Contributors: Kalen Abbott, MD – EM Physician and Medical Director for AirLife Denver Brendan Reiss – Flight Nurse AirLife Denver Matt Spoon – Flight Paramedic AirLife Denver Jordan Ourada – EMS Coordinator at Swedish Medical Center and Paramedic Summary: In this episode, hosted by Jordan Ourada, Brendan Reiss and Matt Spoon present a first-hand experience…
Read MoreContributor: Aaron Lessen MD Educational Pearls: What is Carbamazepine (Tegretol)? Carbamazepine is an anti-epileptic drug with mood-stabilizing properties that is used to treat bipolar disorder, epilepsy, and neuropathic pain. It functions primarily by blocking sodium channels which can prevent repetitive action potential firing. What are the symptoms of an overdose? Common initial signs include diminished…
Read MoreContributor: Aaron Lessen MD Educational Pearls: Patients with alcohol use disorder are frequently discharged from the ED without further resources Pharmacological treatments to reduce cravings in AUD exist Naltrexone Effective at reducing alcohol cravings and heavy drinking Gabapentin Reduces the percentage of heavy drinking days in AUD Patients being discharged from the ED should be…
Read MoreContributor: Travis Barlock MD Educational Pearls: Alcohol binds the GABA receptor, which produces an inhibitory response, hence the “depressive” effects of ethanol beverages. Over time, alcohol downregulates the GABA receptors, leading to unopposed glutamate activity. Given that glutamate is excitatory, this can lead to seizures. Alcohol also suppresses REM sleep; in patients with chronically suppressed…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: What is Tranq? Tranq is the street name for xylazine, a sedative drug typically used in veterinary medicine. Xylazine has recently emerged as a recreational drug, often mixed with heroin or fentanyl. The mechanism of action of xylazine is similar to dexmedetomidine (Precedex), an alpha-2 adrenergic receptor agonist. At…
Read MoreContributor: Meghan Hurley, MD Educational Pearls: Venomous snakes in the United States include species from the family Elapidae and subfamily Crotalinae In prehospital setting, elevate the bitten extremity and transport to hospital immediately Do not attempt interventions with the bite site Monitor for progression of swelling past any joint line, systemic symptoms or lab abnormalities…
Read MoreContributor: Peter Bakes, MD Educational Pearls: Lithium remains a commonly used medication for treating bipolar disorder Lithium toxicity can be acute, acute-on-chronic, or chronic Measuring blood lithium level Therapeutic range of lithium is around 1.6-1.8 mEq/L >2 mEq/L is likely to cause significant toxicity >4 mEq/L necessitates lifesaving treatment The lethal dose of lithium is…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: There are several online products that have been marketed towards individuals with SI Sodium nitrite Food preservative that can cause methemoglobinemia when ingested in large amounts Patients present with blue skin discoloration and severe respiratory distress Treat with methylene blue to reduce methemoglobin back to hemoglobin Formic acid and…
Read MoreContributor: 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…
Read MoreContributor: 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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