Practical Summaries in Acute Care Archives – December 1, 2005
December 1, 2005
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Clinical Briefs in Primary Care supplement
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Central Venous Lines Pose High Risk for Infection
Central line-associated bloodstream infection (BSI) is the third most common nosocomial infection reported from the medical/surgical intensive care unit (ICU) setting (after ventilator-associated pneumonia and catheter-associated urinary tract infection). Approximately 250,000 central line-associated BSIs occur annually in the United States. -
The Follow-Up on Follow-Ups Looks Bleak
Timely follow-up care is necessary to prevent adverse outcomes in patients who are discharged from the emergency department (ED). In particular, it may be unsafe to discharge a patient with a potentially serious health problem if timely and appropriate follow-up care cannot be ensured following the visit to the ED. -
Improving Survival When Cardiogenic Shock Complicates Acute MI
Based upon the results of studies showing that early mechanical revascularization substantially reduces mortality among patients with acute myocardial infarction (AMI) complicated by cardiogenic shock, the American College of Cardiology and American Heart Association classified this intervention as a class I recommendation in their 1999 guidelines. -
ACS without ST-Segment Elevation: How Fast to the Cath Lab?
It is well-established that patients with acute coronary syndrome (ACS) with ST-segment elevation (STE) on the electrocardiogram (ECG) benefit from early coronary revascularizationpreferably by percutaneous coronary intervention (PCI), but also via fibrinolysis. -
Atrial Fibrillation Management Pearls
Several years ago as a medical student, I was wisely taught that the clinician should approach the patient with atrial fibrillation in the acute setting with the following thoughts in mind: 1) the patients hemodynamic state; 2) control of the ventricular rate; and 3) consideration of acute cardioversion. Certainly, nothing has changed regarding the consideration and classification of hemodynamic instability. -
ECG Review: The P Holds the Key
The electrocardiogram (ECG) in the Figure was interpreted as showing premature ventricular contractions (PVCs) and chamber enlargement. Do you agree? Can you identify at least four findings "keyed by the P" in this ECG?