Archive for category: Pharmacology

What’s Your Drug Shortage Plan: Part I

29 May
May 29, 2017

Many drugs critical to patient management are showing up on national shortages (most pertinent to the ED list below).  Is your institution feeling the effects?  Do you have a drug shortage plan? In this post we will cover potential alternatives to combat drug shortages for the following medications: Atropine Calcium Chloride Calcium Gluconate Dextrose 50% Epinephrine […]

Peri-Intubation Anaphylaxis

08 May
May 8, 2017

Background: Peri-operative anaphylaxis is an unexpected complication of intubation. The major life threat in anaphylaxis is typically loss of airway, however profound hypotension and circulatory collapse are still possible life threats even in the setting of a protected airway. Peri-operative anaphylaxis is considered an important enough issue to be the subject of the NAP 6 (National Audit […]

Low-Dose Ketamine for Acute Pain in the ED: IV Push vs Short Infusion?

10 Apr
April 10, 2017

Background: Ketamine’s role in the ED has expanded in recent years.  The clinical reasons for this make it easy to understand why, and include analgesia, amnesia, and anesthesia. Amazingly, ketamine does not only reduce acute pain, but it also decreases persistent chronic and neuropathic pain as well. More importantly, use of low-dose ketamine (0.1 – […]

Diabetic Gastroparesis Needs HUGS

30 Mar
March 30, 2017

Background: Anyone practicing in emergency medicine has taken care of a patient with diabetic gastroparesis.  Although, it is not a sexy topic to discuss, nor a disease process associated with significant mortality, it is associated with decreased quality of life, and increased resource utilization due to frequent hospitalization.  Furthermore, opioid analgesia, can further decrease gastric […]

Effectiveness of Diazepam Adjunct Therapy in Acute Low Back Pain

02 Mar
March 2, 2017

Background: Low back pain is an extremely common presentation to US Emergency Departments (EDs) representing 2.4% or 2.7 million visits annually. The vast majority of presentations are benign in etiology but can be time consuming and frustrating for both patients and physicians. For patients, most will have persistent symptoms a week after presentation and many […]