M&M - Dr. Zahn

Electrical Storm 
- Refractory Ventricular rhythm , >3 episodes in 24 hours 
- Fix the underlying causes (ischemia, electrolytes, arrythmogenic meds)     - LBBB & MI - difficult to interpret - remember your Sgarbossa Criteria!
- Amiodarone is medication of choice, add beta blockade early with refractory condition 

Ectopic Pregnancy 
- Ectopic pregnancy - number 1 cause of 1st trimester deaths
        - Goal of the ED provider - EXCLUDE ECTOPIC by confirming IUP!
- Start scan by finding the uterus! 
- Endomyometrial mantle - distance from the wall of the gestational sac to the outer wall of the uterus - in a normal pregnancy, measurement should be >0.8 cm 

- Switch to transvaginal probe if unable to obtain adequate views 
- IUP can only be diagnosed by yolk sac or fetal pole within gestational sac

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