The effect of position change on vital signs, back pain and vascular complications following percutaneous coronary intervention

ConclusionsIt was found that systolic blood pressure and back pain were at the lowest levels in the standard fowler's position in the 6th  hr after the procedure when the HOB was elevated 45–60° and the result was clinically significant and the position change decreased back pain without causing any vascular complications.Relevance to clinical practiceLow fowler's position was applied in which HOB was elevated 15 –30° and standard fowler's position was applied in which the HOB was elevated 45–60° could be safe and applicable in patients by nurses after the procedure.
Source: Journal of Clinical Nursing - Category: Nursing Authors: Tags: ORIGINAL ARTICLE Source Type: research

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One of our residents who just graduated 3 months ago texted me this ECG:" Hey Steve, would be grateful for any thoughts on this EKG.  60-something with 2 days of waxing and waning epigastric pain and diaphoresis.  Also diffuse abdominal tenderness. "Presenting ECG:What was my answer?What is the management? My Answer: " Inferior and lateral OMI "Detailed Interpretation:Sinus rhythm.  Left axis deviation, but not quite LAFB (no r-wave in inferior leads; no q-wave in aVL).  There is less than 1 mm STE in inferior leads, with reciprocal ST depression. There are hyperacute T-wav...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Case written and submitted by Ryan Barnicle MD, with edits by Pendell MeyersWhile vacationing on one of the islands off the northeast coast, a healthy 70ish year old male presented to the island health center for an evaluation of chest pain. The chest pain started about one hour prior to arrival while bike riding. It was a constant ache on the left side of his chest that forced him to stop cycling and call for an ambulance. It was radiating to his bilateral upper arms. It was associated with nausea but he denied dyspnea, dizziness, and headache.He explained that he had the same chest pain the day prior as well, on and off....
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Rationale: de Winter electrocardiograph (ECG) pattern signifies proximal left anterior descending coronary artery (LAD) occlusion and extensive anterior myocardial infarction, and it is found in about 2% of patients with proximal LAD occlusion. However, it is often unrecognized by physicians. In this case report, we present a patient with chest pain but showing an atypical and delayed de Winter ECG pattern. Patient concerns: A previously healthy 61-year-old man attended our emergency department with chest pain radiating to the left arm and back for 4 hours, who was without serious cardiovascular risk factors. ECG at...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Cardiologists are grappling with at least  half a dozen time windows  in the management of STEMI. (It can be combinations of any of the following :Symptom – DAPT Loading – Door – Needle /Balloon-Sheath, wire crossing etc ) Time windows are Important in choosing the right (or no)modality of re-perfusion . Though superiority of  primary PCI  is thought to be established in academic community , it  may not be in real world. Published studies that suggest pPCI is superior to lysis at any time window  still lack good evidence. Why is this long drawn confusion&n...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: cath lab tips and tricks PCI PTCA Hardware Primary -PCI STEMI STEMI -Managment STEMI-Primary PCI Thrombolysis how to estimate the age of thrombus in stemi acs soft vs hard thrombus in stemi thrombus hardening time thrombus organising t Source Type: blogs
Most years I write an update on any big developments in AF ablation. This year’s version will be a short one. I have little new to report. But it’s worth reviewing some basic issues. We still do not know the cause of atrial fibrillation (AF). That makes it hard to fix with ablation. Knowledge Deficits: To explain why not knowing the cause of AF impairs our ability to ablate it, it’s useful to compare AF ablation to WPW ablation. Wolfe-Parkinson-White or WPW syndrome causes rapid heart rates because of an extra pathway from the top to the bottom (atria and ventricle) of the heart. You can cure WPW by ablat...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs
This study is unable to comment on whether patients with STEMI(-) Occlusion MI have benefit from emergent cath, because that is not the population studied and this subgroup is not commented on.This study is just the most recent in a long long line of similar literature. Context is everything for understanding this study. See below for an excerpt from theOMI Manifesto which summarizes the existing literature and provides details on each study:-------------------------------------------------------------------------------------------------------------- Counter-argument:“Haven’t there been RCTs showing no benefit ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
ConclusionsIt was found that systolic blood pressure and back pain were at the lowest levels in the standard fowler's position in the 6th  hr after the procedure when the HOB was elevated 45–60° and the result was clinically significant and the position change decreased back pain without causing any vascular complications.Relevance to clinical practiceLow fowler's position was applied in which HOB was elevated 15 –30° and standard fowler's position was applied in which the HOB was elevated 45–60° could be safe and applicable in patients by nurses after the procedure.
Source: Journal of Clinical Nursing - Category: Nursing Authors: Tags: ORIGINAL ARTICLE Source Type: research
Journal of Clinical Nursing,Volume 0, Issue ja, -Not available-.
Source: Journal of Clinical Nursing - Category: Nursing Authors: Source Type: research
ConclusionThe immediate return of low risk STEMI patients to their originating hospitals after PPCI is safe and feasible and is effective strategy to provide this prefer and effective re-perfusion therapy to vast majority of patients with STEMI.
Source: Journal of the Saudi Heart Association - Category: Cardiology Source Type: research
By BENJAMIN WERTZER, MD Doctors can be two-faced. This isn’t necessarily a negative attribute. Doctors have distinct personas for our patients and our colleagues. With patients, doctors strive for a compassionate but authoritative role. However, with each other, doctors often reveal a different demeanor: thoughtful and collaborative, but also opinionated and even sometimes petty. These conflicts are often the result of our struggle with evidence-based medicine. The modern practice of evidence-based medicine is more than the scientific studies we read in journals. Medicine doesn’t just change in rational, data-d...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs
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