Approach to Chest Pain

Clinical factors that INCREASE likelihood of ACS/AMI: CP radiating bilaterally > right > left Diaphoresis associated with CP N/V associated with CP Pain with exertion

Oxygen therapy for acutely ill medical patients: a clinical practice guideline

What you need to know It is a longstanding cultural norm to provide supplemental oxygen to sick patients regardless of their blood oxygen saturation A recent systematic review and meta-analysis has shown that too much supplemental oxygen increases mortality for medical patients in the hospital For patients receiving oxygen therapy, aim for peripheral capillary oxygen […]

2018 Bradycardia Clinical Guidelines

Colours correspond to Class of Recommendation.*Atropine should not be given in patients after heart transplant.†In patients with drug toxicity and severe symptoms, preparation for pacing should proceed simultaneously with pharmacologic treatment of drug toxicity.AADs indicates antiarrhythmic drugs; AV, atrioventricular;BB, beta blocker; CCB, calcium channel blocker; COR, Class of Recommendation;ECG, electrocardiographic; H+P, history and physical examination; IMI, inferior […]

T-Waves

Hyperacute T-waves are often the first manifestation of complete vessel occlusion; they are wide, bulky and prominent. Hyperacute T-waves are not necessarily tall, and small T-waves can still be hyperacute when paired with a low-amplitude QRS complex. De Winter T-waves represent LAD occlusion (a STEMI equivalent) requiring immediate revascularization. Previously inverted T-waves can appear normal and upright in […]

The Heart Score

The risk of ACS in patients with negative biomarkers and normal ECGs approaches 0.2%. Prior risk scores, such as TIMI and GRACE, provide little, if any benefit, in risk stratification for ED chest pain patients. The HEART score and pathway can risk stratify patients into three separate categories: low (0-3), moderate (4-6), and high score (> 7). Low-risk patients on […]

NSAIDS increase risk of Heart Attacks

A cohort of 446 763 individuals including 61 460 with acute myocardial infarction was acquired. Taking any dose of NSAIDs for one week, one month or more than a month was associated with an increased risk of myocardial infarction. With use for one to seven days, the probability of increased myocardial infarction risk (posterior probability […]

Emergency Medicine Kenya Foundation

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