Sudden cardiac arrest has very poor outcomes; less than 11% of patients in cardiac arrest in the Emergency Department survive to discharge from the hospital. The management of cardiac arrest is algorithmic because providers have limited tools at their disposal and limited knowledge of the patient’s past medical history. EKG is limited in its evaluation of cardiac function.
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Journal Review
Transesophageal Echo in Cardiac Arrest
Core
Life-Threatening Asthma
Adept management of the life-threatening asthmatic patient reduces morbidity and mortality. We review the keys to management.
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Journal Review
Ottawa Aggressive Atrial Fibrillation Protocol
Atrial fibrillation (AF) is one of the most common dysrhythmias encountered in the ED. Patients with chronic AF often present with increased heart rates, chest pain and weakness among other presentations. However, it’s the patients with new onset AF that really peak our interest. Why? Well, the management of these patients is potentially exciting, filled with procedures and clearly debatable.
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Core
Aortic Dissection
Aortic dissection is a true medical emergency where time to diagnosis and treatment greatly effects morbidity and mortality.
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Journal Review
D-dimer in Aortic Dissection
Acute Aortic Dissection (AD) is an uncommon, but potentially fatal cardiovascular disorder with a mortality of 1-2% per hour. This requires rapid identification and diagnosis, however, there are a limited number of screening tools available. Currently three diagnostic studies are employed: CT, MRI and TEE. Unfortunately, these modalities are time consuming, carry the risk of radiation and contrast reactions (in the case of CT) and are not always accessible (i.e.
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Core
A Simplified Approach to Tachydysrhythmias
Tachydysrhythmias are common in the ED. An organized approach to diagnosis + management is critical.
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Post
A Call to Use and Infuse High Dose Insulin! – Hyperinsulinemia Euglycemia Therapy (HIET) for Beta Blocker and Calcium Channel Blocker Toxicity
A 45-year-old male is brought into your resuscitation bay by EMS. He was found down, with empty prescription bottles for metoprolol, amlodipine and verapamil on his person. His heart rate is in the 30s and his blood pressure is 80s/40s. He is unresponsive but has palpable pulses. You intubate the patient, start IV fluids and give glucagon and calcium for the presumed beta-blocker and calcium-channel blocker overdose.
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