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Shift Pearls: Acute Heart Failure Exacerbation Disposition

Shift Pearls returns with disposition of the ED patient with heart failure exacerbation.

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    Articles

    Mesenteric Ischemia: A Power Review

    • 3 Comments
    It’s a typical busy afternoon ED shift for you. The rack seems to be overflowing, and 3 new patients have just checked in. All have abdominal pain. You have a systematic approach to your abdominal pain patients. But, does your approach keep one critical diagnosis in mind? [...]
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    The Low-Risk Chest Pain Conundrum: Part 1

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    [Editor's note: For a limited time, Tintinalli's is making their full chapter entitled "Chest Pain: Cardiac or Not?" available to emDocs readers.]

    Low-risk chest pain. Examining and challenging "standard of care."
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    • practice updates

    Ask Us Anything With Mike & Matt

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    Our AMA with Dr. Mike Mallin & Dr. Matt Dawson from the Ultrasound Podcast, held on Friday, November 14th from 2-3:30pm EST.
    Live Blog Ask Us Anything with Mike & Matt
     
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    • practice updates

    The Wheeze That Wasn't – An Observation on Enterovirus D-68

    • 2 Comments
    These children are often a mixed picture of viral bronchitis/bronchiolitis PLUS an asthma exacerbation. Treatment with albuterol, ipratropium, magnesium sulfate, steroids, fluids, etc are all reasonable and prudent in this population. If they begin to clinically improve within 30 minutes then you can feel good about soothing their reactive airways.
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    • practice updates

    The Future of Emergency Medicine Education

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    Trying to predict the future is a task that is riddled with risk. There is a very high potential that I will be wrong and my thoughts will end up being complete baloney. I'm okay with this. According to Strengths Finder 2.0, I'm futuristic, meaning that I'm inspired by the
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    Clinical Case: Bounceback Leg Pain

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    Leg pain...anticoagulation...Hb drop... A rare but dangerous diagnosis you do not want to miss
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    Acute heart failure exacerbation disposition

    Not all patients require admission

     

    Consider patient hemodynamics, respiratory status, ECG, labs (Cr, troponin, sodium/electrolytes), ability to ambulate, follow up

     

    Elevated troponin and serum Cr associated with worse outcomes

     

    Don’t use risk tools alone for DC, but Ottawa Heart Failure Risk Scale may assist in admission (ACEP Level B)

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