@WUSTL_EM #EMConf #FOAMed Supplement No. 40
Dermatology
- Don’t be this person when you talk about rashes: http://gomerblog.com/2016/08/dermatologists-ears-bleed-listening-internist-describe-rash/
- Real Derm FOAM can be found in the locations we’ve previously covered thanks to Dr. Bruton last academic year
NonST Elevation ACS & ECMO
Source: 2014 AHA/ACC NSTE-ACS guidelines (emphasis mine)
- There are multiple indications to activate the cath lab that are not STEMI. The 3-part series by the Amal Mattu starting at 27:00 or so is pretty enlightening.
- If a nonSTE ACS patient has intractable ischemia or acutely decompensated heart failure, it is a class IA recommendation in the national AHA/ACC guidelines to get the patient to the cath lab within 2 hours. (2014 AHA/ACC Non-STE ACS Guidelines. Amsterdam et al. Circulation, 2014)
- Please listen to this (3-part) post from Amal Mattu’s blog - No login required
- Mattu Class I - do the cath (national or international guidelines to back you up)
- Good review of the definition of STEMI & tips to not miss a posterior STEMI
- The punchline is V1, V2, V3 depression :: do a posterior EKG
- https://ecgweekly.com/2015/10/amal-mattus-ecg-case-of-the-week-october-26-2015/
- Good review of the definition of STEMI & tips to not miss a posterior STEMI
- Mattu Class IIA - Increasing evidence, but you probably shouldn’t get too much argument
- Mattu Class IIB - Really good evidence - Have a good discussion with your Cardiologist
- Mattu Class III - Don’t do the cath
- Mattu Class I - do the cath (national or international guidelines to back you up)
- Please listen to this (3-part) post from Amal Mattu’s blog - No login required
- What happens though, when your metric for “good care" is door-to-balloon time (a non patient-centered outcome)? The long and the short of it is that your rate of negative cath goes up and your patients do worse. Going for cath is not a benign procedure.
- http://rebelem.com/beyond-acls-cpr-cath-new-accaha-cardiac-arrest-algorithm/
- ED ECMO
- Folks: there’s an entire blog for ED ECMO. It’s aptly named: http://edecmo.org
- EM Crit’s covered it: http://emcrit.org/podcasts/ecmo/
MSK & Radiology of the Hip
- http://lifeinthefastlane.com/hip-and-pelvis-injuries/
- http://www.orthobullets.com/trauma/1037/femoral-neck-fractures
- http://www.orthobullets.com/recon/5013/tha-periprosthetic-fracture
- http://www.orthobullets.com/trauma/1038/intertrochanteric-fractures
- Since it was brought up: http://lifeinthefastlane.com/the-john-thomas-sign/
- http://www.emsworld.com/article/10613724/managing-unstable-musculoskeletal-injuries