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Background Nitroglycerin (NTG) is an important intervention to consider for patients with Sympathetic Crashing Acute Pulmonary Edema (SCAPE) as it significantly reduces preload, and even modestly reduces afterload with high...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
Background There are a few unique scenarios when beta-blockers may be indicated for patients in cardiac arrest. Use of esmolol for refractory ventricular fibrillation was summarized in a 2016 PharmERToxGuy...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
Background Naloxone can be administered via multiple routes, with nebulization gaining popularity in the past decade. A previous ALiEM Trick of the Trade presented this unique method of administration. In...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
Background Bupropion ingestions are one of the scarier poisonings due to a relatively narrow therapeutic index and the numerous adverse effects that may occur. Medical toxicologist Dr. Dan Rusyniak details...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
Background A previous ALiEM post from 2013 by an EM pharmacist colleague argued the case against one-time vancomycin doses in the ED prior to discharge. The take-home points from this...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
Background Rapid and precise control of blood pressure is vital for patients with a hypertensive emergency or an acute stroke. Commonly, nicardipine is utilized in these situations, with nitroprusside being...
Mike O'Brien, PharmD |
Droperidol is safe and effective for the treatment of severely agitated patients in the ED [1-3]. But what about its use for agitation in elderly patients specifically? Droperidol Efficacy Two...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
Background There are three primary fluids used for resuscitation, each contains varying amounts of potassium per liter (Table 1): 0.9% Sodium Chloride (normal saline) Lactated Ringer’s solution Plasma-Lyte A Additionally,...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
A previous EM Pharm Pearl focused on the adverse events associated with the use of IV olanzapine for agitation. This pearl addresses concerns around using parenteral (IV or IM) olanzapine...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
The ability to safely and effectively sedate agitated patients in the emergency department (ED) is paramount to provide prompt medical care and protect ED staff. Intravenous (IV) antipsychotics are frequently...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
In the continued fight against COVID-19, a January 22, 2021 press release from the Montreal Heart Institute touted the potential of colchicine, citing results from the COLCORONA trial [1, 2]....
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
The 2020 ACLS guidelines provide recommendations on the medication-specific management recommendations for toxicology [1]. Although the name of the guidelines emphasize they are ‘Advanced,’ these are still relatively basic toxicology...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
The 2020 ACLS guidelines provide recommendations on the medication-specific management for arrhythmias including wide-complex tachycardia, regular narrow-complex tachycardia, atrial fibrillation/flutter, and bradycardia [1]. There are also our 2020 ACLS guideline...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP |
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