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the County Consult

A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.

Figure 1. Still image of B-lines on pulmonary POCUS.

Critical Care Pearls - Sympathetic Crashing Acute Pulmonary Edema

November 22, 2023

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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In Critical Care, Cardiology Tags Critical Care, Cardiology
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Source: Image by jannoon028 on Freepik

The Cheese - Review of Antiarrhythmics in Shockable Rhythm Cardiac Arrest

November 15, 2023

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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In Cardiology, Critical Care Tags Cardiology, Critical Care
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Figure 1. Still images from point of care echocardiography of patient noting a dilated aortic root, early RV diastolic collapse in the context of a pericardial effusion, and an aortic dissection flap. Left: aortic root measuring 5.3cm; Right: early RV diastolic collapse with dissection flap

Cool County Cases - Aortic Dissection with Hemopericardium and Cardiac Tamponade

September 15, 2023

The Case:

A 40-year-old man with no known past medical history presented for evaluation of chest pain. According to the patient’s fiancée, the patient was experiencing chest pain one day prior to presentation. He continued to have chest pain and was seen at an urgent care clinic, where he was referred to the Emergency Department for an abnormal EKG and chest radiograph. While in the waiting room, the patient had a syncopal episode and was brought back to a station. The patient has no significant surgical or family history. He is a lifelong nonsmoker and occasional social drinker.

Vladimir Bernstein MD

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In Cardiology, Critical Care
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