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Cases

October 2015

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Refusing to bear weight on left leg x2 days
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Journal Review

Age Adjusted D-dimer in PE – The ADJUST-PE Study

Filed Under: Tags: , October 8th, 2015 Leave a Comment

 Background

Acute pulmonary embolism (PE) is a common disease associated with high degrees of morbidity and mortality. The D-dimer assay has the potential to be a valuable test in the workup of PE as it is sensitive for thrombus formation. Unfortunately, specificity is low and indiscriminate use can lead to increased advanced imaging.
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Core

Lunate Dislocation

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Lunate dislocations are unusual but have severe morbidity associated with them if the diagnosis is delayed or missed.
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Journal Review

Transesophageal Echo in Cardiac Arrest

Filed Under: Tags: , October 1st, 2015 Leave a Comment

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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Core

Life-Threatening Asthma

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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

Filed Under: Tags: , September 24th, 2015 One Comment

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

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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

Filed Under: Tags: , September 17th, 2015 4 Comments

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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