Cervical Artery Dissection

Cervical artery dissection (CAD) accounts for 1-2% of all ischemic strokes but 10-25% of strokes in younger individuals.  CAD includes extracranial carotid and vertebral artery dissections.  A review of the literature suggests that there ma…

Opioid Substitution Therapy

ED physicians need to be comfortable with the various modalities of opioid substitution therapy (OST) and their associated complications.  We are all familiar with the patient who has missed a daily dose of methadone on the way to booking a…

Use the HEART Score

There are approximately 8 million ED visits annually in the United States for chest pain. 10%-20% go on to receive an acute coronary syndrome diagnosis. The goal of the ED physician is to differentiate between ischemic chest pain and other,…

Permissive Hypotension

Resist the urge to administer a large crystalloid bolus in hypotensive trauma patients. Doing so worsens coagulopathy and acidosis. This practice should be abandoned. Normotensive trauma patients need no fluid resuscitation. The practice of…

PE Risk after Induced Abortion

It’s well known that the risk of venous thromboembolism is increased during pregnancy.  It is thought to be two-to-six times higher than the risk in non-pregnant women.  However, these risk estimates are based on pregnant populations…

Pacemakers Review pt. 3

Today we will review complications associated w/ implanted pacemakers that you may encounter in the ED and thus ought to be familiar with. Generally, complications can be divided into two categories: early vs. late Early complications typic…

Pacemakers Review Pt. 2

Cardiac pacing as an intervention can be conceptualized as addressing problems in electrophysiological conduction and/or.  So, for example, if there is a disruption in the electrical continuity between the atrium and the ventricle, a pacer…

Pacemakers Review Pt. 1

The pursuit of mastery over cardiovascular emergencies demands a rough familiarity with implanted devices which includes why they get implanted in the first place (indications), how they work, how they malfunction, and how they affect the E…

June 2022
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