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Tactical Medicine News

REBEL Core Cast – Basics of EM – Chest Pain

by Marco Torres
Jun 01, 2022
Take Home Points Take chest pain seriously – ACS and PE patients don’t always appear ill – look for the silent killer cases Remember 4-2-1 approac...
Tactical Medicine News

Retrospective Validation of High-Sensitivity Troponin with 5 Clinical Decision Instruments

Background: Chest pain is the second most common reason for presentation to the emergency department (ED) and accounts for nearly 6.5 million visit...
Tactical Medicine News

GRACE Guidelines: A Pragmatic Approach to Recurrent Low-Risk Chest Pain

In the United States, a patient with chest pain presents to the emergency department (ED) every 5 seconds. By the time you finish reading this post...
Tactical Medicine News

Chest Pain and Chemotherapy: 5-FU Induced Coronary Vasospasm

58 y/o female with colorectal cancer recently started on continuous 5-FU chemotherapy presents to the ED with chest pain, shortness of breath, and ...
Tactical Medicine News

The HEAR Score: Does Very Low-Risk Acute Chest Pain Not Require Troponin Testing?

Background:  Chest pain is one of the most frequent presenting patient complaints in emergency departments (ED) and has an extensive differential d...
Tactical Medicine News

Single Troponin Testing in ED Patients With Suspected Acute Myocardial Infarction

Background: One of the most common reasons for Emergency Department (ED) visits is chest pain. While most of these presentations are at a low risk ...
Tactical Medicine News

Ep 128 Low Risk Chest Pain and High Sensitivity Troponin – A Paradigm Shift

In the age of high sensitivity troponins and the HEART pathway, which patients are safe to discharge home from the ED? What are the most useful his...
Tactical Medicine News

Chest Pain, “Negative” Stress Tests, POCUS, & ECG Equations

I was working a busy shift in the ED, like many of us do, and the next patient I was going to see was a 57 year old male with no real medical probl...
Tactical Medicine News

Does My Patient with Chest Pain Have Acute Coronary Syndrome?

Background: We have already discussed the value of a good history in assessing patients with chest pain on REBEL EM. What is known about chest pain...
Tactical Medicine News

Low Risk Chest Pain and Clinically Relevant Adverse Cardiac Events (CRACE)

Background: In 2010, 5.4% of all emergency department (ED) visits in the United States were for chest pain. Admission or observation of such patien...
Tactical Medicine News

Is it Time to Start Using the HEART Pathway in the Emergency Department?

There are approximately 8 to 10 million patients complaining of chest pain coming to Emergency Departments (EDs) in the United States annually. In ...
Tactical Medicine News

Accelerated Diagnostic Protocol for Chest Pain Not Useful in a US Population?

There are approximately 8 to 10 million patients coming to Emergency Departments (EDs) in the United States annually. In the US, we use a very libe...
Tactical Medicine News

REBEL Cast Episode 7: BLS vs ACLS in OHCA & Anatomic vs Functional Testing for CAD

Welcome to the REBEL Cast Episode 7, where Swami, Matt, and I are going to tackle a couple of articles just published this year. Today we are going...
Tactical Medicine News

Chest Pain: Can we do 2-hour Rule Outs?

Hospital admissions for chest pain often incur costly and resource-intensive workups for ACS. Is there a way to identify a low risk group who can b...
Tactical Medicine News

Chest Pain: Coronary CT Angiography in the ED

It is well known that taking a good history and physical, getting a non-ischemic EKG, and serial cardiac biomarkers, results in a risk of death/AMI...
Tactical Medicine News

The HEART Score: A New ED Chest Pain Risk Stratification Score

Chest pain is a common presentation complaint to the emergency department (ED) and has a wide range of etiologies including urgent diagnoses (i.e. ...
Tactical Medicine News

Chest Pain: What is the Value of a Good History?

Every year there are 6 million visits to the Emergency Department (ED) for chest pain, and approximately 2 million hospital admissions each year.  ...
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