Tachydysrhythmias are common in the ED. An organized approach to diagnosis + management is critical.
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A Simplified Approach to Tachydysrhythmias
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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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Journal Review
Insulin Glargine in DKA
Diabetic ketoacidosis (DKA) is a diagnosis commonly encountered in the emergency department (ED), with the numbers of patients presenting in DKA rising. The increasing number of DKA patients has led to a concomitant rise in cost, with a substantial part of the cost related to intensive care unit (ICU) stay. Treatment of DKA involves correcting acidosis/electrolyte derangements,
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Core
Hyperinsulinemia Euglycemia Therapy (HIET) for Beta Blocker and Calcium Channel Blocker Toxicity
Cardiogenic shock from beta blocker/calcium channel blocker overdose can be difficult to treat. HIET is a life-saving treatment modality.
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Journal Review
Revisiting the “Golden Hour” of Trauma
“The Golden Hour”, a widely accepted concept that transport of the trauma patient within the initial 60 minutes after injury purports better outcomes has little empiric evidence directly supporting this relationship between time and outcome. While there have been many studies that suggest a survival benefit to shorter on-scene time and shorter transit time; most studies fail to substantiate a relationship.
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Core
Acute Pulmonary Edema
Acute Pulmonary Edema (APE) is a life-threatening condition caused by neurohormonal overdrive. Rapid assessment + treatment is critical.
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Journal Review
ATLS: Archaic Trauma Life Support?
ATLS teaches inexperienced providers a systemic approach to trauma, with focus on stabilization and appropriate transfer of care. It is designed for providers who do not have much trauma exposure, not necessarily for providers who work in major trauma centers. This article reviews the scope of ATLS training and asks whether it is important or relevant for providers in major trauma centers.
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