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Podcast 785: Pepper Spray

Contributor: Jared Scott, MD Educational Pearls: Pepper spray is a chemical irritant derived from oleoresin capsicum (OC), an extract from pepper plants. It can be used by police for riot or crowd control, or by individuals for self defense.   In the event of an exposure, those affected should immediately disperse from the area, remove contact…

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Podcast 784: Wastewater Surveillance for COVID

Contributor: Jared Scott, MD Educational Pearls: About 50% of those infected with SARS-CoV-2 will shed the virus in their feces   Wastewater surveillance can be used to track COVID burden, which may be easier than collating test data from multiple hospitals across a region  Viral shedding begins 5-7 days prior to symptom onset, so wastewater data…

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Podcast 783: LAD Occlusion & Troponin

Contributor: Jared Scott, MD Educational Pearls: A study randomized 34 healthy patient to have their left anterior descending artery (LAD) occluded by balloon for 0, 15, 30, or 90 seconds   Subsequently,  cardiac troponins (cTns) and Copeptin were measured every 15 minutes for 3 hours, then every 30 minutes for the next 3 hours 5 conclusions…

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Podcast 782: Ventilator Management

Contributor: Aaron Lessen, MD Educational Pearls: Tidal volume is the amount of breath a patient receives in a single ventilation  Traditional tidal volume (TV) setting was 10 ml/kg but studies showed lower TV had less incidence of respiratory distress, ARDS, and overall better outcomes  ED ventilation settings may get carried on for hours or days…

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Podcast 781: Foxglove, Dropsy, and Salvador Dali

Contributor: Chris Holmes, MD Educational Pearls: Foxglove plant contains the cardiac glycoside digoxin   Foxglove leaf potions were once used to treat Dropsy; a historic term for symptoms of heart failure  Digoxin, previously used for treating heart failure, works by increases heart contraction strength and slows heart rate Of note, the EKG of patient on digitalis…

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Podcast 780: Pediatric Sedation Post-Intubation

Contributor: Aaron Lessen, MD Educational Pearls: Recent study looking at a pediatric emergency department to determine what percentage of patients after intubation received sedation within 10 minutes after intubation About 25% of the patients in the study received sedation within 10 minutes after intubation Only 75% of the patients in the study received sedation in…

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Podcast 779: Pulse Pressure in Trauma

Contributor: Aaron Lessen, MD Educational Pearls: Pulse pressure is the difference between the systolic and diastolic blood pressure, normal is about 40 A narrow pulse pressure is generally thought of as less than 30 mmHg which may signal peripheral vasoconstriction in response to lower blood volumes 2020 study examined hypotension and narrow pulse pressure in…

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Tastes so good, hurts so bad

tastes so good, hurts so bad Chief Complaint: Esophageal Foreign Body HPI: 31-year-old male presents to emergency department with reports of an esophageal foreign body. He states that he was eating chicken and had a large piece of chicken get stuck in his chest. He is vomiting up liquid after attempts of swallowing water, not…

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Podcast 778: tPA for Frostbite Injury

Contributor: Peter Bakes, MD Educational Pearls: Mild frostbite injury usually only requires supportive care In severe frostbite injury, patients should receive an immediate angiogram, be admitted, and receive tPA if there is evidence of vascular occlusion Salvage rate is around 80% for appropriate patients who receive tPA in phalangeal frostbite injury References Paine RE, Turner…

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Podcast 777: Grass, Weed, and Ancient Rome

Contributor: Chris Holmes, MD Educational Pearls: Antiemetics were used in ancient Rome to help with sea-sickness and included toxic substances such as wine and wormwood and white hellborn The first antihistamine used for nausea, dramamine, was introduced in 1947 for motion sickness After this chlorpromazine, prochlorperazine, and promethazine came about in the 1950s and 1960s…

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