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Is epinephrine harmful in cardiogenic shock?

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We’re only going to focus on one facet of today’s article in our discussion, but Dr. Sean van Diepen wrote an excellent editorial that covers several other important points. [1] There is more to the paper than I’m going to dive into here, so check out his editorial if you have access around the paywall. […]

In Defense of Morphine (Part 2)

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Yesterday, I introduced some of the history preceding the recent Thrombosis and Haemostasis study looking at morphine in patients experiencing ST-elevation myocardial infarctions (STEMIs). [For the curious, we’ll talk about that new article in Part 3. I have to work today, so I can’t guarantee that it’ll be up tomorrow, but soon!] We started with […]

In Defense of Morphine (Part 1)

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Every time I hope this debate is going to die out, or that science will swing back toward rationality, another study gets published and throws a wrench in things. I’ll type this very carefully: There is no convincing evidence that morphine causes harm to patients experiencing ST-elevation myocardial infarctions (STEMIs). As long as there isn’t […]

Triaging Triage ECGs

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I’ve spent nine years working in an emergency department, which means I’ve also spent nine years performing electrocardiograms at triage. With a couple thousand waiting-room ECGs under my belt, I’ve noticed a few things: A lot of ECGs are ordered at triage. Many of them are performed on low-risk patients. Very few of those ECGs […]

No, doubling the paper speed will not reveal hidden P-waves

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Apparently I went to the Rick Bukata School of Titling Articles. A 22-year-old male presents with agitation and delirium after smoking an unknown substance that an equally unknown person on the street offered him. You note a rapid radial pulse at around 150 bpm and attach him to the cardiac monitor: Well now we’re in […]

The 12 Leads of Christmas: V3

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This is the eleventh and penultimate article in our latest series, The 12 Leads of Christmas, where each day we examine an individual electrocardiographic lead. Lead V3 Today we’re going to discuss V3, and there’s no way I can do that without talking about isolated posterior myocardial infarction. Of all twelve, fifteen, eighteen, or even […]

The 12 Leads of Christmas: V2

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This article is the tenth in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead V2 I love V2. It’s probably been my favorite lead to examine and ponder this past year. The cool thing is that it doesn’t seem all […]

The 12 Leads of Christmas: V4

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This article is the eighth in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead V4 Like aVF, V4 is a tough lead to discuss on its own. It’s part of the natural flow of the complexes across the precordium and […]

The 12 Leads of Christmas: V1

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This article is the seventh in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead V1 Happy New Year everyone! Today’s post is going to be a bit of a hodge-podge as I recover from yesterday’s post on ST-elevation in aVR. […]

The 12 Leads of Christmas: aVR

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This article is the fifth in our latest series, The 12 Leads of Christmas, where each day we examine a new finding particular to an individual electrocardiographic lead. Lead aVR I have a love-hate relationship with aVR. There is one big question that always looms around it: Is ST-elevation in aVR a STEMI-equivalent? Like most […]

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