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REBEL Core Cast 108.0 – Angioedema

REBEL EM

Urticaria and pruritus = MAST CELL mediated, which is treated like a standard allergic reaction. Features Urticaria and pruritis Rapid onset (1-2 hours) IgE Dependent (Type I Hypersensitivity) Reactions An allergen cross-links two or more IgE molecules on mast cells or basophils and initiates a signal cascade leading to degranulation.

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Cetirizine Vs Diphenhydramine For the Treatment of Acute Urticaria in the ED

REBEL EM

Background: Diphenhydramine, a first-generation antihistamine, is the most common pharmacologic agent used to treat acute allergic reactions. Article: Abella BS et al. Moreover, the FDA approved intravenous (IV) cetirizine to treat acute urticaria in 2019. Ann Emerg Med 2020. in the IV cetirizine group and 2.1

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STREAM-2: Half-Dose Tenecteplase vs Primary PCI in Older Patients with STEMI?

REBEL EM

Paper: Van de Werf, F et al. The STREAM-1 trial found that for [2] patients with STEMI presenting within 3 hours of symptom onset and unable to attain PCI within 1 hour of first medical contact, a pharmaco-invasive strategy resulted in similar rates of death, shock, heart failure, or reinfarction compared to primary PCI.

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

REBEL EM

The overall incidence of biphasic reactions is unknown with rates quoted from < 0.5% This varied incidence can be due to inconsistent definitions or inclusion of mild reactions. Since half of biphasic reactions occur within the first 6-12 hrs ( Lee 2014 ) physicians often choose an observation time of 4-6 hrs. Read More: 1.

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emDOCs Podcast – Episode 94: GLP-1 Agonist Complications

EMDocs

Hypersensitivity reaction to a GLP-1 agonist, type 1 diabetes mellitus, and pregnancy. Hypersensitivity/dermatologic: GLP-1 agonists are synthetic peptides; may lead to antibody formation and allergic reaction/injection site reaction. Reactions are usually minor: transient warmth, pruritis at injection site that resolves.

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EM@3AM: Traumatic Iritis

EMDocs

Dilation of conjunctival vessels resulting in hyperemia and edema (A) is the underlying pathophysiology of conjunctivitis, which can be brought on by infection or allergic reaction. Lu, Kevin, et al. Answer : Traumatic Iritis Epidemiology: There are approximately 55 million eye injuries worldwide annually. [1] UpToDate , 30 Oct.

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Are Steroids really slow to act?

FOAMfrat

These steroids are undoubtedly part of the cocktail we reach for in patients presenting with acute asthma, allergic reactions, or anaphylaxis - and traditional clinical logic has taught us these drugs work to reduce inflammation in the airways and reduce bronchial mucus production. Namely, Solumedrol and Dexamethasone (Decadron).