Background Treatment of digoxin toxicity can be quite complex and generally involves the use of digoxin immune Fab (DigiFab®) for symptomatic patients. The dosing of DigiFab can vary depending on the amount ingested, serum concentration, and/or suspected chronicity of toxicity. Alternatively, for an acute ingested of an unknown amount where the serum concentration is not [+]
The post Simplified Dosing Scheme for DigiFab® in Acute Digoxin Poisoning appeared first on ALiEM.
Background Sodium bicarbonate during a cardiac arrest is widely debated and used in many cases. In a 2018 PULMCrit post, Dr. Josh Farkas reviews much of the data regarding this topic and states that use of sodium bicarbonate is a “source of eternal disagreement.” A 2013 EMCrit article and podcast by Dr. Scott Weingart also [+]
The post Pre-Arrest Acidemia and the Effect of Sodium Bicarbonate on ROSC appeared first on ALiEM.
Background Bleeding patients or those undergoing procedures that are at high risk of bleeding may require correction of their INR. Multiple products can be used to achieve this, including fresh frozen plasma (FFP). FFP contains many substances, including clotting factors, fibrinogen, plasma proteins, electrolytes, and anticoagulant factors. It is sometimes said that the intrinsic INR [+]
Background Succinylcholine is frequently used in the ED to facilitate intubation, but it may be avoided in some cases due to the risk of hyperkalemia. The underlying physiology of this effect appears to be directly related to its therapeutic mechanism of action. When succinylcholine binds to and activates acetylcholine receptors, it leads to an influx [+]