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emDOCs Podcast – Episode 85: Tricky Cases Part 1

EMDocs

Learning points: Consider differential – sepsis, thyroid storm, thalamic stroke, exertional and classic heat stroke, serotonin syndrome, neuroleptic malignant syndrome, sympathomimetic toxicity, and anticholinergics. Reference: EM@3AM – Heat Stroke Case 2: 40-year-0ld female feels unwell but no other specific complaints.

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Annals of B Pod: Anti-Xa Overdose

Taming the SRU

Given her intracranial hemorrhages, significant attempts were made to improve coagulation including administration of IV vitamin K, 3 units of fresh frozen plasma, and administration of four-factor prothrombin complex concentrate (PCC, Kcentra). The patient is agitated on a backboard with C-collar in place.

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Grand Rounds Recap 8.16.23

Taming the SRU

for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 84
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Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

2][3] If earlier treatment with TXA is better, would there be benefit in its administration in the prehospital setting? Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. MI or stroke). If so, could this be done safely? JAMA Neurol. 2021;78(3):338–345.

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Diagnostics: GI Bleeding

Taming the SRU

100U (30-60 min prior), 0.25-0.375/100U 100U (30-60 min prior), 0.25-0.375/100U 100U (30-60 min prior), 0.25-0.375/100U

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Grand Rounds Recap 3.15.23

Taming the SRU

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.

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Episode 20 - Emergency Department Management of North American Snake Envenomations

EB Medicine

Jeff: Hypotension should be treated with isotonic fluids and, as usual, anaphylaxis should be treated with the usual cocktail of antihistamines and epinephrine at first IM and then via infusion if refractory. Note that antivenom will NOT reverse anaphylaxis on its own. Regardless, the treatment is the same – epinephrine.