recent articles

practice updates

Asymptomatic Hypertension

"We should only intervene under very specific circumstances"
Asymptomatic hypertension in the ED: Should we be screening for end-organ damage? Should we intervene? Joshua Bucher, MD covers the 2013 ACEP Clinical Policy addressing these common questions.

practice updates

D-Dimer in Aortic Dissection Workup

"Higher d-dimer levels correlate with more segments of the aorta involved, with false lumen type dissections, and with higher mortality rates"

D-dimer has great sensitivity for aortic dissection, but its true clinical utility in the workup of this high-risk diagnosis remains undefined. Tim Schaefer, MD reviews diagnosis and management, as well as the recent literature on the role of the d-dimer.

practice updates

Carotid Artery Dissection

"Significant cause of strokes in young/middle aged patients"
Olabiyi Akala, MD summarizes the signs, symptoms, and imaging options for making the diagnosis of carotid artery dissection, and discusses current controversies in management.

practice updates

Wellens’ Syndrome

"One of the essential instant recognition abnormalities on ECG"
Knowing how to spot Wellens' morphology is crucial, but knowing when to expect those ECG changes is the other half of the battle. In this excellent article, Brendon Browning, DO covers the intricacies of this deadly entity, including diagnostic criteria, management pitfalls, and how to identify mimics.

practice updates

Ventricular Assist Device Management

"Some will not have a palpable pulse, and unfortunately, manual BP cannot be obtained. In addition, pulse oximetry is unreliable"

No pulse? No problem! Manpreet Singh, MD covers a stepwise approach to troubleshooting ventricular assist device complications in the emergency department.