Emergency Medicine has made significant contributions to the proliferation of Observation Medicine, an attractive alternative to admission for patients with low- and moderate-risk chest pain. Selecting the right patient, identifying appropriate interventions, and documenting appropriately are just some of the challenges discussed in the latest ACEP E-QUAL Network podcast, a partnership with ALiEM to promote clinical practice improvements. We review highlights from a podcast with experts Dr. Anwar Osborne (Emory University) and Dr. Michael Granovsky (LogixHealth).
High-quality chest compressions and early defibrillation are the cornerstones of effective cardiac arrest care.1 When implemented correctly these two interventions enhance patient outcomes and improve overall survival.2 However, despite simplified advanced cardiac life support (ACLS) algorithms and extensive training of providers, cardiac arrest scenarios in the emergency department (ED) are still high-stress and mortality rates remain high.3,4
Congratulations, you’ve made it! On July 1, thousands of medical students across the country made the transition to becoming Emergency Medicine residents. It was a particularly competitive year for Emergency Medicine, with 99.7% of first-year spots filled despite a whopping 2,047 positions being offered in 2017 (up by 152 spots compared to last year).1 Now begins the most crucial 3 or 4 years of your medical training that will prepare you for the rest of your career in Emergency Medicine.
In emergency medicine, we are so heavily trained in resuscitation that any senior resident could recite the ACLS algorithm to you after being woken up at 3 am. However, the real work begins after the pulse return. Up to two-thirds of patients with return of spontaneous circulation (ROSC) will not survive to discharge.1,2 This approach, modeled after the 2015 American Heart Association Guidelines3 and an excellent review article by Dr. Jacob Jentzer et al,4 can help guide you through the chaos to stabilize your next post-ROSC patient.
Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this case series, we focus on a real clinical case where point-of-care ultrasound changed the management of a patient’s care or aided in the diagnosis. In this case, a 40-year-old woman presents with a fever, chest pain, shortness of breath, cough, and generalized weakness.
Patients with left ventricular assist devices (LVAD) often cause much anxiety amongst providers in the emergency department. This is understandable with all of the hardware, diminished or absent peripheral pulses at baseline, and potential for complications. To add to the already helpful reviews about LVADs at REBELEM and emDocs, this is a PV card set providing a methodical approach to troubleshooting LVAD complications, including a reproduction of an algorithm for managing the LVAD patient with altered mental status from EMCrit.1–3