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Seeing is Believing...
You settle in to your 6th of 6 shifts in a row in B Pod in your tertiary referral center when you sign up for your first patient. Ms. Circling is an 86 year old female who presents with abdominal pain and altered mental status. She presents with her family who gives most of the history that for the last 2 days the patient has been complaining of abdominal pain and has not been eating or as active as normal...
Grand Rounds Recap March 30, 2016
M&M with Dr. LaFollette
Modified Sgarbossa Criteria to aid in diagnosing STEMI in the setting of LBBB
- Can be used in the setting of induced (paced) LBBB
- Unweighted scoring (any of the following indicates STEMI equivilance)
- Concordant ST elevation
- Concordant ST depression in V1,V2,V3
- Inappropriate discordance of >25% ST elevation / S wave amplitudes
- Improves your test metrics from the original criteria from sens/spec of 36%/96% to 80%/99% respectively in a new validation study
If it Bleeds, it Leads………
It’s late on a Saturday night and you are moonlighting as the single provider at a community hospital about 15 minutes from UC. You’re trying to disposition five current patients when a new patient is brought in by EMS with a complaint of vomiting blood. The patient smells of alcohol and states that he drinks daily, though he may have “overdone it” the last 2-3 days since he has had friends in town...