EMDocs

MAY 25, 2023

Outcome: No statistically significant difference in primary outcome, which was absence of clinically apparent seizures without the need for additional anti-convulsant medications AND improving responsiveness at 60 minutes after the start of trial-drug infusion, as determined by the treating physician.

Seizures 64

Seizures Administration Anaphylaxis Outcomes 64

The Skeptics' Guide to EM

SEPTEMBER 16, 2017

Though this disorder is routinely treated with medications for anaphylaxis (i.e. A 2015 phase 2 study published in the NEJM (Bas et al) touted the role for icatibant in the treatment of these patients. We covered ACE-I induced angioedema and reviewed the 2015 icatibant study on SGEM#110. Reference: Sinert et al.

Anaphylaxis 52

Anaphylaxis Administration EMS Emergency Department 52

Northwestern EM Blog

JANUARY 24, 2022

Anaphylaxis Anaphylaxis may present as hypotension alone. Thus, it may easily be confused with a different form of shock and treated with vasopressors such as norepinephrine and vasopressin, which are not first line for anaphylaxis. Urticaria should prompt consideration of anaphylaxis. Understanding adrenal crisis.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Taming the SRU

SEPTEMBER 1, 2023

2015) reported a sensitivity of 98.9% 2015) reported a sensitivity of 98.9% 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.,

Sepsis 94

Sepsis Fractures Documentation/Coding Administration 94

Northwestern EM Blog

FEBRUARY 14, 2022

The study was designed as a phase III multicenter randomized placebo control trial taking place across 75 intensive care units in the United States from 2015 to 2017. The primary outcome of the study was the response in MAP three hours after the start of angiotensin II infusion.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

EM Guide Wire

NOVEMBER 2, 2020

Primary outcome was discharge to home at 24 hours. mcg/kg/min Can increase dose q30 min to max dose of 10 mcg/kg/min Can cause elevations in troponin If there hasn’t been improving, consider IM epinephrine instead Same as anaphylaxis dose 0.01 2015 Oct-Dec; 27(4): 390–396. mg may be nebulized Q4-6 hours.

Pediatrics 52

Pediatrics Anaphylaxis Administration Hospitals 52

EB Medicine

SEPTEMBER 1, 2018

As some background, from 2006-2015 there were almost 66,000 reported snake exposures and 31 deaths from snake envenomation in the US. Nachi: Not only are they out, they actually worsen outcomes, so definitely don’t pursue any of them. Note that antivenom will NOT reverse anaphylaxis on its own. Jeff: What a team!

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40