A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
A 60-year-old male with a past medical history of hypertension, coronary artery disease status post stenting of the left anterior descending (LAD) artery and right coronary artery (RCA) in 2023 presents to the emergency department (ED) with a chief complaint of left-sided chest pain that started one hour prior to arrival.
Michael Hohl, MD; Taylor Wahrenbrock, MD; Ari Edelheit, MD
Read MoreWhen intubating patients with anatomically or physiologically challenging airways, first-pass success is of utmost importance to minimize procedural complications (1). According to the INTUBE trial, two or more attempts at intubation were associated with an increased risk for major adverse events (2). Specifically, the risk of severe hypoxemia increased from 5% on the first pass to 20% on the second pass and 30% on the third pass. Let’s examine whether the bougie may be a useful adjunct to improve first-pass success in the Emergency Department (ED) and potentially minimize the risk of severe hypoxemia and other adverse events.
Kathryn McGregor, MD; Taylor Wahrenbrock, MD; and Eric Leser, MD
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Figure 1. Index ECG.
A 25-year-old G2P1 female with a past medical history of fetal demise 4-5 months prior to this Emergency Department (ED) visit presents with chest pain and palpitations that started at 1:00 AM, approximately 10 hours prior to arrival. Her pain is central and constant without associated cough, shortness of breath, or increased work of breathing. She reports one similar episode of palpitations that resolved spontaneously 2 weeks ago. Mourning a recent loss, she has been drinking approximately 7 beers per shift in her new job as a bartender over the past several months. Her last drink was 2 days ago. She has no history of dysrhythmia, venous thromboembolism, diabetes mellitus, hypertension, alcohol use disorder, or alcohol withdrawal. There is no family history of sudden cardiac death. An index ECG was obtained in triage (Figure 1).
Leslie Cachola, MD and Ari Edelheit, MD
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