A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
Figure 1. Index ECG notable for sinus tachycardia with inferolateral borderline ST-segment depressions.
The Case:
A 47-year-old M with a PMHx of unspecified substance use was transferred from blue team to red team for progressive altered mental status, fever, and episodes of severe bradycardia with confusion (ECG from Cook County). Figure 1 was obtained when the patient initially arrived to red team, and 40 minutes later Figure 2 was obtained, with the patient having intermittent tachycardia and bradycardia in between.
Jose Reyes, MD
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Figure 1. Still image of B-lines on pulmonary POCUS.
The Case:
A 55-year-old female with a past medical history of hypertension, end-stage renal disease (ESRD) on hemodialysis, insomnia, depression, and opioid use disorder presents with rapidly worsening dyspnea that began several hours prior to arrival. She endorses an associated cough productive of clear sputum and admits to inhalation opioid use the day prior. She most recently received hemodialysis two days earlier and has not missed any sessions recently.
Michael Dorritie, DO
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Source: Image by jannoon028 on Freepik
This week’s cheese post will review recent literature that examines the role of antiarrhythmic medications in shockable cardiac arrest. Although algorithmic, these data may suggest some nuance in your approach to the management of shockable rhythms can improve your chances of obtaining ROSC.
Vladimir Bernstein, MD
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