Noradrenaline_97

EMERGENCY MEDICINE 💉

[Noradrenaline_97 @asmar097]

@o_o_dr طبخ

[Noradrenaline_97 @asmar097]

@hamood578 @Heem_9083 @ReemYahyaAz @ward_mesh @reyoof1927 @1Ather__ شي دراسة؟؟

[The EM Journal Club @emergencyclub1]

Do Prehospital Applied Pelvic Binders Impact Mortality?

📊 Patient Cohorts: Three groups - 14 with appropriately applied binders, 14 with inappropriately applied binders, and 38 without binders.

💡 Key Findings: Survival rates were 92% with binders and 81% without, but this difference was not statistically significant.

🔍 Conclusion: Pelvic binders did not significantly affect outcomes for patients with unstable pelvic fractures. Injury Severity Score (ISS) was a more significant survival predictor.

[Noradrenaline_97 @asmar097]

Presented with SOB and clinical pulmonary oedema
Diagnosis??

[Dr Joshua Walinjom @walinjom]

71yrs Male brought by ambulance
to ED.
He complains of Palpitations
BP 74/45mmHg
Potassium = 1.5 mEq/L

1. Diagnosis ?
2. Immidiate Treatment ?
3. Work-up ?

[The EM Journal Club @emergencyclub1]

🔬 Study: High vs. Low Dose Nitroglycerin in Heart Failure & 🫁 Pulmonary Edema

💊 High-Dose: 600-1000 mcg bolus, 100 mcg/min infusion
💊 Low-Dose: 20-40 mcg/min infusion, no bolus
🇮🇳 Research in India, 54 Patients
🕒 Outcomes at 6 & 12 Hours
📊 Primary Outcome: Symptom Resolution
📈 6hr Results: 65.4% in high-dose vs. 11.5% in low-dose group
📈 12hr Results: 88.5% in high-dose vs. 19.5% in low-dose group
🔍 Conclusion: High-dose leads to significantly better symptom resolution at 6 & 12 hours
🔄 Clinical Implication: Supports higher dose efficiency in SCAPE management

[Noradrenaline_97 @asmar097]

#heart #cardiology

ECG in Acute Pericarditis Vs ECG in Acute STEMI

[The EM Journal Club @emergencyclub1]

😅Rapid Agitation Control With Ketamine in the Emergency Department: A RCT 😅

1️⃣Study Objective: 🎯 Evaluate if intramuscular ketamine reduces time to sedation in agitated ED patients.
2️⃣Methods: 📊 Randomized trial comparing ketamine with midazolam-haloperidol in patients with severe agitation.
3️⃣Patient Treatment:
💉 Ketamine group: 5 mg/kg; Midazolam-haloperidol group: 5 mg each.
💉 Primary Outcome: ⏱ Time from medication to sedation (RASS ≤-1).
4️⃣Results: 📈 Median sedation time: Ketamine - 5.8 mins; Midazolam-haloperidol - 14.7 mins. Ketamine faster (8.8 mins difference).
5️⃣Adverse Events: 🚨 Ketamine: 12.5% patients; Midazolam-haloperidol: 5% patients.
6️⃣Conclusion:
✅ Ketamine provides quicker sedation in severe agitation in the ED, with a higher rate of serious adverse events.

[The EM Journal Club @emergencyclub1]

🔵 Amiodarone Uses:
- Ventricular & supraventricular arrhythmias
- 1st line for pulseless V-tach/V-fib
- Atrial arrhythmias in low EF patients

🔴 Contraindications:
- Allergy to class/drug
- Iodine or shellfish allergy
- Pregnancy

⚠️ Adverse Reactions:
- Bradycardia
- Hypotension (older formulation)
- Prolonged QT
- Thyrotoxicosis (5-20%)
- Iodine-induced hyperthyroidism
- Drug-induced thyroiditis
- Amiodarone Pulmonary Toxicity
- Hyperpigmentation rash

[Noradrenaline_97 @asmar097]

55 years old patient presenting with chest pain.
Diagnosis??

[Noradrenaline_97 @asmar097]

STEMI🧐

[The EM Journal Club @emergencyclub1]

@ManualOMedicine ECG Changes in electrolyte imbalance

[The EM Journal Club @emergencyclub1]

🩺 Classic EKG in Pericarditis:
- Diffuse ST elevations
- Concave upwards STE
- PR depressions in multiple leads (viral)
- PR elevation in aVR

🔴 Ruling out STEMI:
- STE III > STE II (strongly favors STEMI)
- STD in leads other than aVR/V1 (indicates acute MI)
- Presence of new Q waves
- STE convex upwards or horizontal (favors STEMI)

#Cardiology #EKG #STEMI

[Noradrenaline_97 @asmar097]

Diuretics

[Noradrenaline_97 @asmar097]

Difference between VF and VT

[The EM Journal Club @emergencyclub1]

Chvostek sign and Trousseau sign are clinical tests used in the diagnosis of hypocalcemia.
⏺️Chvostek sign is elicited by tapping the facial nerve, causing twitching of the facial muscles if positive. ⏺️Trousseau sign is induced by inflating a blood pressure cuff, leading to carpal spasm in cases of hypocalcemia. These signs are indicative of neuromuscular irritability due to low calcium levels.

[Noradrenaline_97 @asmar097]

Anteroseptal STEMI RBBB

[Noradrenaline_97 @asmar097]

Middle-aged patient presenting with chest pain

[Noradrenaline_97 @asmar097]

Middle-aged patient presenting with chest pain

[Noradrenaline_97 @asmar097]

High lateral STEMI (south
Africa flag sign)

[Noradrenaline_97 @asmar097]

74-year-old man presenting with one hour of central chest pain

Diagnosis?
Treatment?