September REBELCast

02 Sep
September 2, 2014

rebelcast_logo2Welcome to the September REBELCast 2014, where Matt, Swami, and I are going to tackle a couple more scenarios to help your clinical practice.  Today, we are going to specifically tackle two different topics:

Topic #1: The use of Non-Invasive Positive Pressure Ventilation (NIPPV) in the Pre-Hospital Treatment of Patients with Severe Respiratory Distress
Topic #2: Once Weekly Dalbavancin for Skin Infections

September REBELCast 2014 Podcast


Click here for Direct Download of Podcast

What are the clinical questions that will be covered in September REBELCast 2014?

Question #1: In patients with undifferentiated respiratory distress, does the use of NIPPV in the pre-hospital setting reduce in-hospital mortality?
Question #2: Is weekly dosing of Dalbavancin as effective as routine therapy for skin infections?

What are the specific articles we will be covering?

Article #1: Mal S et al. Effect of Out-of-Hospital NonInvasive Positive-Pressure Support Ventilation in Adult Patients with Severe Respiratory Distress: A Systematic Review and Meta-Analysis.  Ann of EM 2014; 63: 600 – 7. (24342819)
Article#2: Boucher HW et al. Once-Weekly Dalbavancin Versus Daily Conventional Therapy for Skin Infection. N Engl J Med 2014; 370: 2169 – 79. (24897082)

What are the clinical bottom lines for the above clinical questions:

Bottom Line #1: NIPPV should be considered in all patients with severe respiratory distress in the prehospital setting
Bottom Line #2: IV Dalbavancin is an alternative antibiotic for skin infections that can be dosed on a weekly basis, but as with other new medications, cost may be an issue and a non-drug company sponsored study would need to be conducted before implementation.

September REBELCast 2014 Show Notes

Word Document: September 2014 REBELCast Shownotes
PDF: September 2014 REBELCast Shownotes

For more on the above topics checkout:

 

Bibliography

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Salim Rezaie

Emergency Physician at Greater San Antonio Emergency Physicians (GSEP)
Creator & Founder of R.E.B.E.L. EM
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4 replies
  1. Max says:

    Hey Salim,
    Short and sweet podcast. Just looked up the cost of Dalbvancin. According to Lexi comp Dalvance Intravenous)
    Cost per 500 mg (1): $1788.00.

    Hope that clarifies things.
    Max

    Reply
    • Salim Rezaie says:

      Hey Max,
      TY for listening to the podcast and your comment. So at $1788/500mg we are talking about $5,364 dollars for an entire course. I wonder what the cost of an observation in the hospital for one day is? TY for finding this information.

      Salim

      Reply
  2. Patrick Bafuma says:

    Found this for observation costs- roughly 1200/night. Roughly.

    http://www.acep.org/Clinical—Practice-Management/Observation-Care-Payments-to-Hospitals-FAQ/

    Compared to about 1600/night as per the Cleveland clinic price list for an inpt stay in 2011.

    Reply

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