A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
County Coronaries: Considering Cook County ECG Cases
Case: A 70 yo male with a history of hypertension, CKD, and diabetes presents after 4 syncopal episodes over the last 3 weeks. These episodes are preceded by mild dizziness and a “funny” sensation in his chest, as if his heart was “skipping a beat”.
His initial ECG is shown:
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For the high yield teaching points from our simulation sessions
Case: Post-Partum Hemorrhage
A 24 year-old G2P1 female at 38 weeks of pregnancy arrives by EMS after delivering the ambulance. You work at a community emergency department with no in-house OB/GYN. In-house pediatricians will take over care fo the newborn. At time of arrival, EMS has clamped and cut the cord.
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EM Perles: For your ED pharmacology pearls
Clinical Conundrum:
Do direct oral anticoagulants (DOACs) require overlapping or “bridging” with low molecular weight heparin (example: enoxaparin) or unfractionated heparin upon initiation of therapy?