As we all know hyperkalemia is a life threatening condition. But how can something so basic be shrouded in such confusion? So many choices and everyone has their own recipe to fix it. Along with all the treatment choices, come pitfalls and side effects. Thus, we need to know what is the best way to […]
Read More Hyper K, The EBM Way: Protect, Push, and Purge
The long awaited (you were all waiting for it right?) PARAMEDIC2 trial for epinephrine in “out of hospital cardiac arrest” (OHCA) is finally here from the UK. We all know and love epi. We give it every 2-5 minutes in codes but why are we doing it? How well does it help us in return […]
Read More Quick Hit Article #5: Epi in cardiac arrest – Saving the heart! Saving the brain?
Pharmacology is a favorite subject of mine and so I think it super interesting to discuss. Unfortunately, this post may be one of my most boring write ups. Luckily, the content makes up for it! (Hopefully). I bolded the key points to help. This one is a quickie. Clopridogrel (Plavix) Loading Dose: 300mg or 600mg […]
Read More Anti-Platelets in PCI: Which one and Why?
CASE: A 70 yo male presents to the ED with dizziness. He has normal vital signs and his ECG appears as below: AVD original ANSWER: AV Dissociation without complete heart block DISCUSSION ON COMPLETE AND INCOMPLETE HEART BLOCK Remember that AV dissociation can occur WITHOUT complete heart block. Let’s discuss blocks. The definition is the […]
Read More JULY ECG: A BLOCK PARTY
Chest pain pathway PROTOCOLS Ok here we are the main show, the reason for reading, the Trump of testing…well you get the idea. The whole goal of a protocol is to identify a low risk group of patients and then do something to make them even lower risk (<1%) to send them home without admitting […]
Read More CHEST PAIN PROTOCOLS PART II
INTRODUCTION Why have protocols? Well, so we don’t miss anything. Right?! But how many Myocardial infarctions (Heart attacks or “MI’s”) ARE we missing from the ED. Well any medical student knows that answer… anyone, anyone, Bueller?! Umm yes 2% (see note C), correct! That being said if we “do miss 2%” what should be an […]
Read More CHEST PAIN PROTOCOLS PART I
For Reversal of Major Bleeding Definition: Major Bleed(s) are all bleeds associated with hemodynamic compromise, occurring in an anatomically critical site (e.g., intracranial), or associated with a decrease of hemoglobin >2 g/dL (when baseline is known) or requiring transfusion of >2 U of packed RBCs. Bleeding due to Vitamin K antagonists (VKA): Vitamin K: 10 […]
Read More Reversal Agents for Anti-coagulation