)
Hemorrhagic stroke accounts for only 11-22% of all strokes but up to 50% of all stroke mortality. Additionally, there is significant disability associated with the disease in survivors. Much of our attention in the Emergency Department is guided towards preventing expansion of bleeding and secondary injury after the initial insult. Physiologically, controlling blood pressure has always appeared to be a reasonable goal as it may decrease hematoma expansion and thus mortality.
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Anaphylaxis
Anaphylaxis is a severe, life-threatening reaction requiring rapid recognition and treatment.
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Journal Review
Platelet Transfusion in Spontaneous Intracerebral Hemorrhage on Antiplatelet Agents (PATCH Trial)
Spontaneous, non-traumatic, intracerebral hemorrhagic strokes accounts for 11-22% of incidence strokes but 50% of all stroke deaths. There are about 2 million of these bleeds a year world-wide. Many patients with these types of bleeds and strokes in general will be on anti platelet agents like aspirin and clopidogrel. Anti-platelet therapy has been shown to increase incidence of and worsen outcome of spontaneous intracerebral hemorrhage.
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Post-Intubation Sedation and Analgesia
ED initiation of analgesia and consideration for sedation in mech ventilated patients is critical in preventing long-term complications
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Get Better Quickly, Rob Rogers!
Earlier this week, I got a text from one of my mentors, Rob Rogers (@EM_Educator):
This would be at least a slightly anxiety provoking EKG on a shift but was much more worrisome when I saw the name at the top. Fortunately, Rob was quickly taken to a cardiac catheterization lab and PCI was successfully performed.
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Journal Review
Focused Transesophogeal Echo in the Emergency Department
Cardiac ultrasound is an established diagnostic modality in Emergency Medicine (EM). We use it to diagnose pericardial effusions (medical and traumatic), to discern the etiology of shock, to evaluate for congestive heart failure, and to guide treatment and prognosis in cardiac arrest. Nonetheless, the trans-thoracic approach (TTE) to cardiac ultrasound has its limitations: poor windows (in the trauma patient,
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