This is part two of a three-part series to answer the question, “it is acceptable to order a single troponin in an elderly patient with dizziness, weakness, or a similarly vague anginal equivalent?” So far, we understand that troponin testing can be tricky, and while it’s common clinical practice to order a single troponin, only serial troponins […]
You’re working in Geri and have 10 elderly patients with dizziness and/or SOB on your board. None of them can reliably recall when their symptoms started. You are about to order “just one trop” on all of them. After all, elderly patients have atypical presentations of ACS, right? And most of them have cardiac risk factors including […]
Given the evolving definition of sepsis and the continual push to report sepsis measures to State Health Departments and CMS, I thought the time is ripe to revisit a popular topic: the significance of elevated lactate in the ED. After all, not all elevated lactate is sepsis, and we may be able to spare some […]
If you’re like me, you probably hook your chest tube up to a Pleur-Evac, put it on the ground, then back away slowly. Who knows what goes on in that mysterious bubbling white box? Hopefully this will post shed some light. [spacer height=”20px”] Isn’t this just a container for stuff that comes out of the […]
If you’ve ever been confused about why cooling matters in post-cardiac arrest, when to do it, how to order it, or what temperature (34C? 36C?) is best, read on. [spacer height=”20px”] Why do we do this? To protect the brain from the effects of poor profusion due to cardiac arrest. There is good evidence that […]
When Should I Use It? For cases of profound beta blocker overdose with clinically significant cardiovascular depression (symptomatic bradycardia, hemodynamic instability). [spacer height=”20px”] Since many patients are on both beta blockers and calcium channel blockers, it can sometimes be difficult to tell which was the source of overdose. One hint is that beta blocker overdose […]
