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ERcast Lite

Welcome to ERCast, a focused discussion on the questions, quagmires and known unknowns we face everyday in the emergency department.

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Should we cardiovert acute Atrial Fibrillation in the ED?

Oct 27, 2012

Is it safe to cardiovert a hemodynamically stable patient with recent onset atrial fibrillation? The evidence says yes, but not everyone is a believer...

I've talked quite a bit about atrial fibrillation on ERCast, and the topic that generates the most emails, by a wide margin, is cardioverting the hemodynamically...

Jeff Kline talks D-dimer: is the cutoff too low?

Oct 2, 2012

There is no perfect way to rule out pulmonary embolism. But what if we could change the game and move the d-dimer cutoff higher in the low risk patient? From 500 ng/ML to 1000ng/mL. You’d think that the specificity of the test would improve - fewer false positives. But what would we sacrifice in sensitivity? Would we...