Brooklyn EM

The Official Twitter for the Brooklyn Hospital Emergency Medicine Program

[Brooklyn EM @TBHCEM]

Trotman-Syncope 1.50% no etiology 2.No prodrome? Think cardiac 3.Admit >65 and/or risk fx https://t.co/yjbxX555ut-exertion - mechanical

[Brooklyn EM @TBHCEM]

Shaikh-4.No magnet 5.Magnet turns pace into fixed mode, risk R on T 6. Magnet turns off AICD 7.Only if cutaneous pacing + pt. being shocked

[Brooklyn EM @TBHCEM]

Shaikh-Pacemakers 1.AICD > pacemaker (size+cost) 2.If 2 ventric. spikes ->posterior lead for contractility 3.AICD shocks at approx.60-80J

[Brooklyn EM @TBHCEM]

Shaikh-Pacemaker 4.Confirm CAPTURE with palpating pulse, pulse ox heart rate and monitor 5. Monitor will show LBBB

[Brooklyn EM @TBHCEM]

Shaikh-Pacemaker 1.Unstable dx is clinical: AMS/syncope 2. Mobitz II or 3rd degree +/- pacemaker 3. 3rd degree narrow more stable than wide

[Brooklyn EM @TBHCEM]

Danik-Tachy 1. Unstable->SHOCK! 2. Stable - Narrow i. Vagal ii. Adenosine iii. AV blocker 2. Wide - Treat like vtach ->Antirhymthic

[Brooklyn EM @TBHCEM]

Hug-CHF 1. BP classification i.HTN ii.Normtotensive iii.Hypotensive 2. BiPaP 3. High dose nitro 4. +/- ACE-I 5. Lasix? May cause harm

[Brooklyn EM @TBHCEM]

Viswanath-HEART 1. Patient population Netherlands different than BK 2. Pt's had good follow up 3. Unknown when troponin drawn

[Brooklyn EM @TBHCEM]

Terrin-HEART 1. Simple to calculate 2.Quickly risk stratifies 3.Can change management 4.First tool that incorporates low risk chest pain

[Brooklyn EM @TBHCEM]

Gowda-ACS 1. Recognize early 2. NSTEMI/STEMI - Dual anti-platelet therapy + anticoagulation 3. STEMI - TNK if no PCI in 60 minutes

[Brooklyn EM @TBHCEM]

Thandi-Presentations 3. EXCITATION! Be excited! Unique opportunity to teach your peers! Take pride! What you say will save lives!

[Brooklyn EM @TBHCEM]

Thandi-Presentations 2.Preparation-Organization, 3-4 take home points, slide design: Pic superiority, Empty Space, Signal to Noise Ratio

[Brooklyn EM @TBHCEM]

Thandi-Presentations 1. Inspiration - Learn from great speakers i.e. TED, youtube, TV and how ER speakers educate i.e. F.O.A.M.

[Brooklyn EM @TBHCEM]

Lappin 1.HTN emergency is catergorization, not dz process 2.Years to cause symptoms 3.Treat underlying dz not # 4.Don't use term "Urgency"

[Brooklyn EM @TBHCEM]

SIM-Peds1.FS is 6th vital sign! 2.Arrest Epi 0.01 mg/kg IV 3.Defib=2,4,10 J/kg 4.Atropine 0.02 mg/kg 5.Amiadorone 5mg/kg 6.Glucose 0.5-1g/kg

[Brooklyn EM @TBHCEM]

SIM -Asthma 1.Epi, epi, epi! O.5 mg IM q3-5 min (1:1,000) 2. Or 1-5 mcg/min IV (1:10,000) 3. Duonebs 4. Steriods 5. Mag 6. Bipap 7. Intubate

[Brooklyn EM @TBHCEM]

SIM - Eclampsia 3. Mag tox antidote=Calcium gluconate 1g IV 4. Mg decreases seizure risk flby 50% 5. BP control! Hydralazine or labetelol

[Brooklyn EM @TBHCEM]

Sim - Eclampsia - 1. Preclampsia + seizure/coma 2. Preclampsia=BP > 140/90 +proteinuria > 0.3 g in 24hrs 3. Tx: Mag 4-6 G IV and drip 2g/hr