Run Time: 6 minutes Author: Dr. Eric Miller Educational Pearls: The QT interval is the time from the depolarization of the ventricle through the repolarization of the ventricle. Long QT increases the risk for dangerous dysrhythmias. The QTC – the corrected QT interval – abnormal is over 440ms for men and 460ms for women. Several…
Read MoreRun Time: 4 minutes Author: Dr. Martin O’Bryan Educational Pearls: PERC Score: age >50, HR <100, O2 >95%, no history of PE or DVT, no recent trauma, no hemoptysis, no oral contraceptive, and no unilateral leg swelling. If all are negative then probability of a PE is under 2%. A WELLS Score of <4 =…
Read MoreRun Time: 5 minutes Author: Dr. Peter Bakes Educational Pearls: Common symptoms for congestive heart failure (CHF) are dyspnea, lower extremity edema, and chest congestion. Right heart failure usually presents with JVD and pedal edema. Left heart failure usually presents with chest congestion with rales and rhonchi. A crescendo and decrescendo murmur on presentation indicates congestive…
Read MoreRun Time: 4 minutes Author: Rachael Duncan, PharmD BCPS Educational Pearls: Propranolol overdose presents with bradycardia, hypotension, decreased activity, and decreased body temperature. Propranolol is a lipophilic beta-blocker. Appropriate reversal agents for overdose on propranolol are epinephrine, dopamine, glucagon, calcium, levophed, and an IV lipid sink to sequester the propranolol. In cardiogenic shock, the heart begins…
Read MoreRun Time: 4 minutes Author: Dr. Jared Scott Educational Pearls: The number first most common reason for sudden death after a motor vehicle accident is head injury, the second is traumatic aortic rupture. Due to the increased pressure of blood in the aorta, a rupture leads to rapid exsanguination. The most common location for a traumatic aortic…
Read MoreRun Time: 4 minutes Author: Dr. Nicholas Hatch Educational Pearls: Risk of DVT and PE does go up with pregnancy and increases in each trimester. 1 in 50,000 people develop blood clots in the first trimester with 1 in 10,000 people developing blood clots in the second trimester. The risk for PE or DVT in pregnancy is…
Read MoreRun Time: 3 minute Author: Dr. Samuel Killian Educational Pearls: 5 million people are on Coumadin. Coumadin is in the top 5 of most adverse events. 2 options for reversal in the ER: Vitamin K and FFP or vitamin K and 4 factor PCC. FFP is cheap but harder to use and takes longer –…
Read MoreRun Time: 3 minutes Author: Dr. Aaron Lessen Educational Pearls: New guidelines about treating small clots in the leg and lungs published by the American Academy of Chest Physicians. In a patient with a DVT in the calf, without cancer or long term immobility concerns, there is a 15% chance of the clot moving up…
Read MoreRun Time: 4 minutes Author: Dr. Gretchen Hinson Educational Pearls: Sick Sinus Syndrome is a malfunction of the sinoatrial node causing any combination of bradycardic dysrhythmias, sinus arrests, and tachycardic dysrhythmias. Symptoms include dyspnea on exertion, palpitations, fatigue, and/or chest pain. On a cardiac monitor, patients can be bradycardic and immediately after tachycardic as a common…
Read MoreRun Time: 2 minutes Author: Dr. Christopher Holmes Educational Pearls: Rate control with beta blockers or calcium channel blockers; with a slightly increased efficacy using calcium channel blockers. It is not contraindicated to give both if the first medication tried does not work. Magnesium has been shown to supplement the beta blockers and calcium channel blockers…
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