In light of the JAMA and NEJM articles that have been recently published regarding outcomes associated with therapeutic hypothermia (TH) status post-cardiac arrest, I figured this would be a good time as any to cover complications associated with this phenomenon- namely, shivering. As we all know, the goal in TH status post-cardiac arrest is to reach a goal core body temperature between 32 and 34 degrees Celsius for a period of 12 to 24 hours in [...]

When I was a little kid, I was always asked the question, “So what do you want to be when you grow up?” I would answer emphatically, “That’s easy- a journalist.” Why? I have always found the profession to be quite fascinating. The work that it entails- researching and writing to deliver a news story to be shared with an audience of readers, listeners, and viewers- is right up my alley. Even as a kid, [...]

The case: TR is a one-year-old infant who presents to your emergency department with a tonic-clonic seizure. According to the paramedics, the seizure has lasted for approximately 10 minutes. She has no known past medical history. Vital signs are relatively stable, and a bedside blood glucose is performed, revealing a level of 105 mg/dL. She has a weight of 10 kg. IV access is established and 1 mg of lorazepam IV push is administered. The [...]

Here are some fast facts clinicians should be aware of regarding Kcentra: Kcentra is marketed in over 25 countries around the world by CSL Behring as Beriplex® or Confidex®. It is four-factor PCC, containing factors II, VII, IX, and X, in varying amounts, based on the size of the vial. It also contains Proteins C and S as well as heparin and antithrombin III. The table below provides a breakdown of the contents per 500 [...]

A patient is wheeled into your trauma bay after a nasty head-on collision on a major highway. According to the paramedics, the downtime and length of anoxia in the patient is unknown, and because of this, the patient is intubated. Vital signs are unobtainable, and pulses are lost on the scene. The patient is now in pulseless electrical activity (PEA), and cardiopulmonary resuscitation is initiated. The decision is made to perform an emergent thoracotomy. The [...]

Let us take a trip down memory lane. The year: 2011 The month: January The event: Onsite interview for a PGY-1 pharmacy residency program The place: Swanky office of the residency program director It was very early in the morning, and I had a full day ahead, with back-to-back meetings with various preceptors and residents of the pharmacy residency program. It was my very first interview of several, and so I was understandably very nervous. [...]

Let's say you have a male patient who presents to the emergency department with an abscess in the right axilla. The patient appears to be a relatively healthy gentleman with no significant past medical history (other than the heartburn that develops when he socially drinks on the weekends every now and then). He has not been hospitalized for any previous infection or recent surgery within the past year, and he denies the use of IV [...]

I recently had a discussion about what makes a good EM pharmacist.  Below is a great essay by my EM pharmacy resident discussing just that. Being A Crystal Baller Nadia Awad, Pharm.D. There is one running theme that I have learned to appreciate and embrace since I started my emergency medicine pharmacy residency nearly three months ago. This theme can be summed up in one word: ANTICIPATION.Why is this important? For me, emergency medicine is [...]