Acute Pulmonary Embolism: Size does matter and ECG can give us clues

Acute pulmonary embolism (PE) is a common condition that can be both severe and difficult to diagnose. Half of all acute PE cases are diagnosed in the emergency department, and acute PE follows acute coronary syndrome as the second most common cause of sudden unexpected death in outpatients. Also, right ventricular dysfunction is a consequence of massive/submassive acute pulmonary embolism and correlates with a poor prognosis and high mortality rate. Although an ECG lacks both sensitivity and specificity for acute PE, there are some clues that can help in determining the size of an acute PE.

The prevalence of hyperthyroidism in the general population is about 1-2%, and is ten times more likely in women than men. The spectrum of hyperthyroidism ranges from asymptomatic or subclinical disease to thyroid storm. So how do we diagnose various presentations of hyperthyroidism in the Emergency Department? Below are answers to 7 common questions that commonly arise.
The faculty and fellows of the UCSF EMS/Disaster Fellowship Program met monthly over the past 2 years to to write a study guide for for the EMS Medical Board exam based on the National Association of EMS Physician’s (NAEMSP) seminal textbook Emergency Medical Services: Clinical Practice and Systems Oversight [
Imagine a consult service located IN the ED. The consultants are some of the friendliest people you’ve met and are there to help you. They tirelessly go out of their way to guide you through hospital protocols, help you with treatments, keep a close eye on your work, and ensure that you and your patients stay out of trouble. Not only are these consultants helpful to you, but also your residents, mid-levels, nurses, and the admitting teams. Everything they know, they teach you – and some are very active in FOAMed and emergency medicine research.