Contributor: Jared Scott, MD Educational Pearls: About ½ of the patients in the ED present with some form of pain One study looked at patients presenting in pain and followed up two days after discharge to determine if their pain was addressed, asking if the patient received anything for pain and if the patient refused…
Read MoreContributor: Peter Bakes, MD Educational Pearls: Incidence 2.5-10 per million people occurring primarily in those with environmental allergens Typically occurs with mRNA vaccines in lipid nanoparticles (Moderna/Pfizer) rather than the adenovirus vaccine (J&J) Recommendation is to forego 2nd dose of the mRNA vaccine and instead get the adenovirus vaccine after weighing the risks and benefits…
Read MoreContributor: Jared Scott, MD Educational Pearls: 1-3 cases of rabies per year in US with 55,000 people per year receiving rabies prophylaxis 90% of rabies cases come from wildlife, most commonly by racoons, bats, foxes, and skunks Because of rabies prophylaxis, domesticated pets almost never have rabies in the United States Rabies is typical transmitted…
Read MoreContributor: Alicia Oberle, MD Educational Pearls: Down Syndrome with Trisomy 21 have three copies of chromosome 21 Current birth rates are around 1 in 700 births Average life span 25 years in 1980, today the average life span is 60 years of age Patients with Down syndrome require additional therapies in the first 3 years…
Read MoreThis week’s episode features a fascinating conversation with Dr. Nadia Tremonti, medical director for the pediatric palliative care program at Children’s Hospital of Michigan in Detroit. Dr. Tremonti was the featured physician in an independent short film Palliative and subsequent New York Times shorter excerpt Dying in your Mother’s Arms that explore her work with…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: Droperidol for sedation in agitated patients in the emergency department was studied compared to ziprasidone (Geodon) and lorazepam (Ativan) Double-blinded RCT showed droperidol was 65% effective to get patients to a good level of sedation in 15 minutes compared to ativan and geodon which were 25-35% effective Droperidol had…
Read MoreContributor: Ricky Dhaliwal, MD Educational Pearls: Primarily affects children <6 years old and adults with kidney disease Caused by staph aureus releasing exotoxins that result in erythema and sloughing of the skin Present with significant pain, dehydration and underlying staph infection Treatment typically oxacillin/nafcillin with admission for wound care with petroleum gel and xeroform Burn…
Read MoreContributor: Ricky Dhaliwal, MD Educational Pearls: Rhabdomyolysis occurs when high levels of myoglobin are released from dying muscle tissue into the blood Severe levels of myoglobin cause renal injury Causes include elevated temperature, excessive exercise, toxins, infection, muscle ischemia, crush injury, and prolonged immobilization Can also be caused by medications, like antipsychotics, statins, SSRIs, colchicine,…
Read MoreContributor: Aaron Lessen, MD Educational Pearls: Study in NEJM looked at occult hypoxemia, when oxygen saturation reads at >92% when the actual saturation is <88% Rate of occult hypoxemia was 3 times higher in those who identified as black (12% vs 4%) Keep this disparity in mind when providing care to patients of all backgrounds…
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