A 63-year-old male arrives to the resuscitation bay in cardiac arrest with ongoing cardiopulmonary resuscitation (CPR). Per EMS, the patient was found in ventricular fibrillation (Vfib) and has received defibrillation 6 times with four rounds of epinephrine and 2 doses of amiodarone (300 mg, 150 mg) prior to arrival. In the emergency department (ED), the patient is noted to still be in Vfib and a dose of 1 mg/kg of lidocaine is administered without termination [...]

Clinicians in emergency departments across the country have increasingly become more savvy in their approach to the management of common pain conditions that patients may present with in this setting. In the effort to overcome the effects and consequences of the opioid abuse epidemic, great emphasis is now being placed in leveraging opioid-free alternatives in new ways for the management of these frequently encountered common pain conditions. This may involve utilizing target-specific agents in the [...]

Standard technique for transferring a medication from a glass ampule involves swabbing the ampule with isopropyl alcohol and breaking the neck of the ampule with the alcohol pad or gauze. The problem that many can attest to is the glass breaking in a way that punctures through the pad or gauze and cuts into one’s digits.Not only is this a painful issue, but there are other considerations when a member of the team cuts themselves: [...]

Standard technique for transferring a medication from a glass ampule involves swabbing the ampule with isopropyl alcohol and breaking the neck of the ampule with the alcohol pad or gauze. The problem that many can attest to is the glass breaking in a way that punctures through the pad or gauze and cuts into one’s digits.Not only is this a painful issue, but there are other considerations when a member of the team cuts themselves: [...]

2016 proved to be a fantastic year for Emergency Medicine PharmD. We have shared a lot of great content with you, and we hope to maintain our trajectory within the world of #FOAMed. Below are the top 10 posts in view count published this year on the blog: Trick of the Trade: Diphenhydramine for Local Anesthesia Author: Nadia Awad, PharmD, BCPS (@Nadia_EMPharmD) No More Epinephrine Ratios! Author: Craig Cocchio, PharmD, BCPS (@iEMPharmD) Managing Rate Control [...]

Thinking ahead is something most EM pharmacists are excellent at and we are – amongst other things – in the business of saving lives. On the (hopefully) rare occasion that the 30-something-year-old trauma patient rolls in with a blatantly obvious and observable poor prognosis, being steps ahead may be doing just that. In the back of your mind, you think this otherwise healthy patient could potentially be an organ donor. In the immediate, sense you [...]

At the 2016 Midyear Clinical Meeting of the American Society of Health-Systems Pharmacists (ASHP), my colleague Bryan Hayes (@PharmERToxGuy) and I presented a continuing education program on debates in the management of hyperkalemia. The learning objectives from our session are below: Evaluate recommendations for dosing and administration of parenteral calcium in the treatment of hyperkalemia.  Apply practical methods for co-administration of insulin and dextrose in the management of hyperkalemia. Discuss evidence-based literature surrounding administration of [...]

It sometimes is a bit wondrous how our past actions can influence how our future pursuits. I have discussed how #FOAMed has made an impact on research, discovery, and my professional pursuits here and here. To be quite frank, I can't imagine how my life would be if I was not engaged in social media. But obviously, at one point, I did, and I may have predicted my own engagement in #FOAMed without even realizing [...]

In my opinion, pharmacist "interventions" are a bad thing. While there are many reasons behind this, but I prefer creating a culture of open, prospective discussion rather than reactive drug policing. If I approach a prescriber in the ED, I'm greeted with "What did I do now?" I'm doing something wrong. Discussing new papers, institutional protocols, sharing interesting patient cases, or you know, general human-to-human conversations are great opportunities for taking about drug therapy approaches, new [...]

In my opinion, pharmacist "interventions" are a bad thing. While there are many reasons behind this, but I prefer creating a culture of open, prospective discussion rather than reactive drug policing. If I approach a prescriber in the ED, I'm greeted with "What did I do now?" I'm doing something wrong. Discussing new papers, institutional protocols, sharing interesting patient cases, or you know, general human-to-human conversations are great opportunities for taking about drug therapy approaches, new [...]