Stressed vs unstressed volume

Dr. Rory Spiegel, from EMNerd, wrote a recent piece in Clinical and Experimental Emergency Medicine about how our undying love for left ventricular function in shock patients is perhaps overdoing it and the focus should rather be on the venous return.

The Clinical Utility of BNP in Acute CHF

ER physicians diagnose CHF often and actually very well on clinical grounds at the bedside.  So why are we ordering BNP’s when we already know the diagnosis?  The evidence clearly states in which situations the BNP will not help you.  Check out the proposed algorithm recently published in EM Resident and let’s put the evidence …