Logo

Log In Sign Up |  An official publication of: American College of Emergency Physicians
Navigation
  • Home
  • Multimedia
    • Podcasts
    • Videos
  • Clinical
    • Airway Managment
    • Case Reports
    • Critical Care
    • Guidelines
    • Imaging & Ultrasound
    • Pain & Palliative Care
    • Pediatrics
    • Resuscitation
    • Trauma & Injury
  • Resource Centers
    • mTBI Resource Center
  • Career
    • Practice Management
      • Benchmarking
      • Reimbursement & Coding
      • Care Team
      • Legal
      • Operations
      • Quality & Safety
    • Awards
    • Certification
    • Compensation
    • Early Career
    • Education
    • Leadership
    • Profiles
    • Retirement
    • Work-Life Balance
  • Columns
    • ACEP4U
    • Airway
    • Benchmarking
    • Brief19
    • By the Numbers
    • Coding Wizard
    • EM Cases
    • End of the Rainbow
    • Equity Equation
    • FACEPs in the Crowd
    • Forensic Facts
    • From the College
    • Images in EM
    • Kids Korner
    • Medicolegal Mind
    • Opinion
      • Break Room
      • New Spin
      • Pro-Con
    • Pearls From EM Literature
    • Policy Rx
    • Practice Changers
    • Problem Solvers
    • Residency Spotlight
    • Resident Voice
    • Skeptics’ Guide to Emergency Medicine
    • Sound Advice
    • Special OPs
    • Toxicology Q&A
    • WorldTravelERs
  • Resources
    • ACEP.org
    • ACEP Knowledge Quiz
    • Issue Archives
    • CME Now
    • Annual Scientific Assembly
      • ACEP14
      • ACEP15
      • ACEP16
      • ACEP17
      • ACEP18
      • ACEP19
    • Annals of Emergency Medicine
    • JACEP Open
    • Emergency Medicine Foundation
  • About
    • Our Mission
    • Medical Editor in Chief
    • Editorial Advisory Board
    • Awards
    • Authors
    • Article Submission
    • Contact Us
    • Advertise
    • Subscribe
    • Privacy Policy
    • Copyright Information

Discharge Tachycardia: Remember the Big 4 and Don’t Play with Fire

By John Bedolla, MD, FACEP, FAAEM | on May 8, 2025 | 2 Comments
Medicolegal Mind
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
Print-Friendly Version

 

You Might Also Like
  • Tips for Tachycardia in Children
  • Defining Sepsis Then & Now, Part 1
  • Noninvasive Management of Sepsis
Explore This Issue
ACEP Now May 03

 

References

  1. Salhi RA, Greenwood-Ericksen M, Kocher KE. National Trends in Vital Sign Abnormalities at Arrival to the Emergency Department. West J Emerg Med. 2023;24(3):401-404. Published 2023 May 5.
  2. Sklar DP, Crandall CS, Loeliger E, Edmunds K, Paul I, Helitzer DL. Unanticipated death after discharge home from the emergency department. Ann Emerg Med. 2007;49(6):735-745.
  3. Neilson HK, Fortier JH, Finestone PJ, et al. Diagnostic Delays in Sepsis: Lessons Learned From a Retrospective Study of Canadian Medico-Legal Claims. Crit Care Explor. 2023;5(2):e0841. Published 2023 Feb 1.
  4. Morrone D, Morrone V. Acute Pulmonary Embolism: Focus on the Clinical Picture [published correction appears in Korean Circ J. 2018 Jul;48(7):661-663. doi: 10.4070/kcj.2017.0998.]. Korean Circ J. 2018;48(5):365-381.
  5. Maughan BC, Jarman AF, Redmond A, Geersing GJ, Kline JA. Pulmonary embolism. BMJ. 2024;384:e071662. Published 2024 Feb 8.
  6. Theofilis P, Antonopoulos AS, Sagris M, et al. Silent Myocardial Ischemia: From Pathophysiology to Diagnosis and Treatment. Biomedicines. 2024;12(2):259. Published 2024 Jan 23.
  7. Kwok CS, Burke H, McDermott S, et al. Missed Opportunities in the Diagnosis of Heart Failure: Evaluation of Pathways to Determine Sources of Delay to Specialist Evaluation. Curr Heart Fail Rep. 2022;19(4):247-253.
  8. Arrigo M, Jessup M, Mullens W, et al. Acute heart failure. Nat Rev Dis Primers. 2020;6(1):16. Published 2020 Mar 5.
  9. Maughan BC, Asselin N, Carey JL, Sucov A, Valente JH. False-negative chest radiographs in emergency department diagnosis of pneumonia. R I Med J (2013). 2014;97(8):20-23. Published 2014 Aug 1 9.
  10. Stein PD, Beemath A, Matta F, et al. Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II. Am J Med. 2007;120(10):871-879.
  11. Brabrand M, Hallas P, Folkestad L, Lautrup-Larsen CH, Brodersen JB. Measurement of respiratory rate by multiple raters in a clinical setting is unreliable: A cross-sectional simulation study. J Crit Care. 2018;44:404-406.
  12. Maestre-Orozco T, Ramos-Rincón JM, Espinosa B, et al. Mortality after emergency department discharge: an analysis of 453599 cases. Mortalidad tras el alta desde el servicio de urgencias hospitalario: análisis de 453.599 episodios. Emergencias. 2024;36(3):168-178.
  13. Manfredini R, Portaluppi F, Grandi E, Fersini C, Gallerani M. Out-of-hospital sudden death referring to an emergency department. J Clin Epidemiol. 1996;49(8):865-868.
  14. Valensi P, Lorgis L, Cottin Y. Prevalence, incidence, predictive factors and prognosis of silent myocardial infarction: a review of the literature. Arch Cardiovasc Dis. 2011;104(3):178-188.
  15. Cohn PF, Fox KM, Daly C. Silent myocardial ischemia. Circulation. 2003;108(10):1263-1277.
  16. Maestre-Orozco T, Ramos-Rincón JM, Espinosa B, et al. Mortality after emergency department discharge: an analysis of 453599 cases. Mortalidad tras el alta desde el servicio de urgencias hospitalario: análisis de 453.599 episodios. Emergencias. 2024;36(3):168-178.
  17. Schulzer M, Mak E, Ayas NT. Does this dyspneic patient in the emergency department have congestive heart failure? JAMA. 2005;294(15):1944-1956.
  18. Knudsen CW, Clopton P, Westheim A, et al. Predictors of elevated B-type natriuretic peptide concentrations in dyspneic patients without heart failure: an analysis from the breathing not properly multinational study. Ann Emerg Med. 2005;45(6):573-580 18.
  19. Peltan ID, McLean SR, Murnin E, et al. Prevalence, Characteristics, and Outcomes of Emergency Department Discharge Among Patients With Sepsis. JAMA Netw Open. 2022;5(2):e2147882. Published 2022 Feb 1.
  20. Gabayan GZ, Gould MK, Weiss RE, Chiu VY, Sarkisian CA. A Risk Score to Predict Short-term Outcomes Following Emergency Department Discharge. West J Emerg Med. 2018;19(5):842-848.

Pages: 1 2 3 4 5 | Single Page

Topics: acute cardiomyopathycongestive heart failuredischargedischarge tachycardiaMyocardial Infarctionmyocardial ischemiaPulmonary EmbolismSepsistachycardia

Related

  • Anticoagulant Selection Is Cornerstone of Pulmonary Embolism Treatment

    March 11, 2025 - 1 Comment
  • Case Report: Murine Typhus Presents as Severe Pneumonia and Sepsis

    February 19, 2025 - 0 Comment
  • 2024 Emergency Medicine Research Highlights: Forced Air, Sepsis, and More

    January 5, 2025 - 0 Comment

Current Issue

ACEP Now: July 2025

Download PDF

Read More

2 Responses to “Discharge Tachycardia: Remember the Big 4 and Don’t Play with Fire”

  1. May 17, 2025

    Mark Kramer Reply

    Loved the article/More of a clinical what to do if persistent tachycardia than how to hyper document to avoid a successful lawsuit/at least that’s my perspective after 14 years of retirtement in ER medicine

  2. May 19, 2025

    Thomas Barrows, MD Reply

    Very nice article. My colleagues hate the smell of our ER, but I can’t resist taking the shoes and socks off all my patients looking for rotten feet. This is a commonly missed part of our skin examination and the causes of more than a few ‘occult’ sepsis cases!

    Shout out to Dr Bedolla, my mentor 25 years ago!

Leave a Reply Cancel Reply

Your email address will not be published. Required fields are marked *


*
*

Wiley
  • Home
  • About Us
  • Contact Us
  • Privacy
  • Terms of Use
  • Advertise
  • Cookie Preferences
Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 2333-2603