Marco Torres | Sep 27, 21
The TOGETHER Trial: COVID-19 and Fluvoxamine Take Two
Background: Despite having a safe and effective set of vaccines for COVID-19, there have been some low resource countries in which it has been very challenging in getting the vaccine allocated. Therefore, identifying an inexpensive, widely available, and effective therapy against COVID-19 is still an important topic of research.
We have written before on fluvoxamine on REBEL EM. It is a selective serotonin reuptake inhibitor (SSRI) and a sigma-1 receptor (S1R) agonist. This makes this medication interesting as it has several potential favorable mechanisms in the treatment of COVID-19, including anti-inflammatory and antiviral effects.
Jason Elzinga, MD | Sep 27, 21
Breaking the Cycle: ED Management of Cannabinoid Hyperemesis Syndrome
What is cannabinoid hyperemesis syndrome? Cannabinoid hyperemesis syndrome (CHS) is a condition in which patients who have been using cannabis or synthetic cannabinoids for a prolonged period of time develop a pattern of episodic, severe vomiting (usually accompanied by abdominal pain) interspersed with prolonged asymptomatic periods. When should you consider cannabinoid hyperemesis syndrome as a [+]
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Chris Belcher, MD | Sep 26, 21
ALiEM AIR Series | Vascular 2021 Module
Welcome to the AIR Vascular Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to vascular emergencies in the Emergency Department. 9 blog posts met our standard of online excellence and were curated and [+]
Marco Torres | Sep 25, 21
Rebellion21: Alteplase for Stroke of Unknown Time of Onset
In this 9 minute video from day 2 of Rebellion in EM 2021, I go over the evidence for advanced imaging use in acute ischemic stroke of unknown time of onset to help guide treatment with intravenous alteplase.
Dr Ramon REYES, MD | Sep 24, 21
ACS TQIP BEST PRACTICE IN THE MANGEMENT OF TRAUMATIC BRAIN INJURY
ACS TQIP BEST PRACTICE IN THE MANGGEMENTE OF TRAUMATIC BRAIN INJURY
Marco Torres | Sep 23, 21
Awake Proning for COVID-19 Acute Hypoxemic Respiratory Failure
Background: Awake prone positioning was an intervention adopted early in the COVID-19 pandemic for patients with hypoxemic respiratory failure. Unfortunately, many early trials were not powered to show improvements in oxygenation, escalation of respiratory support, or mortality. The one meta-analysis (Link is HERE) including 50 trials with ≈3000 patients suffered from methodological flaws of the included studies. Most of the trials were small, observational, with very wide confidence intervals which made interpreting these trials of limited utility and really an interpretation of the absence of evidence, rather than an absence of benefit. Despite the lack of high-quality evidence, many clinicians continue to apply awake prone positioning and the approach has even incorporated into some clinical guidelines. Better evidence to guide this practice is clearly needed.