Remove ACS Remove ICU Remove Naloxone
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emDOCs Revamp – Acute Chest Syndrome

EMDocs

mg q20-30 min per dose) PRN naloxone in case of respiratory depression Some patients have SCD crises pain plan for reference Antimicrobials 11 Ceftriaxone + azithromycin if penicillin allergy for both children and adults. Chinawa JM, Ubesie AC, Chukwu BF, Ikefuna AN, Emodi IJ. C or 100.4 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4

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Sickle Cell Disease Module

Don't Forget the Bubbles

Opioids do not cause ACS but they can exacerbate hypoxia in patients with ACS. Naloxone (opioid antidote) should be available in ED in case of severe respiratory depression. The treatment for ACS is mainly supportive: Oxygen : supplemental oxygen should be given only when the patient is hypoxic (saturation of oxygen < 94%).

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Tranq dope (fentanyl-xylazine combination): A new horizon in opioid withdrawal treatment

ALiEM

We have certainly seen patients who have pain which is controlled and still have psychomotor agitation and sympathetic activation, leading some to require ICU admission for dexmedetomidine and/or ketamine infusion. DOI: Papudesi BN, Malayala SV, Regina AC. Or one can start methadone induction. 2023 Aug 1;89(2):231. Xylazine toxicity.

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