Background: Supraventricular tachycardia (SVT) is not an uncommon condition in the emergency department. Epidemiologically, SVT has an incidence of 35/100,000 person-years in the United States.2That is roughly 89,000 new cases per year. The Valsalva maneuver is a recognized treatment for SVT, ...
Shock is defined as circulatory failure leading to decreased organ perfusion. In a shock state there is an inadequate delivery of oxygenated blood to tissues that results in end-organ dysfunction. Effective resuscitation includes rapid identification and correction of inadequate circulation. ...
Background: Rapid sequence intubation (RSI) involves the use of an induction agent followed by a neuromuscular blocking (NMB) agent to obtain optimal intubating conditions. Administration of a NMB results in apnea which, in turn, can lead to oxygen desaturation. Oxygen desaturation ...
Background: Tramadol is a centrally acting synthetic opioid analgesic approved for use in the United States in 1995 by the Food and Drug Administration. In 2014, the Drug Enforcement Agency classified tramadol as a Schedule IV controlled substance. ~41 million ...
Take Home Points: Get definitive airway control when necessary Use modality you’re most comfortable with Hard signs – pulsatile bleeding, bruit or thrill, expanding hematoma, airway compromise, massive hemoptysis (think airway injury), hematemesis (think esophageal injury), grossly injured trachea, neurologic ...
Background: Epinephrine (adrenaline) has been used in advanced life support in cardiac arrest since the early 1960s. Despite the routine recommendation for its use, evidence to support administration is less than ideal. Although it is clear from multiple observational studies ...
Background: Working in the emergency department means frequently performing painful procedures on patients, often we turn to procedural sedation to make these procedures more tolerable for patients, families and clinicians alike. Ketamine is often used for this purpose, particularly in pediatrics, ...
Background: Convulsive status epilepticus is the most common pediatric neurological emergency worldwide. Currently, phenytoin (UK & Europe) or fosphenytoin (USA) is the recommended second-line IV anticonvulsant for the treatment of pediatric status epilepticus. Some evidence and providers however suggest that ...
Background: Migraine is a chronic neurologic disease characterized by attacks of throbbing, often unilateral headache that are exacerbated by physical activity and associated with photophobia, phonophobia, nausea, vomiting, and, in many patients, cutaneous allodynia. Migraine is very common, and the burden ...
Normal saline started being used based on work done in the 1830s with cholera. We are still doing the same thing the same way and it’s not until recently we have begun to ask the hard questions about why we ...
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