HEART and High Sensitivity Troponin

HEART and High Sensitivity Troponin

Combining a Δ1h high-sensitivity troponin (hsTn) with the HEART score in a diagnostic algorithm helped decrease admission rates (59% to 33%) and median health-care costs ($1,748 to $1,079) with no significant difference in clinical outcomes. It is important to realize that this study was not randomized and was underpowered to detect differences in clinical outcome.

Enhancing Sgarbossa Criteria for STEMI

Enhancing Sgarbossa Criteria for STEMI

The original Sgarbossa criteria have a high specificity (96%) but low sensitivity (36%), meaning it is useful when positive, but a negative result does not rule out MI. The modified Sgarbossa criteria by Smith et al., have a much better sensitivity (91%) with a slight decrease in specificity (90%). You should apply the modified Sgarbossa criteria to evaluate for MI in LBBB and paced rhythms.

Shockingly Ineffective - Double Sequential Defibrillation for Refractory Vfib and Vtach

Shockingly Ineffective - Double Sequential Defibrillation for Refractory Vfib and Vtach

Prehospital double sequential defibrillation was not associated with improved survival for out-of-hospital cardiac arrest patients with refractory ventricular fibrillation or pulseless ventricular tachycardia.

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