article thumbnail

Clinical Conundrums: How Long Should We Monitor After Giving IM Epinephrine for Anaphylaxis?

REBEL EM

How Long Should We Monitor After Giving IM Epinephrine for Anaphylaxis? Bottom Line Up Top: After prompt recognition and appropriate treatment with IM epinephrine, the risk of biphasic reactions are exceedingly low. At the time of discharge, appropriate patient education and prescriptions for IM epinephrine are essential.

article thumbnail

SGEM#238: The Epi Don’t Work for OHCA

The Skeptics' Guide to EM

Date: December 6th , 2018 Reference: Perkins et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. Date: December 6th , 2018 Reference: Perkins et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. There is one randomized control trial on epinephrine for OHCA by Jacobs et al.

professionals

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Neurogenic Shock in Children

Pediatric EM Morsels

Both norepinephrine and epinephrine can be used. Epinephrine is key if there is significant bradycardia. 2018 Oct;14(2):47-54. Epub 2018 Oct 31. Crystalloid may help, but neurogenic shock may not respond to fluid administration. Alpha 1 agonists are necessary to maintain appropriate blood pressure. Korean J Neurotrauma.

E-9-1-1 300
article thumbnail

Updates in High dose Insulin and Euglycemia Therapy (HIET) for the treatment of Beta-adrenergic Receptor and Calcium Channel Antagonists Overdose

Core EM

HIET improves contractility without increasing SVR, while vasopressin and epinephrine transiently increase SVR/MAP but worsen cardiac output in anesthetized dogs given propranolol (Holger 2007). Insulin versus vasopressin and epinephrine to treat β-blocker toxicity. Strong trend across different study designs for superiority of HIET.

Overdose 246
article thumbnail

SGEM#231: You’re So Vein – IO vs. IV Access for OHCA

The Skeptics' Guide to EM

[display_podcast] Date: September 21st, 2018 Reference: Kawano et al. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. display_podcast] Date: September 21st, 2018 Reference: Kawano et al.

BLS 130
article thumbnail

SGEM#247: Supraglottic Airways Gonna Save You for an OHCA?

The Skeptics' Guide to EM

JAMA 2018 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a physician assistant practicing in emergency medicine in the Seattle area and an adjunct faculty […] The post SGEM#247: Supraglottic Airways Gonna Save You for an OHCA? JAMA 2018 * Population: Adults who had a non-traumatic OCHA.

CPR 130
article thumbnail

emDOCs Revamp: Left Ventricular Outflow Tract Obstruction

EMDocs

EPINEPHRINE-INUDCED SHOCK: LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION ON VASOPRESSORS. doi:10.1136/BCR-2018-225879 Dawood S, Hill A, Al Rawi O. m/s)—problematic and elevated > 50 mm Hg (2.5 Clin Cardiol. 2009;32(7):397-402. doi:10.1002/CLC.20594 20594 MOZELL D, SHAH N, CASTILLON JJR, GONUGUNTLA VT, AWERBUCH E. doi:10.1016/J.CHEST.2024.06.1821

E-9-1-1 87