RebelEM

MARCH 22, 2023

An alternate administration approach can be found on ALiEM. Multiple studies comparing verapamil to adenosine demonstrate equal efficacy of either agent with verapamil causing more hypotension ( Delaney 2011 , Hood 1992 ) Dose: 0.07 2011; 18(3): 148-52. Can J Cardiol 2011; 27(1): 105-9. Can J Cardiol 2011; 27(1): 105-9.

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

EMDocs

AUGUST 3, 2023

IV is usually recommended due to faster onset, ease of administration, and shorter protocol duration. 2011 Jun;49(5):423-5. In vitro analysis of N-Acetylcysteine (NAC) interference with the International Normalized Ratio (INR). Clinical Toxicology , 60 (4), 489–492. link] Heard K, Schaeffer TH. Clin Toxicol (Phila). PMID: 21740141.

Poisoning 98

Poisoning Seizures Administration Pediatrics 98

EMDocs

SEPTEMBER 7, 2024

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 97

EMS Fluid Resuscitation Resuscitation Radiology 97

EMDocs

JANUARY 29, 2024

hypertensive emergency, need for thrombolytic administration) [1]. 2011 Sep;15(2):211-40. Current guidelines do not recommend acute treatment of hypertension in these patients unless extreme (SBP > 220 mmHg or DBP > 120 mmHg), or another indication is present (e.g. N Engl J Med. 2016 Sep 15;375(11):1033-43. Epub 2016 Jun 8.

Stroke 98

Stroke Outcomes EMS Seizures 98

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Intravenous drug administration during out-of-hospital cardiac arrest: A randomized trial. Resuscitation 2011 * Hagihara et al. There have been a number of papers published since OPALS that support the findings of not using ACLS drugs like epinephrine for OHCA: * Olavseengen et al. JAMA 2009 * Jacobs et al.

CPR 52

CPR Academics Resuscitation Hospitals 52

PulmCCM

NOVEMBER 11, 2021

In 2011, Meng and colleagues evaluated the effects of phenylephrine [100 – 200 mcg] and ephedrine [5 – 20 mg] boluses on cardiac output and cerebral oxygenation during post-induction hypotension [5]; esophageal Doppler was used to measure blood flow. Anesthesia & Analgesia 2011, 113(2):211-213.

Stroke 40

Stroke Sepsis Administration Wellness 40

Pediatric Emergency Playbook

AUGUST 1, 2017

2011; 364(3):255-264. 2011; 29:1136-1140.:205-211. 2011; 523-527. 2011; 24: 552-561. 2011; 146(6):660-665. Plasma levels of lidocaine following nebulized aerosol administration. Necrotizing Enterocolitis. N Eng J Med. Niño DF et al. Necrotizing enterocolitis: new insights into pathogenesis and mechanisms.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Critical Care Now

APRIL 21, 2022

Crit Care Med 2011; 39:3 PEER Reviewed by Dr. Mike Tom PEER Reviewed by Dr. Lauren Igneri PEER Reviewed by Dr. Ruben Santiago Clin Infect Dis 2009; 49:433-7. Bogard K, Peterson N, Plumb T, et al. Antibiotic dosing during sustained low-efficiency dialysis: Special considerations in adult critically ill patients.

Burns 52

Burns Administration Outcomes Hospitals 52

ACEP Now

OCTOBER 26, 2023

However, to the extent these practices derive from departmental or institutional policies, emergency physicians need to work with ED nursing and clerical staff and hospital administration to revise overly conservative approaches to PHI transmittal of relevant clinical information. Published 2011. GovInfo website.

Infectious Diseases 52

Infectious Diseases Documentation/Coding Hospitals Emergency Department 52

EMDocs

OCTOBER 21, 2023

15 Treatment: Several treatment modalities have been described for BAO, including intravenous thrombolysis (IVT) which involves systemic administration of agents such as TNK or tPA, intra-arterial thrombolysis (IAT) via microcatheter at thrombus site, or mechanical endovascular thrombectomy (EVT). 2011, 10:1002-1014. Lancet Neurol.

EMS 97

EMS Stroke Outcomes Hospitals 97

Pediatric Emergency Playbook

MAY 1, 2017

Also, newborns have a double-whammy administrative load. 2011; 128(4):825-31. 2011; 32(8):341-9. Newborns are terrible at answering emails. There is a lot of unread unconjugated bilirubin is floating around. The liver and spleen are just not able to keep up. The infant’s gut is relatively sterile, so no admin assistance there.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

ACEP Now

AUGUST 1, 2023

This is an important opportunity for board certified emergency physicians to secure those positions today, impressing upon hospital administrations the essential benefits to the patients, the medical staff, and the hospital itself uniquely enabled by board certified emergency physicians.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Don't Forget the Bubbles

SEPTEMBER 5, 2024

In this study, the Broselow tape had the best overall accuracy, with 50.7% (vs 30.88% for APLS 2011) of estimates occurring within 10% of measured weight and 80.0% (vs 55% for APLS 2011) estimates within 20% of measured weight. The median patient age was 8.2 years (IQR 2.5–14.2 years), with a slight male predominance (51.5% were male).

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52

RebelEM

MARCH 23, 2023

and IM, and the physician was able to choose the method of administration. This study differed in that the phenobarbital administration was administered in a symptom-triggered protocol as opposed to a bolus. 2011 May;29(4):382-5. The protocols in the hospitals in the study included phenobarbital and lorazepam IV, p.o.,

Emergency Department 52

Emergency Department Burns Outcomes Hospitals 52

PHEM Cast

APRIL 10, 2016

The control group received many similar treatments as the ‘intervention’ group (just not full protocolised EGDT) highlighting that with good sepsis care (fluid resuscitation, close monitoring, early appropriate antibiotic administration), mortality can be reduced. 2011 Aug 30;18(9):934–40. Academic Emergency Medicine.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

RebelEM

MAY 15, 2024

Early administration of antibiotics is the only factor known to reduce this mortality. Early administration of antibiotics is the only factor known to reduce this mortality. 2011 Jun;153(6):773-9. Epub 2011 Apr 22 Coyne CJ, Le V, Brennan JJ, Castillo EM, Shatsky RA, Ferran K, Brodine S, Vilke GM. Warnick, J., Stretton, K.,

Infectious Diseases 98

Infectious Diseases Administration Sepsis Anaphylaxis 98

EMDocs

DECEMBER 6, 2024

In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. In the late 1990s, iron was the leading cause of poisoning deaths reported to poison control centers for children less than 6 years of age. McGraw Hill; 2016. & Rangan, C.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

RebelEM

JANUARY 29, 2024

PMID: 37188358 Clinical Question: What is the efficacy and safety of low-dose (25mg) prolonged administration (over 6hrs) of alteplase in patients with massive PE? Reduced-Dose Systemic Fibrinolysis in Massive Pulmonary Embolism: A Pilot Study. Clin Exp Emerg Med 2023. PMID: 21422387 Wan S et al. Circ 2004.

Stroke 136

Stroke Outcomes Hospitals Administration 136

RebelEM

FEBRUARY 29, 2024

Discussion In patients with brain injury who required ICU admission and mechanical ventilation, the PROPHY-VAP trial found that early administration of a single dose of ceftriaxone decreased the risk of VAP, exposure to ventilation, exposure to antibiotics, prolonged ICU and hospital stay, and mortality, with no safety concerns. Vermeij, J.

CDC 119

CDC Radiology Radiology Head Injuries 119

Taming the SRU

JULY 2, 2023

An abrupt increase in end-tidal is an indicator of the return of spontaneous circulation (however this can also represent recent administration of bicarbonate). 2011): 544-549. 2011): 189-196. Capnography in the emergency department: a review of uses, waveforms, and limitations." The Journal of emergency medicine 53.6

Emergency Department 89

Emergency Department Pediatrics CPR Resuscitation 89

RebelEM

NOVEMBER 16, 2022

benzocaine) Consider the diagnosis in any patient with cyanosis and hypoxia that doesn’t respond to oxygen administration Administer methylene blue to any patient with abnormal vital signs, metabolic acidosis, end organ dysfunction or, a serum level > 25% References: Price DP. Chapter 127. Methemoglobin Inducers. Read more

Seizures 52

Seizures Administration Airway Management COPD 52

Pediatric Emergency Playbook

AUGUST 1, 2016

The subcutaneous tissues will swell to a point where you have a steady state fluid administration rate, and as soon as you stop the infusion, the remaining fluid will start to subside as it is absorbed. in 2007 compared subcutaneous administration of lactated ringer’s solution by gravity with and without hyalurondase. Kuensting et al.

Allergic Reactions 52

Allergic Reactions Dehydration Pediatrics Geriatric Emergencies 52

Dr. Smith's ECG Blog

JULY 21, 2024

Of interest — the ectopic beats triggering PMVT/VFib in such studies were often mapped to endocardial sites displaying Purkinje potentials within the myocardial scar — suggesting potential responsivity to a 1A agent ( Nogami — Pacing Clin Electrophysiol 34(8): 1034-1049, 2011 ). Administration of Procainamide is 10-17 mg/kg at 20 mg/min.

EKG/ECG 130

EKG/ECG Shock Hospitals Sepsis 130

Advanced Emergency Nursing from AENJ

MAY 27, 2014

Davies reported in the British Medical Journal of " A simple portable apparatus for the therapeutic administration of carbon dioxide." St John History Volume 10 (2010-2011) **Australian review of Sparklet Resuscitators and CO2 therapy. A SIMPLE PORTABLE APPARATUS FOR THE THERAPEUTIC ADMINISTRATION OF CARBON DIOXIDE.

Resuscitation 40

Resuscitation Poisoning Research Administration 40

Advanced Emergency Nursing from AENJ

MAY 27, 2015

Dolan, LA Times] Administrators often insist that the hospital be a “weapons-free” zone (as if there was any protection in that), that guards are often unarmed –perhaps with just a radio and a flashlight, and often wearing a “friendly” blazer rather than a uniform of obvious authority. 2011) Emergency Preparedness. Mohammed, A.

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40

EMDocs

APRIL 22, 2024

The Accu-Chek was 214, and there was no response to empiric Narcan administration. 2011 Mar;123(16):1788-1830. Advanced cardiac life support (ACLS) had been initiated and on arrival at the ED, the patient was found to have Pulseless Electrical Activity (PEA). Circulation. doi: 10.1161/CIR.0b013e318214914f. 0b013e318214914f.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

Don't Forget the Bubbles

JUNE 10, 2024

Use of Probiotics : The administration of probiotics to VLBW infants has shown promise in reducing the incidence of NEC, though the optimal strains and dosages remain under investigation. Careful Advancement of Enteral Feeding : Gradual introduction and advancement of enteral feeds can help minimise the risk of NEC. Necrotizing enterocolitis.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

PulmCCM

SEPTEMBER 9, 2021

Yet in 2011 a landmark randomized, controlled trial measured the effect that an intravenous bolus had on mortality in children with severe febrile illness in 3 African countries. Arguably, this might be mitigated by slower volume administration.

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

EB Medicine

AUGUST 1, 2018

Also, be aware that there are various formulations of cannabis that allow for different routes of administration. Basically, any way you can imagine, it seems like a route of administration has been explored. On the longer end, rectal cannabis administration can take up to 8 hours to reach peak plasma concentrations.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Pediatric Emergency Playbook

JANUARY 1, 2017

CRIES is a 10-point scale, using a physiologic basis similar to APGAR: Crying; Requires increased oxygen administration (distress and breath-holding); Increased vital signs; Expression; and Sleeplessness ( Krechel 1995 ). Once the pain is controlled, less frequent administration of medications, with frequent reassessments, are indicated.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

PHEM Cast

NOVEMBER 28, 2022

Here are some links to the excellent Life in the Fast Lane: [link] [link] Acute Coagulopathy of Trauma Tranexamic Acid The Resus Room podcast which discusses Tim and colleagues paper on gender differences in TXA administration is available here: [link] Want to read more about Crash 4? Cochrane Database of Systematic Reviews 2011, Issue 3.

Blood Transfusions 52

Blood Transfusions Administration Research 52

Taming the SRU

SEPTEMBER 1, 2023

for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 96

Sepsis Fractures Documentation/Coding Administration 96

EMDocs

JANUARY 20, 2025

Since then, at least three separate meta-analyses 20-22 have found that on the whole, a restrictive fluid administration approach (variously defined) is at least as effective and possibly better than a liberal approach. Int J Emerg Med 4, 58 (2011). 2011 Sep 9;4:58. Andrews et al. Similar to Andrews et al., Umulisa, I.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

EMDocs

JANUARY 22, 2025

What are the pharmacokinetics of naloxone and how do they vary by route of administration? Route of Administration and Pharmacokinetics 7,11-14 Route Dose Onset (minutes) Time to peak effect (minutes) t Duration IV 0.04-2mg* drug seizure data, 2011-2016. When should a naloxone infusion be considered? 2mg* 2 5 0.5-1.5

Seizures 96

Seizures Administration Emergency Department Poisoning 96

EMDocs

MARCH 6, 2025

link] Diagnosis: DSM-V diagnosis requires 3 : At least 4 weeks of typical dyskinetic movements Development of symptoms following anti-dopaminergic medication administration Classically this would be first- or second-generation antipsychotics but may be expanded to any medication that has a postsynaptic dopamine inhibition, such as metoclopramide.

Psychiatric 73

Psychiatric Emergency Department Administration Wellness 73

Dr. Smith's ECG Blog

FEBRUARY 6, 2025

Intravenous administration was sought for rapid onset of action. Although rare reduced lumen size of one or more coronary arteries has been reported as a cause of sudden death as its initial presentation in previously healthy young adults ( See MacFarland et al J Card Cases 4(3): E148-151, 2011 and Guo et al JACC 17(18)- 2021 ).

EKG/ECG 71

EKG/ECG Wellness Administration 71

EMDocs

NOVEMBER 25, 2024

6 Worldwide ongoing mass drug administration (MDA) with ivermectin, a public health measure made possible via mass donations from Merck, significantly reduces the burden of infection and associated ocular disease. Published online October 2011:1479. 7 Approximately 14.6 million infected people suffer from skin disease and 1.15

Infectious Diseases 73

Infectious Diseases Emergency Department EMS Administration 73