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Cardiology

Atrial fibrillation in the ICU: Tough AF to Treat, Sick AF to care for…

Atrial fibrillation in the ICU: Tough AF to Treat, Sick AF to care for…

July 28, 2020 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Peer Reviewed by Dr. Sagar Dave, DO Every once in a while, it’s a good thing to get down to the nitty gritty of things. I think this is most helpful in common situations. Atrial fibrillation is one of those things to have quickly accessible in your internal brain. In this episode I want to …

Category: AlgorithmsTag: Cardiology, ICU

Quick Hit Article: Difficult vascular access: You know the drill… but do you really know the drill?

July 23, 2019 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Kawano et al. Intraosseous Vascular Access Is Associated With Lower Survival and Neurologic Recovery Among Patients With Out-of-Hospital Cardiac Arrest. Ann Emerg Med. 2018;71:588-596. THE BOTTOM LINE This study was a secondary analysis of a large EMS trial conducted in 7 sites in the US and Canada. This is a really interesting study that looks …

Category: Quick Hit ArticleTag: Cardiology, ICU

LVAD Complications: A review

LVAD Complications: A review

May 18, 2019 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

This is a nice little review by Dr. Long in Dallas entitled: B. Long, J. Robertson, A. Koyfman, et al., Left ventricular assist devices and their complications: A review for emergency clinicians, American Journal of Emergency Medicine, https://doi.org/10.1016/j.ajem.2019.04.050 INTRODUCTION: A ventricular assist device (VAD) can be placed into the right, left, or both ventricles thus …

Category: Quick Hit ArticleTag: Cardiology, ICU

ST segment elevation in aVR is probably NOT a STEMI…BUT, damn, are they sick!

March 21, 2019 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

There I said it. Well Ok I’ve been saying it for a while. But say this to a room full of doctors and you might be ostracized! Well there has been mounting evidence that would argue aVR ST elevation is not an acute STEMI/ STEMI equivalent for a while now. I think this article clinches …

Category: Quick Hit ArticleTag: Cardiology

Recent Recommendations in Neonatal Resuscitation 2019 UPDATE

March 11, 2019 //  by Jesse Shriki, DO, MS RDMS FACEP//  1 Comment

Sometimes we need a reminder and update on the basics… Your Welcome.. Recent Recommendations and Emerging Science in Neonatal Resuscitation. Pediatr Clin N Am 66 (2019) 309–320. https://doi.org/10.1016/j.pcl.2018.12.002 TIMING OF UMBILICAL CORD CLAMPING  – The 2017 NRP guidelines recommend a 30- to 60-second delay in clamping in all term and preterm infants not requiring resuscitation. – …

Category: BasicsTag: Cardiology, ICU, Pediatrics

Cardiac Arrest in Pregnancy: An 2019 UPDATE

March 11, 2019 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Sometimes we need a reminder and update on the basics… Your Welcome.. Cardiac arrest in pregnancy. SEMINARS IN PERINATOLOGY 42(2018)33–38.  https://doi.org/10.1053/j.semperi.2017.11.007 MATERNAL PHYSIOLOGY – The maternal heart rate increases by 20–30% or 15–20 beats per minute – Cardiac output increases by 30–50% or 1.8 L per minute with the uterus receiving approximately 17% of maternal cardiac …

Category: BasicsTag: Cardiology, ICU, Obstetrics

HYPONATREMIA 2.0

HYPONATREMIA 2.0

December 23, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

HYPONATREMIA PART I – TREATMENT RECOMMENDATIONS IN CASE OF HEMODYNAMIC INSTABILITY, THE NEED FOR RAPID FLUID RESUSCITATION OVERRIDES THE RISK OF AN OVERLY RAPID INCREASE IN SERUM SODIUM CONCENTRATION.  TREATMENT GOALS: An increase by 4-6-mmol/L [Na] is sufficient to reverse most serious manifestations of acute hyponatremia. Increase [Na] no more than 10 mEq/L in 24 hour …

Category: AlgorithmsTag: Cardiology, ICU, Renal

Aspirin for All Comer Chest Pain: Is it Naughty or Nice

Aspirin for All Comer Chest Pain: Is it Naughty or Nice

December 4, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  1 Comment

Like it or not,  we do a fair amount of primary care medicine in the emergency department. Therefore, we need to know some of the basics about primary care.  One of the most fundamental concepts is the use of aspirin for prevention of MI either before the first one (primary) OR after (secondary) your patient …

Category: BasicsTag: Cardiology

Quick Hit Article #12: Should you stay or Should you go for syncope

Quick Hit Article #12: Should you stay or Should you go for syncope

November 26, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Anderson. Trends in Hospitalization, Readmission, and Diagnostic Testing of Patients Presenting to the Emergency Department With Syncope. Ann Emerg Med. 2018;72:523-532   Although this study doesn’t tell you who should be admitted it does nicely show the mortality, albeit inpatient only, and some interesting facts about admitted syncope patients. This was a retrospective epidemiology study of syncope-related …

Category: Quick Hit ArticleTag: Cardiology

QUICK HIT ARTICLE #10: How Low Should you Go? BP lowering without hypertensive emergency

September 18, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Miller, JB. Cerebrovascular risks with rapid blood pressure lowering in the absence of hypertensive emergency. Am J Emerg Med. 2018 Aug 21. pii: S0735-6757(18)30690-9. doi: 10.1016/j.ajem.2018.08.052. There are not many studies of affects of blood pressure lowering on ED patients in the absence of end organ disease. This one is an interesting one and should …

Category: Quick Hit ArticleTag: Cardiology

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