The Utility of Troponin Testing for SVT

Washington University Emergency Medicine Journal Club- October 2023 VignetteYou are working a shift in EM1 one afternoon when you encounter Mr. Steven VonTrachtenberg, a pleasant 45-year old male who presents with palpitations thatbegan one hour prior to arrival. He notes a sense of his heart racing and hasshortness of breath with no chest pain. He […]

Prehospital Blood Product Transfusion in Trauma

Washington University Emergency Medicine Journal Club- September 2023 Vignette: During an EMS rotation, you are riding on a Christian Hospital EMS ambulance, 3017. While driving around North Saint Louis County, the radio tone rings out andthe female computer voice states the following: “4610 and 3017. Gunshot Wound.Scene is not secure. Shell Gas Station. 2331 Chambers […]

Aspiration Versus Chest Tube Placement for Spontaneous Pneumothorax

Washington University Emergency Medicine Journal Club– August 2023 Vingnette: You are working a shift in TCC when you get a page that a patient is being moved upfrom EM2 for chest tube placement. When the patient arrives, you are introduced toMr. B, a thin, healthy 35-year-old male who presented with sudden-onset pleuriticchest pain earlier that […]

IV Magnesium Sulfate for Treatment of COPD Exacerbations

Washington University Emergency Medicine Journal Club– July 2023 Vingnette: You’re working a typical shift in TCC one when encounter Mr. B, a 63-year-old malewith a history of hypertension, hyperlipidemia, and COPD. He presents with 3 daysof gradually worsening shortness of breath and cough productive of white sputum.His shortness of breath has been minimally relieved by […]

CT for Occult Scaphoid Fracture

Washington University Emergency Medicine Journal Club– April 20th, 2023 Vingnette: You are working a shift in EM-2 one weekend when you encounter Mr. S, a right-handed 38-year old man with no significant past medical history who presents with right wrist pain. He had had a few drinks the previous evening to celebrate his birthday and […]

Acetazolamide for Decompensated CHF

Washington University Emergency Medicine Journal Club– February 23rd, 2022 Vingnette: You are working a steady shift in EM-2 one Friday afternoon when you encounter Mr. X, a 50-year-old gentleman with a history of congestive heart failure who presents with 2 days of worsening bilateral lower extremity edema, dyspnea on exertion, and orthopnea. He reports compliance […]

Aggressive vs. Moderate Fluid Resuscitation in Pancreatitis

Washington University Emergency Medicine Journal Club– November 2022 Vignette You are moonlighting in a large community hospital ED one afternoon when youencounter Ms. Y, a pleasant 50-year-old woman with a history of hypertension,hyperlipidemia, and alcohol use disorder. She is complaining of about 12 hours ofepigastric abdominal pain that does not radiate, with associated nausea andnonbloody […]

The Hestia Score & Outpatient Treatment of Pulmonary Embolism

Washington University Emergency Medicine Journal Club– January 18th, 2023 Vignette You are moonlighting in a large community hospital ED one afternoon when you encounter Mr. X, a pleasant 68-year-old man with a history of non-small cell lung cancer on chemotherapy, hypertension, and diabetes mellitus. He complains of sudden-onset left-sided pleuritic chest pain and dyspnea. He […]

Trans-esophageal ECHO in Cardiac Arrest

Washington University Emergency Medicine Journal Club – September 22nd, 2022 Vignette: You are working a shift in TCC when you get a pager about a 68-year-old gentleman with a history of atrial fibrillation who was found pulseless after passing out during his weekly golf game. Bystander CPR was initiated and upon EMS arrival his first rhythm […]

The Canadian Syncope Risk Score

Washington University Emergency Medicine Journal Club– October 19th, 2022 Vignette Ms. Jones is a70-year-old female with a history of HTN and type II DM who presents to the ED after a syncopal event which occurred 30 minutes prior to arrival. The event was witnessed by the patient’s husband who states she had collapsed soon after […]