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STEMI and STEMI Equivalents, i.e. Who Needs the Cath Lab Now!
Grand Rounds, Intern Radiology Videos Robert Whitford, MD Grand Rounds, Intern Radiology Videos Robert Whitford, MD

STEMI and STEMI Equivalents, i.e. Who Needs the Cath Lab Now!

1. The ACC/AHA Criteria (1) (2) 

ST-elevation in 2 contiguous leads that is:

  • Men < 40: 2.5 mm ST-elevation in V2 or V3, 1 mm in any other lead

  • Men > 40: 2.0 mm ST-elevation in V2 or V3, 1 mm in any other lead

  • Women: >1.5 mm ST-elevation in V2 or V3, 1 mm in any other lead

STEMI's have a 90-minute door-to-balloon time mandate from the Center for Medicare Services (CMS). To be good stewards of our resources we need to be familiar the false positive STEMI patterns.  Ultimately, however, some degree of over triage and activation for false positives is expected and (potentially even) desirable.

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Interpretation of Cervical Spine CT's
Intern Radiology Videos, Grand Rounds Aalap Shah, MD Intern Radiology Videos, Grand Rounds Aalap Shah, MD

Interpretation of Cervical Spine CT's

It's 6pm in the ED on a sunny summer afternoon- you're working as a single coverage physician at a level 3 trauma center.  You are noticing an uptrend in the trauma patients being brought in over the past few hours. While log rolling yet another patient, an EMS provider tells you that they have been making runs nonstop- all of the hospitals downtown are overloaded, and it doesn't look like it will slow down anytime soon. Your modest trauma bay is already full, and you're starting to sweat about the state of the department- there are 4 patients in the pod you haven't even seen yet, 2 with abnormal vital signs.

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Pediatric Abdominal Ultrasound
Grand Rounds, Intern Radiology Videos Jeffery Hill, MD M.Ed Grand Rounds, Intern Radiology Videos Jeffery Hill, MD M.Ed

Pediatric Abdominal Ultrasound

After a long shift in the adult ED, jam packed with patients presenting with abdominal pain, your looking forward to a brand new day in the Peds ED.  Your first patient, however, gives you PTSD-like flashbacks to the previous days shift.  

Alice is a 8 year old girl who developed abdominal pain last night.  Her parents thought that she would be okay waiting until morning, that the pain would pass in the night.  On waking this morning, however, the pain was still there.

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