Archive for category: Pharmacology

Beyond ACLS: Cognitively Offloading During a Cardiac Arrest

22 Sep
September 22, 2016

Today I am giving a talk at the 25th National Emergency Medicine Symposium by Kaiser Permanente in Maui, HI.  The focus of this talk was on how to cognitively offload our minds as we are running a resuscitation. ACLS provides us with a framework in treating adult victims of Cardiac Arrest (CA) or other cardiopulmonary emergencies. This […]

Macrolide Antibiotics, Prolonged QTc, and Ventricular Dysrhythmias

08 Aug
August 8, 2016

Background: When it comes to treating community acquired respiratory tract infections, macrolide antibiotics (azithromycin, clarithromycin, and erythromycin) are a common choice of agent. In 2010, 57.4 million macrolide prescriptions were written in the U.S. with azithromycin being the most commonly prescribed individual antibiotic agent overall with ~51.5 million prescriptions (Hicks 2013). With more and more patients […]

Complications of Procedural Sedation

22 Feb
February 22, 2016

Background: As Emergency Department (ED) physicians it is not uncommon to give patients procedural sedation and analgesia (PSA) to help facilitate painful procedures. Performing PSA requires close monitoring and is not without potential adverse events. There are numerous analgesic, sedative, and anesthetic agents that can be used in combination for PSA in the ED. Adverse event […]

More Dogma: Epinephrine in Digital Nerve Blocks

03 Sep
September 3, 2015

You are working as an EM resident and have just evaluated a patient with a right long finger DIP joint dislocation. You perform a digital nerve block with 1% lidocaine with 1:100,000 epinephrine, and go to present to your attending before attempting the reduction. Your attending, on hearing about the epinephrine use goes berserk, and […]

Post Intubation Sedation for Pregnant Patients

10 Aug
August 10, 2015

You have just intubated a seizing eclamptic woman who is 34 weeks pregnant. As she is being prepped for transfer to the OB unit for an emergent C-section your nurse asks you what medications you would like for post intubation analgesia and sedation. You have limited recollection of whether Propofol crosses the placenta, and have […]

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