Archive

Author: Darrel Hughes

Benzodiazepine-Refractory Alcohol Withdrawal

Background: Severe alcohol withdrawal syndrome (AWS) accounts for only 10% of the roughly 500,000 annual cases of AWS episodes that require pharmacologic treatment. AWS is characterized by an imbalance between inhibitory GABA and excitatory NMDA receptor stimulation secondary to chronic ethanol …

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Toxicology

Why You Should More Than Consider a Vasopressin, Steroid, and Epinephrine (VSE) Cocktail

The newly published 2015 AHA guidelines recommend that: “In IHCA, the combination of Vasopressin, Epinephrine, and Methylprednisolone and post-arrest Hydrocortisone as described by Mentzelopoulos et al. maybe considered; however, further studies are needed before recommending the routine use of this strategy …

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Resuscitation

Topical Tranexamic Acid for Epistaxis or Oral Bleeds

Recently, there has been a lot of buzz about the use of topical tranexamic acid for epistaxis or oral bleeds on multiple social media platforms. Everyone seems so happy that it works so well, but we thought we would look through …

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Head, Eye, Ear, Nose, and ThroatHematology and Oncology

Any Benefit to Sodium Bicarbonate in DKA?

In a prior post, we discussed the use of an initial insulin bolus in the management of diabetic ketoacidosis (DKA).  Today we will address another facet of DKA management, for which there is less than optimal evidence and that is: …

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Endocrine, Metabolic, Fluid, and Electrolytes

Is There Any Benefit to an Initial Insulin Bolus in Diabetic Ketoacidosis?

Diabetic ketoacidosis (DKA) is a common endocrine emergency encountered in the emergency department.  DKA associated mortality is relatively low in adults, but in children with type 1 diabetes, the elderly, and adults with concomitant illnesses have a mortality rate is …

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Endocrine, Metabolic, Fluid, and Electrolytes

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