Evidence-based updates in primary care medicine By Louis Kuritzky, MD
Interpret the lead MCL-1 rhythm strip shown in the figure. Does this rhythm represent Mobitz I (Wenckebach) or Mobitz II AV block? Is a pacemaker likely to be needed?
The paradigm I grew up with in emergency medicine is that there are a limited number of ways to die, and our role was to intervene and prevent death using the principles of A, B, and C: airway, breathing, and circulation. This concept works well for the previously healthy acutely ill or injured patient. But for the patient nearing the end of a life-limiting illness, it is not appropriate and can even be cruel. The introduction of palliative care to the emergency department at first seems out of place; that is the place where patients are snatched from the jaws of death. But as the authors of this issue explain, the ABC of resuscitation can be revised to the ABCD of palliative care assessment to provide better care to patients and families in times of crisis.
In this issue: Aspirin use and AMD risk; using NSAIDs and antihypertensive agents; and FDA actions.
Weaver and colleagues at Intermountain Medical Center in Murray, Utah, conducted a prospective study to determine the false-positive rate of carboxyhemoglobin (COHb) measurements by pulse oximetry (SpCO) in patients presenting to the emergency department at this level one trauma center.
Lu et al prospectively studied 165 patients with culture-confirmed (bronchoalveolar lavage samples), ventilator-associated pneumonia (VAP) caused by either Pseudomonas aeruginosa or Acinetobacter baumannii.
