ECG Cases 10 – Hyperkalemia: The Great Imitator

Which of the following 9 patients had hyperkalemia? Can you estimate how high their serum potassium was based on the ECG? Jesse MacLaren guides us through 9 ECGs underscoring the fact that while the ECG cannot rule out hyperkalemia, significant hyperkalemia often produces ECG changes in the heart rate (bradycardia, junctional rhythm), electrical conduction (PR prolongation or loss of P waves, QRS prolongation, pacemaker delays), and ST/T waves (Brugada phenocopy, peaked T waves that are narrow/pointy) that can be easily recognized. He suggests when you might pull the trigger on giving empiric calcium treatment based on the ECG finding in this month's ECG Cases...

By |2020-06-15T21:35:47-04:00June 15th, 2020|Categories: ECG Cases, Uncategorized|Tags: , , , , |4 Comments

CritCases 5 – Pediatric Drowning and Hypothermia

In this CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, Dr. Michael Misch discusses the management controversies around a challenging pediatric drowning and hypothermia case, including the nuances of rewarming, oxygenation, CPR or no CPR, the role of ECMO, dosing of epinephrine and more...

Best Case Ever 49 – Post-Arrest Hyperkalemia

Melanie Baimel's Best Case Ever on Post-Arrest Hyperkalemia on EM Cases. Post arrest patients can sometimes be challenging. We need to think of a variety of underlying causes of the arrest, antiarrhythmics, possible cath lab activation, targeted temperature management, sedation and more. To add to this, many post arrest patients do not have ideal vital signs that require attention. In this Best Case Ever, in anticipation of our upcoming episode on A Rational Approach to Hyperkalemia Dr. Melanie Baimel describes a post arrest patient who remains bradycardic and hypotensive despite multiple pressors....

Best Case Ever 30 Rob Rogers’ Mother

I caught up with my friend and education innovation mentor Dr. Rob Rogers at ACEP in Chicago where he told me the tale of his mother's devastating illness - the only EM Cases occurrence of a second Best Case Ever. This powerful story begs many questions, some of which we discuss in the podcast: The importance of considering a lumbar puncture in the setting of altered mental status NYD, cognitive de-biasing strategies and the importance of being a humble patient advocate. We discuss a diagnosis that we should never miss in the ED, how to recognize it early, some pearls and pitfals, as well as how to manage it effectively. We touch how to recover from personal tragedy in anticipation of his upcoming SMACC talk in June 2015. Enough of this.....listen. [wpfilebase tag=file id=517 tpl=emc-play /] [wpfilebase tag=file id=518 tpl=emc-mp3 /]