EKG Toxicology

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EKG Toxicology

Emergency medicine physicians frequently assess and treat patients who have accidental or intentional poisonings. United States poison centers receive over two million case referrals per year. And, about 20% of these poisonings present to an Emergency Department for evaluation. Evaluation of these patients always includes a history and physical, but further testing can provide valuable information. Blood work is often be needed, but an EKG is a faster, cheaper tool that can provide key pieces of information prompting early interventions. 

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Grand Rounds Recap - 3/4/2014

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Grand Rounds Recap - 3/4/2014

IABP With Dr. Wojciechowski

  • What is it? It's a ~10cm long intravascular balloon that inflates with 25-50ml of helium gas during diastole to increase the coronary perfusion pressure and decrease the afterload on the heart (coronary perfusion pressure = diastolic blood pressure - left ventricular end diastolic blood pressure). The catheter itself has a pressure transducer and a catheter that shuttles the helium gas.
  • Why helium? it is low density, metabolically inactive, and dissolves in blood in case the balloon were to rupture.
  • Who gets one? In general they are reserved for hemodynamically unstable patients as salvage therapy (STEMI with cardiogenic shock, acute MI that can't be reperfused, high risk CABG, failed maximal medical therapy).
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