emergency physician maimonides medical center rocuronium, ketamine, droperidol, buprenorphine, chocolate
brooklyn, new york
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The bougie, again.
Conclusion: Difficult placement of a Minnesota tube may be addressed by placing the coudé tip of a bougie into the distal eyelet and advancing the devices in tandem into proper position.
sciencedirect.com/science/ar…
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This smartly designed trial randomized patients getting a neck CT to cricothyroid membrane identification by landmark or ultrasound, and the landmark method was in fact more accurate (vs. CT as gold standard).
For cricothyrotomy, your finger can see.
jem-journal.com/article/S073…
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In this randomized trial, PEFR-guided care did not improve symptom control, reduce resource utilization, or affect disposition compared with symptom-guided care. These findings suggest limited benefit of PEFR use in ED asthma management.
doi.org/10.1016/j.jemermed.2…
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Diltiazem/verapamil is superior treatment for SVT, but if you must expose your patient to the distress of adenosine, start with 12 mg.
doi.org/10.1111/acem.70309
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Treatment of Severe Alcohol Withdrawal Syndrome
Pathways for phenobarbital titration, phenobarbital load, diazepam, lorazepam.
emupdates.com/aws
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I finally found a circumstance that favors succinylcholine over rocuronium
"The drug-seeking behavior in this case was not euphoria but perceived psychological calmness likely tied to transient hypoxia and hypercarbia from respiratory muscle paralysis."
psychiatrist.com/pcc/intenti…
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Emergency Department Diagnosis and Management of Aortic Dissection
emupdates.com/dissection
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At the intersection of obvious and genius:
Naltrexone as Pre-exposure Prophylaxis for Unintentional Opioid Overdose in Stimulant Use Disorder
journals.lww.com/journaladdi…
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Direct to Inject Long-Acting Injectable Buprenorphine. We're still trying to figure out how to do this.
emupdates.com/edbup
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Once again, IM lorazepam is an inferior choice in the management of emergency agitation.
doi.org/10.1016/j.ajem.2026.…
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This paper in JGIM reads more like investigative journalism than a medical manuscript.
"The widespread use of lorazepam for alcohol withdrawal in the USA is likely a legacy of the deceptive practices employed by Wyeth."
link.springer.com/article/10…
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These guys administered rocuronium, then sugammadex, then the patient developed severe anaphylaxis unresponsive to usual therapies, was in extremis, so they treated the patient with another dose of rocuronium.
onlinelibrary.wiley.com/doi/…
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