EM:RAP
Dr. Al Sacchetti weighs in on the issue of etomidate in sepsis and
reviews his recent debate with Dr. Ron Walls in the July issue of
annals of emergency medicine. Here’s a highlight. A single dose of
etomidate will eliminate the adrenal gland’s response to ACTH by
inhibition of 11-ß-hydroxylase leading to a depressed cortisol response.
Read more
Aortic dissection is a difficult diagnosis to make and has been dubbed
the “Great Masquerader” due to the myriad of possible presentations
including stroke, MI, abdominal pain, and lower extremity problems.
D-dimer may be useful as a screening test for dissection because of
reported sensitivities of >99% and negative predictive values
>99% across multiple studies.
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A digest of Mel Herbert’s monthly audio CME series
edited by Chris Feier, MD
Read more
A digest of Mel Herbert's monthly audio CME series
edited by Chris Feier, MD
Read more
A digest of Dr. Herbert’s monthly audio CME series
edited by Chris Feier, MD
Read more
A digest of Dr. Herbert’s monthly audio CME series
edited by Chris Feier, MD
Read more
A digest of Dr. Herbert’s monthly audio CME series
edited by Chris Feier, MD
Read more
A digest of Dr. Herbert’s monthly audio CME series
edited by Chris Feier, MD
Read more
A digest of Dr. Herbert’s monthly audio CME series, edited by Chris Feier, MD
As emergency physicians we want to stratify patients into risk
categories based on their short-term probability of death or adverse
event. This is in contrast to the internist who wants a more global
assessment of a patient’s health to determine long-term preventive
medications, such as statins. There are many tools we can use for this,
but one of the most powerful is the resting EKG.
Read more
1.Use of the PERC (Pulmonary Embolism Rule-out Criteria) rule can significantly decrease work-up for pulmonary embolism.
To apply this rule, the clinician must first use clinical gestalt to
classify the patient as low risk. The PERC rule, which consists of
eight clinical criteria including history, physical and vital signs,
can then be used. If both of these criteria are met, then there is less
than a 2 percent risk that this patient has a PE and no further work-up
is needed.
Read more
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