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emDOCs Podcast – Episode 94: GLP-1 Agonist Complications

EMDocs

Multiple well-designed, multicenter, multinational studies suggest GLP-1 agonists are associated with improved glucose control in diabetes type 2 and approximately a 15% reduction in weight over 1-2 years (around 2/3s of patients regain weight if treatment is stopped). Published June 04, 2021. 2021 Mar 18;384(11):989-1002.

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EM@3AM: Traumatic Iritis

EMDocs

Post septal (retrobulbar) is higher risk to vision and requires CT imaging to diagnose as well as thorough exam to check for proptosis, afferent pupillary defect, increased intraocular pressure [7]. 2021 Oct 7. Orbital hemorrhage: preseptal is less dangerous and more obvious on exam. query=Traumatic+Iritis+and+Chemical+Iritis.

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Nephrotic Syndrome

Mind The Bleep

Steroid resistance Failure to achieve complete remission after 8 weeks of prednisolone at 60mg/m2/day Differentials Heart failure – would present with oedema, shortness of breath, cyanosis Allergic reaction – presents with facial oedema, pruritus. This causes a positive feedback mechanism with the liver producing more albumin.

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ToxCard: Crotalid Envenomation Part 2 – CroFab vs. AnaVip: What’s the Difference?

EMDocs

In April 2021, after a post-hoc analysis of the original phase 3 study suggested non-inferiority of the F(ab’) 2 antivenin against copperhead envenomation, the FDA expanded approval of this antivenom to include copperhead and cottonmouth envenomations. Published online April 2021. Ann Emerg Med. 2020;76(4):S29. Accessed May 7, 2022.

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What the Emergency Clinician Must Know about Remote Monitors in Heart Failure

EMDocs

10 This procedure has well-described rare complications including infection, blood loss, allergic reaction, arrhythmia, pneumothorax if approaching via the internal jugular vein, embolization of the device, and pulmonary artery perforation or dissection. 2021 Jan;14(1):e008693. 8 The device itself is 2 x 2.5 120.008693.

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The PALACE Trial: Direct Oral PCN Challenge in Patients with Low-Risk PCN Allergy?

RebelEM

What They Did: Parallel, 2-arm, noninferiority, open-label, multicenter, international randomized clinical trial Occurred in 6 specialized centers (3 in North America – US & Canada and 3 Outside of North America – Australia) Trial took place from June 2021 to December 2022 Used PEN-FAST to risk stratify patients.

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CT Angiography Head and Neck: Indications and Limitations

EMDocs

2021) found that the top 5 reasons for ordering a CTA head/neck were suspected stroke, neurologic problem, dizziness, headache with new/concerning symptoms, and altered mental status. 34, 40 SAH can be diagnosed with NCCT, but CTA head can be used to locate the causative aneurysm as well as any other, yet unruptured, aneurysms present.

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