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Cardiovascular emergencies are among the most common presentations in the ED. This collection of Emergency Medicine Practice courses provides evidence-based guidance for three different types of cardiovascular emergencies: NSTEMI, patients taking direct oral anticoagulants, and blunt cardiac trauma. You’ll learn how to identify NSTEMI and utilize current guidelines for management, manage ED patients who are taking DOACs, and swiftly identify serious cardiac injury following blunt trauma.
Course 1: Management of Non–ST-Segment Elevation Myocardial Infarction
There are differences between treatment strategies for patients with NSTEMI, STEMI, and unstable angina, and it is critical for emergency clinicians to initiate care that will maximize chances for an accurate diagnosis, reduce pain, and support the ultimate treatment strategy. This course reviews current national management guidelines for NSTEMI as they pertain to the ED, discusses new diagnostic and therapeutic modalities, and addresses issues surrounding special patient populations.
CME Credits: 4
CME Expiration: 01/01/2023
Course 2: Management of Patients Taking Direct Oral Anticoagulant Agents
The use of direct oral anticoagulants – the direct thrombin inhibitor and the anti-factor Xa inhibitors – has increased greatly since 2010, when the first agent was approved by the FDA. Though DOACs offer potential advantages for patients over warfarin, they present diagnostic and therapeutic challenges in bleeding emergencies because their therapeutic effect cannot be easily monitored directly with common clotting assays. This course examines the growing body of evidence on the uses and risks of DOACs in the ED, including initiation of therapy and reversal strategies.
CME Credits: 4 (includes 4 Pharmacology credits)
CME Expiration: 08/01/2022
Course 3: Diagnosis and Management of Blunt Cardiac Injury
The spectrum of blunt cardiac injury can range from minor soreness to dysrhythmia, free wall rupture, hemorrhage, and sudden death. When a patient arrives in the ED following blunt force trauma to the anterior chest wall, the emergency clinician must quickly determine whether or not the patient has a life-threatening cardiac injury that requires urgent operative management. This course reviews the clinical cues, diagnostic tests, and clinical manifestations of blunt cardiac injury as well as best-practice management strategies.
CME Credits: 4 (includes 4 Trauma credits)
CME Expiration: 03/01/2022
Bonus Video 1: Experience with Implementation of cTnT Into Clinical Practice
Judd E. Hollander, MD, of Sidney Kimmel Medical College at Thomas Jefferson University, presents the two things clinicians must know when determining which patients should get a troponin level test to rule out acute coronary syndromes.
Video length: 24 minutes
Bonus Video 2: A Rants of Sorts (AVNRT)
Richard Byrne, MD, of Cooper Medical School at Rowan University, discusses treatment for AV-nodal reentrant tachycardia, including the modified Valsalva maneuver, pharmacologic options, and cardioversion techniques.
Video length: 14 minutes
Publication Date: May 1, 2020
CME Information: Included as part of the 12 credits, this CME activity is eligible for 4 Trauma CME and 4 Pharmacology CME credits, subject to your state and institutional approval. Accreditation: EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This activity has been planned and implemented in accordance with the accreditation requirements and policies of the ACCME. Credit Designation: EB Medicine designates this enduring material for a maximum of 12 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. High-Risk Cardiovascular Emergencies (Trauma CME and Pharmacology CME) is approved by the American College of Emergency Physicians for 12 hours of Category I credit per issue. High-Risk Cardiovascular Emergencies (Trauma CME and Pharmacology CME) has been reviewed and is acceptable for up to 12 Prescribed credits by the American Academy of Family Physicians. Credits may be claimed for one year from the date of the publication. High-Risk Cardiovascular Emergencies (Trauma CME and Pharmacology CME) is eligible for 12 Category 2-A or 2-B credit hours per issue by the American Osteopathic Association.