Archive for category: Clinical

REBEL Core Cast 3.0 – Asthma, COPD + PNA

23 Jan
January 23, 2019

Take Home Points Single dose oral dexamethasone is an excellent choice for asthma exacerbations. It takes away the compliance issue for patients who have trouble getting medications or filling medications once they leave the ED. Antibiotics aren’t always indicated in COPD exacerbations, but are used much more frequently than in asthma exacerbations because the structural […]

The HOUR Trial: Clinical Decision Rule for Opioid Overdose Patients in the Emergency Department

21 Jan
January 21, 2019

Background Information: In 2017, more than two-thirds of the 70,000 drug overdose deaths in the United States involved an opioid.1 Many emergency departments are affected as opioid overdoses increased 30% from July 2016 through September 2017 in 52 areas in 45 states.2 With the half-life of naloxone being between 60-90 minutes the appropriate disposition and […]

IDSA Guideline on Seasonal Influenza Management 2018

14 Jan
January 14, 2019

Article: Uyeki TM et al. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza. Clin Infect Dis 2018. PMID: 30566567 Background: Influenza is an Emergency Department scourge that we deal with every year. The vast majority of patients recover from uncomplicated […]

Journal Abstracts and Why You Should Continue to Use Phenobarbital in Alcohol Withdrawal Syndrome for Patients Requiring Admission

10 Jan
January 10, 2019

Background: The mainstay of treatment for alcohol withdrawal syndrome is a symptom-triggered approach using benzodiazepines. Phenobarbital, however, is an interesting agent in this scenario for several reasons. It is famous for  it is long duration of action. IV Phenobarbital has an onset of action of over 15 – 20 minutes, a duration of action of 10 […]

REBEL Core Cast 2.0 – Cardiotoxic Drugs

09 Jan
January 9, 2019

Take Homes Calcium Channel Blocker (CCB) toxicity usually present with bradycardia and hypotension, but with preserved mental status. This can help differential from Beta Blocker (BB) toxicity, where the patients often have altered mental status. Hyperglycemia is the other hallmark of CCB toxicity, which can help you differentiate from BB. This hyperglycemia may be a […]