MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'chest pain'. Sat, 03 Sep 2011 02:01:57 +0100 http://www.medworm.com/index.php?rid=4984647&cid=t_114748_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2011%2F06%2Fwho-are-you-running-toward.html One minute you're picking daisies in the yard.Then the stumble that warns of pain to come.Finally, the plunge downward, pricklier and more painful than you imagined.Who does he run to?PAPA.Abba, Father, bring me close to you.Help me live my life so that YOU are always my first choice...for comfort,endurance,patience,goodness...You are good, You are goodWhen there's nothing good in meYou are love, You are loveOn display for all to seeYou are light, You are lightWhen the darkness closes inYou are hope, You are hopeYou have covered all my sinYou are peace, You are peaceWhen my fear is cripplingYou are true, You are trueEven in my wanderingYou are joy, You are joyYou're the reason that I singYou are life, You are life,In You death has lost it's stingOh, I'm running to your arms,I'm running to ... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=4984647 Thu, 30 Jun 2011 09:11:00 +0100 4984647 http://www.medworm.com/index.php?rid=4852937&cid=t_114748_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F05%2F23%2F10-things-you-should-know-about-male-depression%2F What looks and feels like depression to a woman may not to a man, which is why so many men in America are misdiagnosed or missed altogether. However, considering that the rates of completed suicide of men are three to four times that of women, we need to educate ourselves about male depression and its unique symptoms. The following are 10 things you should know about male depression, compiled from Johns Hopkins Depression and Anxiety Bulletin and other sources. 1. Depression affects about 6 million American men and 12 million American women each year. But these numbers don’t tell the story of men, and older men, in particular. 2. Suicide in men peaks in the 20s and again in the 60s and 70s. 3. Many men experience “depression without sadness,” which makes it more challenging for prima... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4852937 Mon, 23 May 2011 16:45:23 +0100 4852937 http://www.medworm.com/index.php?rid=4696636&cid=t_114748_88_f&fid=38129&url=http%3A%2F%2Fwww.emergencyweb.net%2Flibrary%2Fmp3.php%3Ff%3Deits_ep038_disaster_help.mp3 The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4696636 Mon, 11 Apr 2011 08:16:03 +0100 4696636 http://www.medworm.com/index.php?rid=4658414&cid=t_114748_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F03%2F30%2Fantioxidants-and-your-health%2F Antioxidants are good for your health. Or at least that is a popular claim. An antioxidant is any molecule that slows down or prevents oxidation reactions.  Originally, oxidation reactions were defined as chemical reactions with oxygen.  More recently, oxidation reactions have been described as reactions in which an atom or molecule loses an electron. Oxidation is a natural part of life.  Excessively high antioxidant levels are detrimental to health. Some people have suggested that oxidation reactions contribute to heart disease, declines in cognitive abilities, and cancer. “Vitamin C, vitamin E, and beta-carotene have been shown to be antioxidants in a test tube, and it is often claimed that they and many other substances are able to function as antioxidants in the body. However, wh... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4658414 Wed, 30 Mar 2011 15:20:01 +0100 4658414 http://www.medworm.com/index.php?rid=4626835&cid=t_114748_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FL1d65XzpRt4%2F Musings on the point of equipoise for investigating and discharging chest pain patients in light of a new paper in the Lancet describing a rapid rule-out protocol for acute coronary syndromes (the ASPECT trial). (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4626835 Wed, 23 Mar 2011 08:55:13 +0100 4626835 http://www.medworm.com/index.php?rid=4580905&cid=t_114748_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fb_8uqx_i6EA%2F The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4580905 Mon, 14 Mar 2011 02:19:27 +0100 4580905 http://www.medworm.com/index.php?rid=4549753&cid=t_114748_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpulmonary-embolism-if-it-can-strike-serena-williams-it-can-ace-anyone%2F2011.03.04 News that tennis star Serena Williams was treated for a blood clot in her lungs is shining the spotlight on a frightfully overlooked condition that can affect anyone — even a trained athlete who stays fit for a living. Williams had a pulmonary embolism. That’s doctor speak for a blood clot that originally formed in the legs or elsewhere in the body but that eventually broke away, traveled through the bloodstream, and got stuck in a major artery feeding the lungs. (To read more about pulmonary embolism, check out this article from the Harvard Heart Letter.) Pulmonary embolism is serious trouble because it can prevent the lungs from oxygenating blood — about one in 12 people who have one die from it. “No one is immune from pulmonary embolism, not even super athletes,” says ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4549753 Fri, 04 Mar 2011 16:00:19 +0100 4549753 http://www.medworm.com/index.php?rid=4360978&cid=t_114748_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprotect-your-heart-when-shoveling-snow%2F2011.01.18 After shoveling the heavy, 18-inch layer of snow that fell overnight on my sidewalk and driveway, my back hurt, my left shoulder ached, and I was tired. Was my body warning me I was having a heart attack, or were these just the aftermath of a morning spent toiling with a shovel? Now that I’m of an AARP age, it’s a question I shouldn’t ignore. Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases when enough of the white stuff has fallen to force folks out of their homes armed with shovels or snow blowers.  What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4360978 Tue, 18 Jan 2011 18:00:40 +0100 4360978 http://www.medworm.com/index.php?rid=4331094&cid=t_114748_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D142 There is great news for cardiology: the reimbursement level for Myeloperoxidase will more than double for FY 2011. Myeloperoxidase is a protein biomarker found in the blood and is more commonly referred to as MPO.  First studied in 2003, it is an early predictor for chest pain patients who are at risk of a heart attack.  Each year, over 5 million patients seek treatment for chest pain in an ER and encounter a long list of possible chest pain causes; some causes can be ruled out with basic tests.  EKGs have been an excellent test for heart problems, but in more recent years, MPO has proven very effective as an early indicator.  When discovered early, physicians can prescribe preventative treatment before damage can occur.  However, reimbursement, in most cases was below the cost of the... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4331094 Tue, 11 Jan 2011 14:24:35 +0100 4331094 http://www.medworm.com/index.php?rid=4233264&cid=t_114748_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D111 Noninvasive, quick, accurate, and at a lower cost.  If that doesn’t make the top of the list, then what does?  Not that long ago, I was asked by the CEO of a forward-thinking hospital to share my views on emerging medical technology because the hospital’s board of directors was looking for a second opinion on their wish list of high-dollar new technology.  Interestingly enough, my presentation coincided perfectly with a recently-recruited cardiologist’s presentation that preceded mine.  For years, the “gold standard” for diagnosing chest pain has been a cath lab procedure.  However, along with being invasive and costly, it is a time-consuming procedure.  Coronary CT angiography has been an evolving technology for years.  Early 8- and 16-slice systems offered limited abilit... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4233264 Mon, 06 Dec 2010 14:52:15 +0100 4233264 http://www.medworm.com/index.php?rid=4214419&cid=t_114748_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2010%2F11%2Fi-am-here-wonderfully-alive.html My appointment with my cardiologist yesterday was unfortunately uneventful. Meaning he cannot fix me - beyond waiting for the Cardiazem to kick in and keep my heartrate under control. I was instructed to stay in bed for the next three days while I wait. So I am trying to do that as much as possible.The nightlight is back in the bathroom (so I can tell if my vision is darkening during the night - the sign that I am about to faint). I sit at the edge of the bed for 5 minutes before getting up to the bathroom. All so I do not break another toilet with my head. A few pictures of joy (making pies with my children a few short days ago) - because that is what is in me as I lie in bed. Fear swells as my heart races, and Christ calms the fear with a whisper...for every heart beat, however fast... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=4214419 Tue, 30 Nov 2010 19:54:00 +0100 4214419 http://www.medworm.com/index.php?rid=4214420&cid=t_114748_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2010%2F11%2Fto-ones-with-wild-hearts.html I am off to the pacer clinic at 11 a.m. and then to see a nurse practitioner and finally, my cardiologist. All are confused as to why my heart is acting up. Please pray they will be able to figure it out, and that if I need to have the pacemaker altered or replaced, that would be very clear to them. There is always the chance of a defective pacemaker or wire, and I am sincerely hoping they can discover if that is the problem today.For those of you interested in the actual technical details: basically, my pacer is not "capturing" my heart's rhythm (so my heart continues to beat unnaturally fast), then kicks into a different mode, trying to "capture" the rhythm in the base of my heart. This works, but my own rhythm is still going in the top of my heart. So the top of my heart and the bottom ... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=4214420 Mon, 29 Nov 2010 16:06:00 +0100 4214420 http://www.medworm.com/index.php?rid=4125013&cid=t_114748_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FVw7FbQmplsc%2F EBM review of Chest Pain Adjunctive Therapies including adjunctive anticoagulant therapy, adjunctive anti-thrombotic therapy and other therapeutic agents (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4125013 Tue, 02 Nov 2010 00:43:24 +0100 4125013 http://www.medworm.com/index.php?rid=4125014&cid=t_114748_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2F8OQ_fLkq61Q%2F including early Management of STEMI or NSTEACS, reperfusion strategies, percutaneous coronary intervention (PCI) and thrombolysis (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4125014 Tue, 02 Nov 2010 00:41:19 +0100 4125014 http://www.medworm.com/index.php?rid=4125015&cid=t_114748_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2Fgj2Lssai_Kw%2F Chest Pain and risk stratification - EBM Review. Coronary heart disease single largest cause of death (16% or 27,000) in 2007 in Australia, but down from 22% in 1998. (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4125015 Tue, 02 Nov 2010 00:40:25 +0100 4125015 http://www.medworm.com/index.php?rid=4125232&cid=t_114748_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2010%2F11%2Fnote-to-heaven-i-need-help.html I traveled this weekend, to the funeral of a dear great-aunt who lit the world with her kindness and housed me for many halcyon childhood nights in her rambling farmhouse in a field on the flats of the White Earth Indian Reservation. Her sons bent to scoop the mound of dirt onto her urn with their hands, loving her so much they didn't even use the spade to scrape the dirt back over what remained of her gentle and beautiful body.And in the pale yellow light of early afternoon, a trouble brewing deep in my body for weeks blossomed and felled me to my knees in a church bathroom. I fainted several times, grew gray, heart aching and throbbing and that horrible sense of dread rising like a lump in the throat. I guess I was out of it enough, gray enough, to cause many relatives concern...which ma... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=4125232 Mon, 01 Nov 2010 11:19:00 +0100 4125232 http://www.medworm.com/index.php?rid=4040502&cid=t_114748_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F10%2Fmyocardial-infarction-signs-symptoms%2F Dressler’s syndrome, “crushing” chest pain (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4040502 Thu, 07 Oct 2010 06:19:27 +0100 4040502 http://www.medworm.com/index.php?rid=3961816&cid=t_114748_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcardiac-stents-alone-don%25e2%2580%2599t-work%2F2010.09.12 I have a friend who had a blocked cardiac artery. A couple of years ago he had angioplasty on it, and his doctor inserted stents. The stents got rid of his chest pain and other symptoms, but didn’t do anything to get at the underlying cause of the blockage, which had to do with an unhappy combination of genetics and a –- perfectly admirable –- taste for rich, fatty foods. Like steak. (More on that in a moment.) Before having the procedure, his doctors spent a lot of time with him explaining what the surgery would and wouldn’t do. In particular, the doctors explained that the stents would do their job, but he had to do his. He needed to eat better, exercise more, and take his medications. He’s followed most of that advice, and is doing well. Unfortunately, his experience is ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3961816 Sun, 12 Sep 2010 12:00:42 +0100 3961816 http://www.medworm.com/index.php?rid=3890476&cid=t_114748_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-little-old-ladys-power-in-the-er%2F2010.08.21 Here’s my column in the August edition of Emergency Medicine News. A person who seems powerless may hold an entire emergency room hostage! Magic Words: ‘I Have Chest Pain’ Propped in her bed, frail and weak, the little grandma sighed. Her complaints were legion: weakness, poor appetite, poor sleep, joint pain, cough, dry mouth. Her daughter, eyes rolling, was trying to balance three reasonable emotions. She desperately wanted to go home and rest after spending the day in the ER. She truly wanted to avoid her mother’s admission to the hospital, and she was, graciously, sympathetic to the physician who brought the bad news. ‘Mrs. Adkins, I know you feel poorly, and I’m sorry. But I have to say, I can’t find any reason to admit you to the hospital. You’re right as ra... Better Health blogs http://www.medworm.com/rss/comments.php?id=3890476 Sat, 21 Aug 2010 16:00:13 +0100 3890476 http://www.medworm.com/index.php?rid=3746694&cid=t_114748_87_f&fid=34872&url=http%3A%2F%2Fblisstree.com%2Ffeel%2F187105%2F Anxiety Leads to Heart Problems: A new study found that people with stable coronary heart disease and generalized anxiety disorder (GAD) had a higher rate of cardiovascular events than patients without GAD. (via ABC News) Post from: BlissTree (Source: Healthbolt) Healthbolt blogs http://www.medworm.com/rss/comments.php?id=3746694 Tue, 06 Jul 2010 17:28:55 +0100 3746694 http://www.medworm.com/index.php?rid=3726596&cid=t_114748_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Femergency-medicine-dilemma-risk-malpractice-or-overtesting%2F2010.07.05 Emergency physicians are in a dilemma. Risk missing a diagnosis and be sued, or be criticized for overtesting. Regular readers of this blog, along with many other physicians’ blogs, are familiar with the difficult choices facing doctors in the emergency department. The Associated Press, continuing its excellent series on overtesting, discusses how lawsuit fears is a leading driver of unnecessary tests. Consider chest pain, one of the most common presenting symptoms in the ER: Patients with suspected heart attacks often get the range of what the ER offers, from multiple blood tests that can quickly add up in cost, to X-rays and EKGs, to costly CT scans, which are becoming routine in some hospital ERs for diagnosing heart attacks … … and the battery of testing may be paying off: A few... Better Health blogs http://www.medworm.com/rss/comments.php?id=3726596 Mon, 05 Jul 2010 20:00:59 +0100 3726596 http://www.medworm.com/index.php?rid=3311887&cid=t_114748_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F02%2Ftwo-down-one-to-go-.html As I mentioned the other day, my recent visit to the ER and then the follow-up appointment with Dr. Lee the First yielded three more medical appointments this week. Yesterday, I saw my cardiologist, Dr. Julie Heyn, and then this morning I had an ultrasound exam of my legs to look for blood clots. The only thing left is a CT of my lower right leg to see if there is a bone met there. That appointment is tomorrow. I've been having pain in that leg, especially at night, but I wasn't too worried about it, partly because other body parts were hurting more, and partly because I thought I couldn't get a met below the knees. Well, Dr. Lee popped that bubble. Mets below the knees (or below the elbows, for that matter) are rare, but not impossible. I'm not sure how q... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3311887 Thu, 25 Feb 2010 21:29:33 +0100 3311887 http://www.medworm.com/index.php?rid=3302589&cid=t_114748_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F02%2Fpushing-back-my-second-walk-in-a-week.html I had another long (make that looooonng) day today, starting when I left the house at 10 to head for my cancer center. All I had before I left the house was coffee, because I wake up slowly and can't eat for an hour or two, but I threw a banana in my bag for later. Good thing I did, because Dr. Lee decided to give me treatment, so I was there until something like 3:30, which is five hours. I started with the blood draw, and then I waited more than an hour to see Dr. Lee. The waiting room was crowded, and some people were getting frustrated, and rude, in my book, but I didn't let it disturb my wa. (One woman was using her cell phone in the middle of the waiting room to loudly announce her appointment time, and then of course the time at that moment. She did this th... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3302589 Wed, 24 Feb 2010 01:47:23 +0100 3302589 http://www.medworm.com/index.php?rid=3291994&cid=t_114748_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F02%2Fsaturday-in-the-park.html Just a quick post to say that I am feeling better and more like myself.Yesterday was horrible, and I'm not going to rehash it here. Also not going to be able to answer all the e-mails I received, at least not right now. I need to take care of some tasks that have been hanging fire and adding to my stress by remaining undone. Also, I haven't walked Connie since the left hip started hurting weeks ago, and Today Is the Day. Connie and I are heading out to the park to get some exercise. It will do us both good. Last night was a tough one, I was in pain and couldn't sleep even though I was exhausted, and I watched a movie called "Bent" on Hulu. About gays in Berlin under the Nazis. A frightening movie, but a good one. I'm behind--again, still--on gett... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3291994 Sat, 20 Feb 2010 20:21:55 +0100 3291994 http://www.medworm.com/index.php?rid=3290965&cid=t_114748_136_f&fid=35303&url=http%3A%2F%2Fwww.assertivepatient.com%2F2010%2F02%2Fnot-a-happy-camper.html So I had an appointment with Dr. Lee the First at 8:30 this morning, 8:30 being normally about the time I wake up, but that was the only appointment time he had this week, or so I was told. (I think the front desk people at the cancer center don't approve of my sleep schedule.) I thought I was getting chemo today, although I wasn't entirely sure.Well, it turns out that Dr. Lee was really booked and double-booked this morning, so he had asked someone on his staff to call me and tell me to come at 10:30 instead, which would have been MUCH better for me, but either they didn't call or I didn't get the message.Then, when I did see Dr. Lee--who had roller skates on this morning, I kid you not--he was not happy about the chest pains. He wanted to hospitalize me to get it sorted o... The Assertive Cancer Patient blogs http://www.medworm.com/rss/comments.php?id=3290965 Fri, 19 Feb 2010 22:38:54 +0100 3290965 http://www.medworm.com/index.php?rid=3079466&cid=t_114748_129_f&fid=36036&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Fkelly-building-a-crohns-disease-community%2Fanxiety-and-crohns-disease%2F The phrase that one of our blog community members, Todd, writes often in our comments is, “Keep your mind in the game.”  That has sort of become my mantra lately.  I have to tell myself this so I can remember what is important in the big picture so I will stop worrying about the little stuff.  I have had problems with anxiety for a while now and I think that it has been building up the last few years.  One of my problems (probably due to the fact that I am female) is that I tend to over analyze everything.  Things happen to my husband, he acknowledges them, and then he forgets them and moves on.  Things happen to me and I analyze every facet of every emotion that I felt and what it was or what could I have done differently.   I am now trying to emulate my husband and be more li... Life with Crohn's blogs http://www.medworm.com/rss/comments.php?id=3079466 Thu, 10 Dec 2009 16:37:26 +0100 3079466 http://www.medworm.com/index.php?rid=2930999&cid=t_114748_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F10%2F27%2Fare-all-aspirin-created-equal%2F “I took an Aspirin when I started feeling the pain.” Close to a decade after the Aspirin for chest pain idea hit the main-stream, more and more folks are medicated themselves at the onset of chest pain. But are all Aspirin created equal? Does chewing make any difference in the rate of absorption? No … and yes. A recent study out of the University of California, San Diego took 14 healthy volunteers and feed them a moderate dose of Aspirin on three separate occasions. First they were asked to swallow adult size tablets, then they were asked to chew adult sized tablets and last they were asked to chew children’s chewable Aspirin tablets. After each administration the volunteers had blood drawn at set intervals. The results were predictable, but telling. After swa... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2930999 Tue, 27 Oct 2009 12:00:44 +0100 2930999 http://www.medworm.com/index.php?rid=2923283&cid=t_114748_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F10%2F24%2Fchest-pain-is-ems-really-best%2F Short answer: Yes. Score one for EMS. A study published last January in the American Heart Journal evaluated transport and treatment times of patients who called 911 for their chest pain and patients who sought private transportation. They found that patients who transported themselves to the emergency room arrived at the hospital in 35 minutes while patients who called 911 arrived in 39 minutes. (On average.) Hold the phone. Before you tell grampa to forget the phone call and jump in the car, consider this; The study also concluded that the patients who dialed 911 received initial stabilizing treatments faster AND definitive treatments faster as well. Those who called the ambulance received initial care like oxygen, aspirin and nitro in approximately six minutes as opposed to the self tra... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2923283 Sat, 24 Oct 2009 12:00:11 +0100 2923283 http://www.medworm.com/index.php?rid=2916134&cid=t_114748_101_f&fid=38969&url=http%3A%2F%2Ftheemtspot.com%2F2009%2F10%2F22%2Fatypical-cardiac-chest-pain%2F We taught you what cardiac chest pain looked like, right? You remember. We painted the perfect picture for you in your cardiac emergencies lecture in your EMT class. The pain felt like a pressure. It was brought on by exertion. It radiated to the left arm and through to the back. Sometimes, in your EMT skills stations, we would get fancy and have it begin at rest and radiate to the jaw. Just trying to keep you on your toes after all. All this stuff is good to know. But we may have done you a disservice. You may be walking around with the idea that you can do a quick OPQRST and a SAMPLE and walk away with a fairly good feel for whether or not your patient is having a heart attack. You may be dead wrong. What we may not have told you was that a large percentage of your patients sufferin... The EMT Spot blogs http://www.medworm.com/rss/comments.php?id=2916134 Thu, 22 Oct 2009 12:00:26 +0100 2916134 http://www.medworm.com/index.php?rid=2463556&cid=t_114748_180_f&fid=38602&url=http%3A%2F%2Fwww.armstrongmethod.com%2Fblog%2Fhow-to-beat-anxiety%2F Do you get anxiety?  Does it stop you dead in your tracks and rob you of your power? For many years I battled with major anxiety.  It wasn’t a nice experience at all.  During my teenage years, anxiety was as much a part of my life as my pimple cream.  I remember feeling so afraid and out of control.  If you experience anxiety, know that I empathize with your experience, I’m sending you lots of love and support, and that you are not alone.   According to AnxietyPanic.com, millions of Americans have some form of anxiety.  It is a normal reaction to stress that helps one deal with tense situations and helps one to cope. But when anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling anxiety disorder. Anxiety can be accompanied by physical e... Armstrong Method blogs http://www.medworm.com/rss/comments.php?id=2463556 Mon, 13 Apr 2009 16:07:02 +0100 2463556 http://www.medworm.com/index.php?rid=2149608&cid=t_114748_82_f&fid=34667&url=http%3A%2F%2Flaryngoscope.blogspot.com%2F2009%2F01%2Fare-you-busy.html I'm standing the preop area in the morning talking to some of the residents before cases get started for the day. One of the preop nurses comes over... "Are you busy?" Fateful last words "Are you covering the recovery room?"No cases have come out into recovery room yet, "I'm not covering, but you need help with something?""Can you come over and look at one of our perioperative techs? She's having some chest pain? We're going to hook her up to the monitors... could you look at her EKG?"They bring her over to a recovery slot, hook her up to monitors, everything looks okay, vital signs stable.... I take one of the residents over with me... we start getting some history.Family history of vascular disease... pain started this morning while she was moving things around in the OR... yes I've had ... i'm so sleepy blogs http://www.medworm.com/rss/comments.php?id=2149608 Sat, 31 Jan 2009 12:45:00 +0100 2149608 http://www.medworm.com/index.php?rid=2125314&cid=t_114748_88_f&fid=34857&url=http%3A%2F%2Fscalpelorsword.blogspot.com%2F2009%2F01%2Fuselessness-of-timi-risk-score.html Supposedly one of the measures which is evaluated during the process of "Chest Pain Center Accreditation" is the use of the TIMI Risk Score in the Emergency Department:Age over 65 yearsMore than 3 risk factors for CAD Known CAD (stenosis ≥ 50%) ASA Use in Past 7 daysSevere angina (≥ 2 episodes within 24 hrs)ST changes ≥ 0.5mm Positive Cardiac MarkerAdd one point for each factor, total up the points, and you now have an estimate of the likelihood in the next 14 days of all-cause mortality, myocardial infarction, or severe recurrent ischemia requiring urgent revascularization.In theory this sounds like a neat way to streamline and validate our medical decision-making, but in practice this system is totally worthless to us in the Emergency Department. Consider these examples: 1) The 64 ... Scalpel or Sword? blogs http://www.medworm.com/rss/comments.php?id=2125314 Fri, 23 Jan 2009 01:47:00 +0100 2125314 http://www.medworm.com/index.php?rid=1482137&cid=t_114748_111_f&fid=36048&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2F302040711%2F New CT technology is offering a quicker and more cost effective way to manage chest pain complaints in the ER. CAT (Computed tomography angiography) aids in identifying patients at low-risk of cardiac problems like the blocked arteries that lead to heart attacks. The center for Medicare and Medicaid services have yet to decide on whether to pay for the service in the ER. What are the benefits of CAT? Costs for patients who received immediate CTA in the emergency department averaged about $1,240, while costs of stress testing and telemetry monitoring topped $4,000 for each patient. CTA also helped get low-risk chest pain patients home faster, potentially reducing emergency room crowding — study patients who received immediate CTA were discharged after an average of 8 hours, compared t... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=1482137 Sat, 31 May 2008 16:21:57 +0100 1482137 http://www.medworm.com/index.php?rid=1179679&cid=t_114748_88_f&fid=34857&url=http%3A%2F%2Fscalpelorsword.blogspot.com%2F2008%2F01%2Frefuser.html An older gentleman presented with vague complaints of not feeling well, just getting over "the flu," maybe a little dizzy, etc. He really didn't want to be there, and he definitely wouldn't have come if his family hadn't insisted. He minimized his complaints and wouldn't elaborate on any of them. He was alert and looked fit for his age, as one might expect of a man who did 100 pushups every day. Of course his troponin was elevated."Sir, I know you didn't really want to come in to see us, but I think you'd better let us put you in the hospital for a couple of days.""Well, I can tell you right now son, that ain't going to happen."I didn't think so. After I explained the risks of going home and the need for further testing, and he explained his philosophies about God, death, and doctors, I on... Scalpel or Sword? blogs http://www.medworm.com/rss/comments.php?id=1179679 Sat, 26 Jan 2008 20:25:00 +0100 1179679 http://www.medworm.com/index.php?rid=861785&cid=t_114748_88_f&fid=34857&url=http%3A%2F%2Fscalpelorsword.blogspot.com%2F2007%2F09%2Fmultitasking-and-why-migraine-patients.html At any given moment during the typical shift in the ER, here is what is happening:There are 10-20 patients in the waiting room. Some have been waiting 6 hours. A couple of them have ankle sprains and were already X-rayed, and their X-rays were already read by the Radiologist as "no bony abnormality, soft tissue swelling." They would like to leave without being seen. We don't argue too much.I'm waiting on a callback from a specialist, and I have two more calls to make after that one. If I paged them all at once, they would all call back at the same time, then two of them would hang up before I was finished talking with the first one. They would be understandably angry when they were repaged, and they would take an hour to call back the second time. So I page them one at a time. As soon as I... Scalpel or Sword? blogs http://www.medworm.com/rss/comments.php?id=861785 Tue, 11 Sep 2007 08:35:00 +0100 861785 http://www.medworm.com/index.php?rid=764999&cid=t_114748_87_f&fid=34866&url=http%3A%2F%2Fwww.thecardioblog.com%2F2007%2F07%2F29%2Fangina-101%2F Filed under: Diet, Prevention, NutritionThe symptoms of angina can be very similar to those of a heart attack -- pain and pressure in the chest and upper body, for one. Though angina is treatable, it is a major red flag that tells you that it's time to pay close attention to your heart health. Angina is your heart's way of warning you that it's working too hard, and left untreated, it can put you at risk for heart attack and cardiac arrest. It can be caused by coronary artery disease, uncontrolled high blood pressure, or narrowing of the arteries, as well as other conditions. If you or someone you love has been diagnosed with angina, here's an excellent article that outlines symptoms, causes, and different types of angina, as well as treatment options and lifestyle changes to manage the di... The Cardio Blog blogs http://www.medworm.com/rss/comments.php?id=764999 Sun, 29 Jul 2007 04:00:00 +0100 764999 http://www.medworm.com/index.php?rid=650883&cid=t_114748_88_f&fid=34857&url=http%3A%2F%2Fscalpelorsword.blogspot.com%2F2007%2F05%2Fhow-can-you-tell.html He was a middle-aged smoker, half a foot taller than the average male, and quite slender. Like many Texans, he had a penchant for spicy food and the reflux esophagitis to go with it. He'd been admitted a few months previously for an extensive chest pain workup which failed to detect any problems with his heart, but which did provide him with the diagnosis of a small hiatal hernia. And yet his father had died of a heart attack at a similar age, so he worried, as would most of us.He was taking his proton pump inhibitor as prescribed, and he watched his diet as reasonably as any of us living in Tex-Mex heaven could be expected to do. But from time to time, he would still get chest pains, and each time he agonized whether to return to the ER for another $10,000+ workup. When he does finally de... Scalpel or Sword? blogs http://www.medworm.com/rss/comments.php?id=650883 Wed, 30 May 2007 21:13:00 +0100 650883 http://www.medworm.com/index.php?rid=564630&cid=t_114748_88_f&fid=34857&url=http%3A%2F%2Fscalpelorsword.blogspot.com%2F2007%2F04%2Fpatient-decision-making.html The previous post stirred up a bit of controversy over informed consent, and whether the "unnecessary" tests I order are for my benefit or the patient's benefit. Ultimately, everything I do is for the patient's benefit. I would never order a test or perform a procedure that had no chance of helping a patient. But many of the tests and interventions I perform do benefit me, and I'm not going to feel bad about that. I go to work every night to benefit me and my family, and I'm blessed that I can earn a living while helping people at the same time. I can think of worse jobs.Let's discuss a simple laceration repair, for example. Currently, we cannot bill for Dermabond closure of simple lacerations, even though many of the wounds that are able to be closed with this "superglue" could also be cl... Scalpel or Sword? blogs http://www.medworm.com/rss/comments.php?id=564630 Mon, 23 Apr 2007 22:43:00 +0100 564630