Category: General EM

Very helpful practice guideline that published recently in Annals of EM. Topics covered in this issue are: Contraindications, Fasting state,bolus and infusion dosage, personnel, co-administration, monitoring, and adverse events. Link to article

BMJ published a a prospective, double-blind, double-dummy, randomised controlled trial regarding Intravenous versus oral Acetaminophen. 87 participants were enrolled. No superiority was demonstrated in this trial with 1 gram intravenous acetaminophen compared with 2 x 500 mg oral acetaminophen in terms of efficacy of analgesia and no difference in length of stay, patient satisfaction, need […]

“Sign out”, “Hand off” is one of the critical action for EM physicians. SBAR (Situation, Background, Assessment, Recommendation) is one of the famous procedure to standardize this action. I-PASS initially came for Pediatric literature is an alternative way to summarize and give some standardize protocol for hand off. Pediatrics Academic Medicine

Hypoglycemia in the treatment of hyperkalemia in ESRD frequently happens! There ae growing in the body of literature to address this issue with different recommendations: administering 25 g of dextrose with insulin and 25 g of dextrose 1 h after insulin based on our result that hypoglycemia occurred 1–3 h after insulin with dextrose. Link […]

When I saw this article in Annals , I was sure that I have seen it before, but could not believe that 2 studies with almost same methods, same number of patients, and same dose of medication.

I used Low Dose Ketamine for Pain relief in ED, and I had a very good experience with it, but new study in AJEM Feb, 6, showed that compare with morphine ,LD Ketmaine

It is good to tell residents something and back it up with some EVIDENCE!!! such as your Mentor is not someone to tell you something that You want to hear! but here some tips that can help you through your career: advice for physicians in training: 40 Tips From 40 Docs

ACEP published Clinical Policy on Procedural Sedation and Analgesia in the Emergency Department in Feb 2014. as usual critical questions and very useful answers. Let’s review them:

Discharge Against Medical Advice, Pitfalls and Troubleshooting. There is a very interesting article from JAMA in Nov. 2013, explaining of misconception and how misleading is information regarding discharge patient with AMA. I always discuss with residents that signing an AMA form does not mean anything unless you document the patient’s condition and mental status and […]

What evidence does exist regarding dosage of Ketolorac? Our practice is usually 60 mg IM and 30 mg IV, but interesting review by Medscape showed may be this is not a right dose.

Pain management in ED is a challenging topic. Teaching residents to start with NSAIDS vs Narcotics and Ibuprofen- Toradol vs Morphine- Dilaudid , always could be a place for discussion/argument.

To estimate the frequency and rates of hospitalization after emergency department visits for adverse drug events in older adults between 2007-2009.