I work at an institution with a Children’s Hospital attached to it, which means that we encounter a fair amount of pediatric patients in the emergency department (ED). One of the most common complaints of children presenting to the ED is fever.Acetaminophen is a routinely administered medication in this population. I recently had the opportunity to review a policy of standing orders for triage nurses in our ED that may be carried out before a [...]
I think that given the very name of this blog and what it represents, it would be extremely remiss if I did not write about such a historic event that unfolded at the annual meeting of the American College of Emergency Physicians (ACEP), which is currently being held in Chicago this week. For the first time, ACEP is now recognizing and supporting the presence and various roles EM pharmacists as members of the multidisciplinary team [...]
Article to be discussed:Driver BE, et al. Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with refractory ventricular fibrillation. Resuscitation, 2014; 85:1337-1341. [youtube https://www.youtube.com/watch?v=Zqkad-ZD-7w?version=3&f=user_uploads&c=google-webdrive-0&app=youtube_gdata&w=320&h=266]
As I have developed a method to my practice (and madness) as an emergency medicine pharmacist, there are certain medications that, for me, fall under one of two categories: those that I have grown to love…and those that I have grown to not be a fan of and can generally live without, even in the absence of drug shortages. For me, parenteral hydralazine falls under the latter category. Why? As many of us already know, [...]
This week I had an opportunity to waive my pharmaco-nerd flag with the online release of the ARISE trial. I could have bought myself a psych eval ticket the way I was running around my shared office with the other pharmacy faculty, printing off copies to share in the ED and asking everyone else what they thought of ARISE, ProCESS and what... oh God what will ProMISE show!? But my excitement aside, the paper should be read [...]
This week I had an opportunity to waive my pharmaco-nerd flag with the online release of the ARISE trial. I could have bought myself a psych eval ticket the way I was running around my shared office with the other pharmacy faculty, printing off copies to share in the ED and asking everyone else what they thought of ARISE, ProCESS and what... oh God what will ProMISE show!? But my excitement aside, the paper should be read [...]
Chan EW, et al. Intravenous Droperidol or Olanzapine as an Adjunct to Midazolam for the Acutely Agitated Patient: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Ann Emerg Med. 2013 Jan;61(1):72-81. https://youtube.googleapis.com/v/Uw3eaTUx3DA&source=uds
In an earlier post, the nuances associated the abuse potential of tramadol and its new schedule IV status, a decision made by the Drug and Enforcement Agency, was discussed. The safety of tramadol in terms of its risk for inducing seizures is a topic that is not clearly understood. Tramadol can cause seizures in overdoses because of the possible induction of serotonin syndrome and/or the modulation of monoamine reuptake inhibition. Tramadol does so by acting [...]
Background:Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac abnormality that manifests itself as a conduction irregularity found between the sinoatrial (SA) and atrioventricular (AV) nodes. In an otherwise healthy heart, electrical conduction begins at the SA node, which is located in the right atrium. An electrical pulse is then sent downward causing the atrium to contract and subsequently reaching the AV node, which acts as the connecting catalyst to allow the electrical pulse to reach the [...]
Note: An edited version of this post has been featured on MedPage Today. As much as it is may be difficult to ignore the fact that traditional systematic reviews and meta-analyses are full of flaws, they have become the bread and butter for not only the purposes of referencing, but also the very basis of why most of us clinicians practice the way we that we do. It becomes very easy to state, “In a meta-analysis conducted [...]