A 70 year-old woman presents to the ER with mid-sternal chest pain, shortness of breath, and diaphoresis. She's clutching her chest with her fist. There is isolated ST elevation in aVR and inferolateral ST depression. That's a STEMI! Or is it?
As a cardiologist involved in critical care, I would like to provide a clear explanation and understanding of the processes involved in resuscitation and critical care. Most particularly, what it must be like for the patient, the patient’s family and the caregivers involved. I will draw on examples from two patients I recently treated, both of whom required acute resuscitation
Managing the Emergency Department is a team sport. That means sharing information with one another, trusting your teammates to perform to the best of their ability, and working together towards a common goal. To that end, one responsibility of [most] ED physicians is supervising mid-level providers.
When evaluating a patient, we rely on a good history to help us form a differential diagnosis. We use our physical exam skills to refine that list. A bedside ultrasound or ECG can further guide our decision-making and save precious time. Beyond these, we rely on seemingly failsafe data: radiographs, blood tests, and urine samples. But sometimes these reliable tests aren't so reliable.
As disease patterns evolve, so too must we. Being aware of emerging illnesses and remaining diligent in identifying their presence ensures a safe environment for the patient and the community. Measles is a highly contagious and potentially lethal viral infectious disease.