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Protocol Change

Peter Canning

In 2016, the state of Connecticut unified all EMS services with statewide protocols , which adopted a format of each protocol starting at the EMT level and then moving up to paramedic. We dont give solumedrol for allergic reactions anymore. The book was approved by the two largest hospitals in Hartford.

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Anaphylactic Shock

REBEL EM

Anaphylactic Shock is an acute, life-threatening hypersensitivity disorder, with a generalized, rapidly evolving, multi-systemic allergic reaction (IgE-mediated disorder). If not treated rapidly can become fatal. We both highly recommend this manual and will put a link at the bottom of the post for you to consider buying it.

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EM@3AM: Traumatic Iritis

EMDocs

We’ll keep it short, while you keep that EM brain sharp. 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. 95% occupational injuries occur in males [1]. Incidence is 12 in 100,000 in the U.S. [2].

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Pediatric Balanitis and Balanoposthitis

Pediatric EM Morsels

It’s never comfortable and is often very distressing to have skin problems and infections, such as intertrigo , folliculitis , panniculitis , omphalitis , or even preseptal or periorbital cellulitis. It’s even more distressing when the skin problem affects the penis.

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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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Clinical Conundrums: Should I Pretreat Patients with Contrast Allergy Prior to IV Contrast Administration?

REBEL EM

Do you pretreat the patient prior to CT scan or proceed without delay and risk an allergic reaction? Administer the pretreatment medications as this should prevent any severe allergic reaction. appeared first on REBEL EM - Emergency Medicine Blog. What Your Gut Says : The patient is stable and can wait 4 hours.

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

REBEL EM

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. Paper: Van de Werf, F et al.

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