Category Archives: Cardiology

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Large Volume Pericardiocentesis

Dr. Menager, PGY-1 EM resident performed this ultrasound on a 47 yr old man complaining of shortness of breath over the last month, worsening in the last day,  associated with increasing lower extremity edema.

PERIOCARDIOCENTESIS PERFORMED – 1500cc removed from pericardium

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18Jul/16
MicroMaxx

How to Perform an US-Guided Pericardiocentesis

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We see patients with pericardial effusions often in the emergency department.   When those effusions are causing tamponade, a pericardiocentesis can be life-saving procedure.  A few months ago, Dr. Plantin, PGY-2 EM resident at HUM, performed his first pericardiocentesis. To watch a video to see how he did, and to learn how to safely perform this procedure, click on the video link above. (video on EMin5.com)

With high rates of tuberculosis, we really do see many pericardial effusions that require drainage.  In fact, Dr. Plantin performed his second pericardiocentesis on his very next shift!  Learn how to perform this procedure now so when the time comes for you to perform it, you will be ready

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ekg-signal-md-1

EKG – 7 – Atrial Flutter

An 18 yr old female with a known history of mitral stenosis presents to the HUM ED with two weeks of shortness of breath and chest discomfort.

This is her EKG.  What does it show?

EKG - 7

HINT:  15 minutes later, after approx 500cc of NS, here is a look at her monitor, how does this help us?

BIGGER HINT:  Below is a video of us giving the patient 6mg of adenosine.

So what does her EKG show?

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26Nov/15
ekg-signal-md-1

EKG – 4 – Atrial Enlargement

A 17 yr old female presents to the HUM ED with acute onset left sided weakness approximately 6 hours prior to arrival.  On exam, she was found to have a left sided facial droop, left arm and left leg weakness (able to walk but does so with significant limp). Her overall examination was consistent with an acute stroke.

An EKG was performed and is attached.  What does this EKG suggest and what other bedside test should it prompt you to perform?

 

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