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

ALiEM

Due in large part to the proliferation of anonymous chemical factories able to produce industrial volumes of inexpensive synthetic opioids without opium or other controlled precursors, fentanyl spilled into the United States, Canada, and Europe, heroin soon fell to market forces [1, 2].

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EM@3AM: Murine Typhus

EMDocs

A 52-year-old male with a history of essential hypertension presents to your South Texas ED for his second visit this week complaining of indolent fever, shortness of breath, pleuritic chest pain, and a rash on his trunk and extremities. We’ll keep it short, while you keep that EM brain sharp.

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EM@3AM: Stercoral Colitis

EMDocs

3, 9, 11, 12 The average age tends to be greater than 60 years old. Up to 1/3 of adults over 60 suffer from chronic constipation. Clinical exam: 2, 3, 9 Abdominal distension and tenderness Nausea and vomiting Stool present in the rectal vault Peritonitis may be accompanied by hemodynamic instability in the case of sepsis.

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Push-Dose Pressors in the Emergency Department

ACEP Now

My goal in this column is to share tips, tricks, and emerging concepts from the intensive care unit (ICU) that you can use on your next shift in the emergency department (ED). For this inaugural column, I wanted to start with a topic near and dear to my heart: push-dose vasopressors in the ED. This column is for you!

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Toxin-Induced Hypotension Treatment Tips

ACEP Now

Acute toxic ingestions are a common reason for presentation to the emergency department (ED) and clinical scenarios range from benign accidental ingestions to large overdoses resulting in hemodynamic instability. mg/kg-1 mg/kg with maximum dose of 50 mg in children. The dose is 25 mg- 100 mg for adults and 0.5

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Current Extraglottic Airway Devices and Prehospital Practices

ACEP Now

1 Prehospital endotracheal intubation and EGAs are typically placed without paralytics and are reserved for unconscious, apneic, and out-of-hospital cardiac arrest patients. 9 LMAs use an inflatable mask expanded using a similar technique to the endotracheal tube cuff. In: Cone DC, Brice JH, Delbridge TR, Myers B, eds.

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The Evidence for Empathy in the Emergency Department

ACEP Now

The emergency department (ED) is full with boarding and critical patients, and 25 patients are in the waiting room. 1 According to the ACEP Code of Ethics: The physician-patient relationship is the moral center of medicine and the defining element in clinical ethics. Empathy may be driven to the back burner by the ED environment.