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#EMDutch Review- 5

3 Oct

Welcome to the #EMDutch Review from October 2013. From now it will be bimonthly! We have a great podcast by Dr. Weingard about tubing the shocked patient. Furthermore we have great tips for you FOAM beginners out there, a video on lateral canthotomy and much more!

Posts

iTeachEM: Great tips for FOAM beginners

Great tips by Chris Nickson for FOAM beginners. Be active, be nice, be a tweeter and much more!

http://iteachem.net/2013/06/ten-tips-for-foam-beginners/

EMS World Expo: STEMI Mimics

Not every ST-elevation is an STEMI! Just think about pericarditis, brugada, ventricular aneurysm etc. Here is a great overview! (in pdf)

http://emsworldexpo.com/z-pdf/2013/handouts/Make_The_Right_Call_2.pdf

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#EMDutch Review – 4

1 Aug

Here is the review from July 2013:

Posts

Academic Life in Emergency Medicine: Geriatric Blunt Trauma: Respect the Lactate

Lactate is often elevated as a result of activation of the sympathetic system. A negative lactate certainly doesn’t rule out serious pathology, but a positive lactate, particularly in the elderly, who may not be able to mount a lactate as robustly as younger patients, might indicate serious pathology. Lactate levels in trauma, however, have not been discussed as often. Some patients may be able to compensate enough that their vital signs appear normal, even if they are at high risk for decompensation, or their vitals may be inappropriately normal because they are unable to elevate their heart rate (due to age, cardiac disease, or beta-blockers). An elevated lactate could help identify patients early on who have normal vital signs with occult hypoperfusion.

“The data supports the use of arterial lactate and base deficit testing to identify elderly normotensive trauma patients who are at increased risk of death and who might benefit from early monitoring and admission to higher levels of care”

http://academiclifeinem.com/geriatric-blunt-trauma-respect-the-lactate/

P2Y12 receptor inhibitors in ACS

22 Jul

The cornerstone of treatment of ACS in the ED is aspirin, anticoagulation and P2Y12 receptor inhibitors. It is in the guidelines, but still it is interesting to look at the evidence behind the guidelines! Just read the article in BMJ called: “Why we can’t trust clinical guidelineshttp://www.bmj.com/content/346/bmj.f3830.

Today we dive into the evidence of  P2Y12 receptor inhibitors for ACS. The ones we look at are clopidogrel, prasugrel and ticagrelor! And just so you know, I have no conflict  of interest!!!

Here is the table with the articles:

Table P2Y12