Tamingthesru

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.

Read More
Grand Rounds Josh Denney Grand Rounds Josh Denney

Ground Rounds Summary 8/19/15

Simulation - Clonidine Overdose

  • 30 yo FM presents after having taking a handful of pills with the following VS: HR 45, BP 83/60, RR 8, 100% RA, T 98.  FS101. It gets better—there's a baby behind that baby bump.  
    • Ddx for AMS, hypotension and bradycardia? Tox, hemoperitoneum, spinal shock, myxedema coma, and a quite atypical sepsis. 
    • By EMS report this lady reportedly took a handful of unknown pills in an effort to harm herself. Remember to consider clonidine overdose in addition to beta blockers and calcium channel blockers. This lady found herself a bottle of clonidine and a near successful suicide attempt.
Read More
Grand Rounds Jeffery Hill, MD M.Ed Grand Rounds Jeffery Hill, MD M.Ed

Grand Rounds Summary 8/12/15

VISITING LECTURER SERIES WITH DR. MATT DAWSON

1) On Technology, Emergency Medicine, and New Frontiers

Today’s tech explosion is leading to health innovations that may make some big differences leading to big changes. Here’s a sneak peak:

Read More