Primary survey: Highlights from this issue

ABSTRACT

Fernando et al report a large retrospective evaluation of prehospital opioid use in patients with ACS, finding no association with major adverse cardiac events, though patients who received opioids were more likely to have critically obstructed coronary flow prior to coronary intervention. Separately, Wilkinson-Stokes et al report a systematic review to examine the assertion that nitrates should not be used in patients with right ventricular myocardial infarction, due to the risk of precipitating hypotension. In that analysis, the absence of blood flow on Doppler ultrasound had a sensitivity of only 58.3% with 81.3% negative predictive value.