Core Journal Reviews

Filed Under: Tags: , , November 9th, 2017 Leave a Comment

Physician Interpretation of Cardiac Standstill on US

Point of Care Ultrasound (POCUS) has gained wider use in resuscitation of patients presenting with cardiac arrest. POCUS can play an important role in determining the etiology of arrest as well as being used to determine the presence or absence of mechanical activity. The REASON study demonstrated that patients with PEA or asystole without cardiac activity on POCUS are extremely unlikely to survive to hospital discharge though this study did not investigate the more important question of a survival with a good neurologic outcome.
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Filed Under: Tags: , , , November 2nd, 2017 Leave a Comment

Should All Patients with AMI Get O2?

Each year approximately 790,000 Americans suffer an acute myocardial infarction (AMI) (Benjamin 2017). Traditional treatment for an acute myocardial infarction has included morphine, oxygen, nitroglycerine and aspirin (MONA) with interventions such as percutaneous coronary intervention providing more definitive management. There has been little data from randomized control studies that supports the use of oxygen in AMI.
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Filed Under: Tags: , , October 26th, 2017 2 Comments

Predicting Dysrhythmia after Syncope

Syncope, the sudden, brief loss of consciousness followed by spontaneous, complete recovery is a common presentation to the Emergency Department (ED). It represents a significant portion of overall admissions to the hospital because while many cases are benign (i.e. vasovagal syncope), some may result from a life-threatening cause (ventricular tachydysrhythmia, myocardial ischemia, gastrointestinal bleeding etc).
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Filed Under: Tags: , , , , , October 19th, 2017 Leave a Comment

Prospective Validation of the HEART Score

Chest pain representing acute coronary syndrome (ACS) is the most common reason patients presenting to the emergency department (ED) are admitted to the hospital. The treatment for ACS is early targeted therapy and missed cases results in increased morbidity and mortality. As a result many clinicians choose to admit patients for further evaluation, resulting in further testing and higher medical costs.
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Filed Under: Tags: , , , October 12th, 2017 Leave a Comment

Safety of PE Treatment with Rivaroxaban

The simplified PE Severity Index (sPESI) is one of several validated prognostic tools for acute pulmonary embolism (PE).  The European Society of Cardiology recommended the use of the sPESI to risk-stratify patients with acute PE into low risk (sPESI=0) and non-low risk (sPESI≥1) in order to guide treatment and disposition (Konstantinides 2014).  Systematic reviews and meta-analyses have found that outpatient management of low-risk PE patients with standard therapy is safe,
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Filed Under: Tags: , , October 5th, 2017 Leave a Comment

Outcomes of Pediatric Patients with Tachycardia at Discharge

Tachycardia is a very common abnormal vital sign in the Pediatric Emergency Department (ED). Tachycardia can have numerous underlying causes including less concerning clinical states such as fever, pain, and anxiety but can also be a sign of impending cardiovascular decompensation which occurs in shock, sepsis, and cardiac dysfunction.
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Filed Under: Tags: , , , September 28th, 2017 Leave a Comment

Impact of US Guided Cardiac Arrest Resuscitation on Compression Pauses

The provision of high-quality compressions with minimal interruptions is central to the management of cardiac arrest. Along with defibrillation, high-quality compressions are the only interventions proven to improve patient-oriented outcomes. Recently, point-of-care ultrasound (POCUS) has gained greater use in cardiac arrest care for determination the cause of arrest as well as guiding the resuscitation and interventions.
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Filed Under: September 21st, 2017 Leave a Comment

Amiodarone in Cardiac Arrest – Systematic Review + Meta-Analysis

In 2016 the annual incidence of out-of-hospital cardiac arrest (OHCA) in the United States was roughly 360,000 and 209,000 for in-hospital cardiac arrest (IHCA) (Mozaffarian 2016). Though survival rates are relatively dismal, arrests in the setting of shock amenable rhythms – ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT) – have an overall better rate of return of spontaneous circulation (ROSC).
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