Search Results for: chest pain

practice updates

To the HEART of the matter

The HEART score is an invaluable adjunct to emergency physicians when deciding which chest pain patients are appropriate for early discharge.

practice updates

Don't be RASH: Emergency Physician's Approach to the Undifferentiated Lesion

Editor's note: This post was listed in both the #FOAMED Review from EM Curious AND in the LITFL Review 154 "Best of #FOAMed" section. As an EM physician, it is difficult to have working knowledge of the hundreds of different types of rashes that exist. However, I argue that it is not the job of the ...

practice updates

Left Bundle Branch Block in Myocardial Infarction: An Update

Editor's note: This article was listed in the LITFL Review 154's "Best of #FOAMed" section. The left bundle branch arises from the Bundle of His, and subsequently is divided into the anterior and posterior fascicles. The anterior fascicle is usually supplied by septal perforators from the Left Anter...

practice updates

Amiodarone vs Procainamide for Stable VT

Case Scenario: A 38-year-old male with a history of hypertension and an unknown heart defect status post repair in infancy presents to the Emergency Department with acute onset chest pain, dyspnea, and diaphoresis.  He had a similar episode at another hospital 1 month prior that resolved after "so...

practice updates

PERC Rule: Application and Limitations

"Pleuritic chest pain [...] is not in a validated clinical decision rule despite having a higher OR for PE than hemoptysis and recent immobilization"The PERC rule can be a wonderful thing, but requires judicious use. Jason West, MD reviews the literature, discussing applicability and limitations of ...

em@3am

EM@3AM: Vaginal Bleeding

 A 22-year-old female presents with three days of vaginal bleeding. She has soaked through multiple pads and has passed clots. She endorses some lightheadedness but no syncope. Her last period was two weeks ago. She has no known past medical history, does not use hormonal contraception, and is sexu...