Author: Rachel Beham, PharmD, Advanced Clinical Pharmacist – Emergency Medicine
- Tetanus Ig is indicated in those who have no or unknown tetanus vaccination history who present with contaminated cuts that or dirty puncture wounds
- The tetanus vaccine is a 5 shot series (DTAP) for children, TDAP is used for adults
- There is no harm is receiving the TDAP more than once if vaccination history is unknown
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Author: Aaron Lessen M.D.
- Ultrasound is helpful in the setting of cardiac arrest for finding a cause like cardiac tamponade or PE, but also for predicting outcomes for non-shockable rhythms.
- One study showed that in those that presented with asystole or PEA and cardiac activity on US had a 4% survival rate, while those without cardiac activity had almost no chance.
References: Philip Salen, Larry Melniker, Carolyn Chooljian, John S. Rose, Janet Alteveer, James Reed, Michael Heller, Does the presence or absence of sonographically identified cardiac activity predict resuscitation outcomes of cardiac arrest patients?, The American Journal of Emergency Medicine, Volume 23, Issue 4, 2005, Pages 459-462, ISSN 0735-6757, http://dx.doi.org/10.1016/j.ajem.2004.11.007.
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Authors: Rebecca van Vliet MS, APN; Michelle Whaley MSN, CNS, CCNS, ANVP-VC
The Stroke Team at Swedish Medical Center gives us a taste of how they are breaking records with door-to-needle time in management of acute cerebrovascular accidents.
Author: Michael Hunt M.D.
Dr. Hunt shares his wealth of experience with biological terrorism over the course of his career.
Run Time: 4 minutes
Author: Jared Scott, MD
- Aortic dissection = separation between 2 layers of vessel wall (usually intima and media)
- Aortic Aneurysm = cystic dilation of the aorta
- Aortic dissection associated with severe HTN or connective tissue disorders (Marfan’s, Ehlers-Danlos, etc.)
- AAA associated with HTN, DM, HLD, smoking (same risks for MI)
- Aortic dissection starts proximal in chest and peels down
- AAA confined to abdomen and can rupture. 90% mortality.
Link to Podcast: http://medicalminute.madewithopinion.com/aortic-dissection/
Run Time: 1 minutes
Author: Aaron Lessen M.D.
- Patients with concussions are frequently seen in the ED, and generally are given good home health care precautions.
- A new study for post concussion management looked at driving performance after a concussion.
- The study showed that 48 hours after symptoms had resolved, patients who were diagnosed with a concussion did worse on a standard performance test than people without a concussion.
Link to Podcast: http://medicalminute.madewithopinion.com/concussions/
Run Time: 3 minutes
Author: Gretchen Hinson M.D.
- Case presentation: a 44 year-old male after a syncope was found to have a heart rate of 261 wide complex tachycardia and a SBP in the 80s for EMS in the field. The patient was given adenosine on arrival to the ED, but with no resolution of the tachycardia, but after electrocardioversion the patient’s heart rate converted to 100 but still in a wide complex tachycardia.
- The missing piece of history for this patient is a diagnosis of lupus with previous pulmonary complications and systemic skin changes.
- Lupus can also cause myocarditis and conduction abnormalities along with the more common skin changes and renal complications.
Link to Podcast: http://medicalminute.madewithopinion.com/lupus-myocarditis/
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