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Allergic Reactions and Anaphylaxis

EB Medicine

— In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the July 2022 Emergency Medicine Practice article on the Management of Allergic Reactions and Anaphylaxis in the Emergency Department. Intro The number of ED visits and hospitalizations Studies show up to 57% of anaphylactic reactions are not recognized, and epinephrine is not administered (..)

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STREAM-2: Half-Dose Tenecteplase vs Primary PCI in Older Patients with STEMI?

RebelEM

In non-PCI-capable hospitals this goal is not always achievable due to delays in transfer. Background: Primary PCI is the recommended reperfusion strategy in patients with STEMI and should be initiated within 2 hours after first medical contact. In these cases, thrombolysis is recommended to improve morbidity and mortality. Primary PCI: 95.7%

EKG/ECG 137
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Toss Up: A Little Bleeding, or A Lot of Platelets

EM Literature of Note

Platelets, like any blood product, are associated significant risks, not limited to acute lung injury, transfusion-related circulatory overload, allergic reactions, and more.

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Rash Week! An atypical antibiotic reaction

PEMBlog

It’s Serum Sickness Like Reaction! This is a delayed allergic reaction to an antibiotic. Your hospital might even have a specific clinic to follow this up – like the PATS – Penciling Allergy Testing Service at Cincinnati Children’s. The child has fever and swollen feet as well.

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

RebelEM

Background: Diphenhydramine, a first-generation antihistamine, is the most common pharmacologic agent used to treat acute allergic reactions. Diphenhydramine versus nonsedating antihistamines for acute allergic reactions: a literature review. Resources: Banerji A, Long AA, Camargo CA Jr. Allergy Asthma Proc. Ledford, D.

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Episode 36 - Diagnosis and Management of Acute Gastroenteritis in the Emergency Department

EB Medicine

Consider them for immunocompromised patients and those with recent abx use or hospitalization. C Difficile testing is recommended for all patients with AGE who are age >2 with a history of recent abx use or recent hospitalization Blood cultures are recommended for patients <3 months old and any patient with signs of sepsis.

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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. HAS can be given as 4.5% HAS should be prescribed at 5-10ml/kg over 2 hours IV.