Cardiology

Getting your chest pain evaluation right: #UMECS16

Last week, while Iain was giving a keynote lecture in Austria, I was also heading for distant shores to speak about chest pain evaluation at a special conference set up by the legendary Amal Mattu: the University of Maryland Emergency…
Read more

JC: High sensitivity Troponin I on presentation. Is it enough to rule out ACS? St.Emlyn’s

As you surely know we love thinking about Troponin at St.Emlyn’s. We have our own world expert in Rick Body and there is loads of stuff here on the site about the use (and abuse) of Troponin as a diagnostic…
Read more

JC The REVERT trial: Dip or doom for SVT in the Emergency Department?

SVT (supraventricular tachycardia) is something we see a lot of in Emergency Medicine.  Any emergency physician will tell you exactly how satisfying it is to treat a patient with SVT.  There must be close to a 100% successful cardioversion rate, one…
Read more

JC: Are typical chest pain symptoms predictive of outcome? St.Emlyn’s

We love a bit of meta-cognition here at St.Emlyn’s. As time passes and we all become a little longer in the tooth it becomes increasingly apparent that it’s not just ‘what’ we know it’s how we use it. In diagnostic…
Read more

The MACS rule: a new user-friendly version

This blog post is based on a paper we’ve just had published in the Emergency Medicine Journal entitled: ‘The Manchester Acute Coronary Syndromes (MACS) decision rule: validation with a new automated assay for heart-type fatty acid binding protein’.  You can…
Read more

Is severe chest pain more likely to be a heart attack?

    Have you ever heard this sort of conversation in your ED? Junior ED doc: Can I run my patient by you, please? Senior ED doc: Sure Junior: I  have a 40 year old man with chest pain.  I don’t think it’s…
Read more

JC: PARAMEDIC trial m-CPR at St.Emlyn’s

  In some ways you might be forgiven for thinking that 2014 was a bit disappointing in terms of EBM. A number of clinical trials that I’ve been looking forward to for some time have in effect produced negative results….
Read more

JC: Getting Chilly Quickly 3. Hypothermia at St.Emlyn’s

In a rather strange co-incidence two articles landed on my desk this soggy Sunday morning. Firstly we have an RCT of intra-arrest therapeutic hypothermia published in Intensive Care Medicine. Secondly we have the ‘cool car‘. Now I like science and…
Read more

New NICE high sensitivity troponin guidance: 3 hours and done?

The National Institute for Health and Care Excellence (NICE) from the UK has just published new recommendations for the use of high sensitivity troponin to rule out NSTEMI in the Emergency Department.  You can find it at this link.  I…
Read more

Translate »