Month: April 2019

Podcast #144 – Should Your RUSH to the Ultrasound in Hypotension?

A relatively recent article, the SHoC-ED trial, can sound like the need for ultrasonography in hypotension is not necessarily beneficial.  In this podcast the trial, along with its strengths and limitations, will be reviewed. Previous papers such as theSasmaz et al. paper published in Emergency Medicine International in 2016, “Effect of Focused Bedside Ultrasonography in

A 40 yo with Chest pain. Only ECG abnormality is minimal ST depression in I and aVL (computer interpretation: normal)

A former resident sent this. He asked: “Hey Steve, Wanted to get your thoughts on this EKG:” What do you think?The computer called it a normal ECG Aside: [There is some “sinus arrhythmia”, which is indeed a normal finding.  Sinus arrhythmia is sinus rhythm whose rate varies with respiration.  If the longest P-P interval is

How long would you like to wait for your Occlusion MI to show a STEMI? Sometimes serial ECGs minimizes the delay.

Written by Pendell Meyers An elderly woman presented with acute onset chest pain and shortness of breath.  EMS showed us their ECG on arrival at her house: What do you think? There is sinus rhythm with minimal STE in V1-V3, not meeting STEMI criteria. However, this STE is definitively abnormal in the setting of a