General Archives - Page 2 of 7 - The Emergency Medical Minute

General

Podcast 734: Push Dose Antibiotics

Contributor: Aaron Lessen, MD Educational Pearls: Recent study at a hospital in Chicago with a shortage of normal saline decided to push IV ceftriaxone rather than the typical infusion of the antibiotic Retrospective chart analysis of about 800 patients to determine safety of giving a push dose of ceftriaxone Only 1 complication due to the…

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Podcast 719: Normal Saline vs. Tap Water for Wound Irrigation

Contributor: Ricky Dhaliwal, MD Educational Pearls: Multiple RCTs and a Cochrane Review found there is no difference in wound infection rates when irrigating with tap water  Pressure of the water and how extensively the wound is irrigated were the most important factors affecting infection rates Quantity and type of water were independently not as important…

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Podcast 716: Resuscitation Fluids

Contributor: Nick Tsipis, MD Educational Pearls: Fluid choice may have an impact on outcomes in resuscitation, and a meta-analysis has relevant insight into their use in sepsis and trauma patients Large volume normal saline fluid resuscitation in sepsis is associated with acute kidney injury and metabolic acidosis compared to Lactated Ringers Choice of fluid did…

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Podcast 706: Pepper Spray Decon

  Contributor: Ramnik Dhaliwal, MD JD Educational Pearls: Pepper spray is a highly irritating compound with active ingredient of capsaicin Techniques to help decontaminate and alleviate symptoms of an exposure include: Disrobing the patient to prevent further exposure Half milk of magnesia and half water mixture can be used to soothe the skin in the…

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Podcast 702: Paralytic Awareness

Contributor: Aaron Lessen, MD Educational Pearls: Known risk factors for being awake and paralyzed in the OR include only receiving IV medications, long-acting paralytics, and no formal monitoring system for being awake The ED-AWARENESS study, a prospective single-center study found 2.6% of patients with induced paralysis during mechanical ventilation were aware Rocuronium was a risk…

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Podcast 698: Empathy, Burnout, and Patient Satisfaction

Contributor: Aaron Lessen, MD Educational Pearls: Survey of EM physicians to self-report empathy and burnout levels and correlated with patient satisfaction scores Patient satisfaction was not affected by what the physicians thought about their level of empathy or burnout  Patient satisfaction was affected by the patient’s perception of empathetic behavior by the physician References Byrd…

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Podcast 695: Einstein and Cellophane

Educational Pearls: Albert Einstein had chronic abdominal pain as a middle-aged man Dr. Rudolph Nissen, founder of the Nissen fundoplication, performed exploratory surgery for this pain and found an abdominal aortic aneurysm (AAA) The only treatment for an AAA at that time was to wrap the vessel in cellophane, causing a fibrotic response to prevent…

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Podcast 690: Rectal Oxygen. Nice,

Contributor: Chris Holmes, MD Educational Pearls: In the 1700s, boxes lined the River Thames to pump smoke up the rectum to resuscitate people who had been found unconscious in the river Sea cucumbers can extract oxygen through their rectum Perflourocarbon, a liquid that can become oxygenated, provided rectally was able to oxygenate pigs and mice…

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Podcast 685: Cultural Sensitivity with LGBTIQ+ Patients

Contributor: Dr. Nick Gorton, MD Educational Pearls: Use transgender people’s correct names and pronouns, the Russell study found a 56% reduction in suicide behavior with chosen name usage ⅕ to ½ of transgender people report they avoided seeking care in the ED because of fear of transphobic treatment Understanding the definitions of gender identity, gender…

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Podcast 684: Acidosis

Contributor:  Nick Tsipis, MD Educational Pearls: pH <7.35 = acidemia; pH>7.45=alkalemia If pH low and pCO2 high, indicates a respiratory acidosis If pH low and pCO2 low, indicates metabolic acidosis After determining type of acidosis, check bicarb to determine compensation for acidosis and check electrolytes to calculate anion gap Metabolic acidosis can present with tachypnea…

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