NSTEMI, STEMI, ACS

Author: Catherine Buckley MD There are about 8 – 10 million ED visits with the chief complaint of chest pain per year in the US. (Owens et al.)10 billion dollars are spent on chest pain, 10% of which goes to the work up for ACS diagnosis. Yet somehow despite these millions we still miss 1-2%

Central Line Placement

Author:  Lauran Wirfs

Background:

Central venous access is an important procedure for critically ill patients. One consideration when placing a venous catheter is the risk of catheter-related bloodstream infections (CRBIs), which can be a significant cause of morbidity and mortality in hospitalized patients. In 2012, there were 15 million central venous catheter (CVC) days per year in the US in ICUs, and the rate of infections per catheter days is 3/1000. This post looks at a systematic review done by Marik et. al. that examines CRBIs among internal jugular, subclavian, and femoral central venous sites.

Wide Complex Tachycardia

Intro

There’s an old adage that wide complex tachycardia is VTach until proven otherwise. While this is true as do not want to miss any potentially lethal arrhythmia, it is also important to understand the differential for wide complex tachycardias so that we can tailor our potential treatments to the specific arrhythmia. It is also important to note that in any unstable patient with a wide complex tachycardia (or narrow complex tachycardia) that electricity is always safe.

Narrow Complex Tachycardias

Intro

The differential for narrow complex tachycardia is extremely important as it is the most commonly seen abnormal EKG in the emergency department. It includes rhythms such as sinus tachycardia, AVnRT, AVRT, atrial flutter, ectopic atrial tachycardia (EAT), atrial fibrillation, atrial flutter, and multifocal atrial tachycardia (MAT).

The goal of this blog is to run through this differential and give some methods to differentiate the rhythms. Although we will not delve too deep into antiarrhythmics, it is important to note that electricity is safe in all unstable rhythms no matter the etiology.

Psychiatric Emergencies

Author: Dr. Corey Goldstein

Intro

We had a great lecture from Dr. Goldstein on psychiatric emergencies and he was also nice enough to write the below blog post for it as well! Very helpful talk as he can approach it from multiple perspectives as he has worked as a psychiatric attending and is about to finish his residency in emergency medicine. Hope you enjoy.

Journal: Canadian C-Spine

Author:  Dr. Keya Patel

Background

Each year, more than 1 million patients are treated in the emergency department for blunt trauma and potential C-spine injury. Cervical CT remains the mainstay of imaging in assessing for injury. Here, we review the Canadian C-spine Rule in determining the need for advanced imaging such as CT.

Pediatric Urologic Emergencies

In this blog, we’re going to dive into the topic of  pediatric urologic emergencies. We’re going to focus on some of the more uncommon emergencies such as:  phimosis, paraphimosis, priapism, entrapment injuries, testicular torsion, epididymitis, varicocele, and hydrocele. It’s important to note that UTI’s and Kidney stones are also common in peds, and often require additional work-up as often indicate abnormal anatomy or disease processes.