Carolinas Case Conference - Dr. Nichols

Wellens Syndrome
-Remember, there are both Type A and Type B Wellens findings on EKG
-Both are extremely high risk for unstable LAD occlusion and reperfusion
-Treat like a ACS
-Emergent cardiac consultation for catheterization
-Beware the Wellens patient that develops chest pain

Medical/Trauma Resuscitation Conundrums
-Never let an initial impression turn off your medical thinking
-If the clinical trajectory isn't making sense, revisit your diagnosis and plan
-Ongoing hypoxia and hypotension demands a full reevalution, consider repeating bedside imaging and ultrasound is your best friend
-Upright film more sensitive than supine for blood in the chest, US even better
-Hemothorax rules: 1500 cc immediately, or 200 cc/hr x 4 hours = OR

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