Keeping the Beat

Keeping the Beat

Heart Failure for the Resuscitationist: The Basics I don’t have to tell you that heart failure is a common condition in the general population and in patients presenting to the emergency department (ED). We see it on a daily basis. Even with this familiarity there are still some conundrums in the care of these patients.

EM/IM Sessions

EM/IM Sessions: Preoxygenation with Flush Rate O2

Preoxygenation With Flush Rate Oxygen: Comparing the Nonrebreather Mask With the Bag-Valve Mask Driver, Brian E et al. Annals of Emergency Medicine, March 2018. [paper] Why I chose this study While preoxygenating during rapid sequence intubation for spontaneously breathing patients, I’ve typically used bag valve mask (BVM) and nonrebreather mask (NRB) interchangeably. This is mainly based

Knowledge Bomb

Knowledge Bomb: TXA for Epistaxis

We continue the series with Knowledge Bomb #18. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background It’s a busy ER shift. Everyone seems pretty sick today. You get a patient into a back room of your emergency department with a pretty bad nosebleed. The

EM/IM Sessions

EM/IM Sessions: Coronary CTA vs Stress Testing

Coronary Computed Tomography Angiography vs Functional Stress Testing for Patients with Suspected Coronary Artery Disease: A Systematic Review and Meta-analysis Foy, Andrew J, et al.  JAMA Internal Medicine 2017. [paper] Why I chose this study Everything is still new and shiny as an intern, even acute chest pain. If the story is good and the

EM/IM Sessions

EM/IM Sessions: HOPPE Score for Low-Risk Pulmonary Embolism

Derivation and Validation of a Novel Prediction Model to Identify Low-Risk Patients With Acute Pulmonary Embolism Subramanian, M. et al. The American Journal of Cardiology 2017. [paper] Why I chose this study The topic of discharging patients with pulmonary embolism (PE) came up in conversation recently. I started asking fellow residents if they have ever

Knowledge Bomb

Knowledge Bomb: Observation for Heroin Overdose After Receiving Naloxone

We continue the series with Knowledge Bomb #17. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background As EM docs we see a lot of opiate overdose cases, usually heroin. As a resident learning from attendings, who have different practice patterns, I have noticed varying

EM/IM Sessions

EM/IM Sessions: Impella for Refractory Cardiac Arrest

The Impella CP Device for Acute Mechanical Circulatory Support in Refractory Cardiac Arrest Vase H, Christensen S, Christiansen A, et al. Resuscitation 2017. [paper] Why I chose this study While perusing LITFL R&R I stumbled on this interesting study. As we have started seeing with increased use of ECMO and the development of tools such as