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Clinical Conundrums: Should You Give the First Dose of Antibiotics IV Before Discharging Home on Oral Antibiotics?

RebelEM

Oral administration of antibiotics: a rational alternative to the parenteral route. 2001; 111(5):367-74. Read More First10EM: Magical Thinking in Modern Medicine: IV Antibiotics for Cellulitis First10EM: Oral Antibiotics are Equivalent to IV (Again) – The OVIVA Trial References MacGregor RR, Graziani AL. 1997; 24(3):457-67.

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SGEM#294: Blood Pressure – Do Better, Keep Rising with NorEpi

The Skeptics' Guide to EM

It was the landmark paper published 19 years ago by Dr. Emanuel Rivers on early goal directed therapy in the treatment of severe sepsis and septic shock that sensitized the medical community ( Rivers et al NEJM 2001). However, it has become evident that patients are often over-resuscitated with IV fluids which adversely impacts outcome.

Sepsis 52
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PEM Currents – Agitation in Children – Episode 3: Pharmacologic Management

EMDocs

Route of administration If the patient is cooperative, offer oral medications first. mg/kg/dose (IM/IV) Has a FDA Black Box warning in 2001 citing concerns of QT prolongation and torsades de pointes (TdP). If a patient has a PRN on their med list do that! This can give the patient a sense of some control. 5 mg PO; 0.05-0.15

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REBEL Core Cast 89.0 – Spontaneous Bacterial Peritonitis

RebelEM

Dig Liver Dis 2001; 33(1): 41-48. Pneumoniae, Enterococci 3rd Generation Cephalosporin covers vast majority of cases Ceftriaxone 25 mg/kg up to 1 gm daily Cefotaxime 25 mg/kg up to 1 gm Q8 Alternate antibiotic choices Ciprofloxacin 400mg IV BID Levofloxacin 750mg IV daily Piperacillin/Tazobactam 4.5g grams/kg within 6 hours 1.0

EMS 52
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1995 Fat intravasation, fat emboli and fat embolism syndrome in adult major trauma patients with intraosseous catheters; a systematic review

Emergency Medicine Journal

Aims and Objectives Intraosseous (IO) administration of medication, fluids and blood products is accepted practice for critically injured patients in whom intravenous (IV) access is not immediately available. doi:10.1111/j.1553 1553 n= 16, weight 5.9-12.3kg 12.3kg Proximal tibia 1 ml NaCl 0.9% doi:10.1016/j.jss.2019.09.005 doi:10.1016/j.jss.2021.04.035

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Cetirizine Vs Diphenhydramine For the Treatment of Acute Urticaria in the ED

RebelEM

2, 2001, pp. The effectiveness of IV cetirizine was determined to be statistically non-inferior. However, according to the American Academy of Allergy, Asthma, and Immunology, “oral antihistamine therapy is equivalent to IV therapy” (Ledford D 2019). Journal of Investigative Dermatology Symposium Proceedings , vol.

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How to prevent central line infections

PulmCCM

per 1,000 central-line days between 2001 and 2009. These measures have dramatically increased hospital administrators’ attention to CLABSI rates, and have likely had an effect of reducing actual rates of CRBSI. As effective practices spread (and changes in reporting occurred), nationwide rates of CLABSI in the U.S.

CDC 52