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Podcast 673: Leaving the ED with Naloxone 

Contributor: Don Stader, MD Educational Pearls: Patients are more likely to survive an opioid overdose if they have naloxone 10% risk of death in the year following an opioid overdose of patients seen in the ED Those who receive naloxone: Have better survival rates Are more likely to enter recovery Are more likely to use…

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Podcast 672: Oxygen Things

Contributor: Aaron Lessen , MD Educational Pearls: Patients on 10L or more of oxygen per minute in the ICU were randomized to oxygen goals of 90% or 96% to compare 90-day mortality rates Mortality rates were about 42% for both of oxygen target groups, indicating no significant difference References Schjørring OL, Klitgaard TL, Perner A,…

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Podcast 671: Scapula Fractures

Contributor:  Adam Barkin, MD Educational Pearls: Represents less than 1% of all fractures that occur, although it has a significant mortality rate of 2-5% Typically occurs in high-energy trauma and are commonly associated with high injury severity scores and other fractures Concomitant Injuries: 50% have rib fracture 25% have clavicle fracture 30% have a spine…

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Podcast 670: Operation Tat-Type

Contributor:  Dave Rosenberg, MD Educational Pearls: In 1951, Operation Tat-Type began tattooing adults with their blood type in an effort to prepare for rapid transfusions in the time of the Cold War and the Korean War School children in northern Indiana and areas in Utah were tattooed with their blood type beginning in 1952 under…

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Podcast 669: VTach Storm

Contributor:  Gretchen Hinson, MD Educational Pearls: Three episodes of ventricular tachycardia within 24 hours or two episodes back-to-back Treat with IV amiodarone and IV beta-blockers initially as well as IV lidocaine Correct underlying causes:  IV magnesium for QT prolongation Replete potassium in hypokalemia Urgent revascularization in ischemia For refractory vtach, urgent radiofrequency ablation or stellate…

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Podcast 668: Opioid-Induced Hyperalgesia

Contributor: Donald Stader, MD Educational Pearls: Opioids target kappa and NMDA receptors that can lead to central nervous system sensitization and therefore increased pain For patients with opioid-induced hyperalgesia (OIH), oral ketamine (25-50 mg) can be used to treat their pain as it targets the NMDA receptor Other treatments are IV magnesium, NSAIDs, Tylenol, and…

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COVID-19 Vaccines

COVId-19 vaccines Introduction COVID-19 has emerged to be the most challenging pandemic faced in the 21st century. With total cases as of April 2021 at about 147 million worldwide and 32 million in the US, this virus has demanded our attention since 2019. International efforts have shifted from limiting the spread of the virus to…

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Podcast 667: Lactated Ringers for DKA

Contributor:  Aaron Lessen, MD Educational Pearls: Recent study looked at whether lactated ringers might be a better choice for fluid resuscitation in patients with DKA compared to normal saline Normal saline can cause a hyperchloremic metabolic acidosis Time to resolution of acidosis was 4 hours less with lactated ringers compared to normal saline Time on…

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Podcast 666: Pain Management & Patient Perspective

Contributor:  Jared Scott, MD Educational Pearls: About ½ of the patients in the ED present with some form of pain One study looked at patients presenting in pain and followed up two days after discharge to determine if their pain was addressed, asking if the patient received anything for pain and if the patient refused…

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Podcast 665: Allergic Reactions after COVID Vaccinations

Contributor:  Peter Bakes, MD Educational Pearls: Incidence 2.5-10 per million people occurring primarily in those with environmental allergens Typically occurs with mRNA vaccines in lipid nanoparticles (Moderna/Pfizer) rather than the adenovirus vaccine (J&J) Recommendation is to forego 2nd dose of the mRNA vaccine and instead get the adenovirus vaccine after weighing the risks and benefits…

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