Elizabeth Uttaro, PharmD, BCEMP

Flu has become so prevalent in my ICU I just assume every patient has it.

Reminds me of COVID where it was almost always present no matter the admitting diagnosis.

Med student: the telemetry monitors are going off on a lot of the patients simultaneously.

Nurse, without skipping a beat: patients are watching football.

PSA: please don’t co-sleep with infants

#TipsForNewDocs

You too will be a patient one day.

Remember that.

With every word you speak, every look you give and every standard you accept, remember that.

🎙️Calling all EM residents!

Submit as idea for our AEMP IGNITE! Resident Pearls

5️⃣ minutes
🏆 Top 3 pearls presented get $100
🚑 open to all pharmacy & medicine residents

Submit here: www.saem.org/meetings-and...!

Today's mantra: I am a stellar pharmacist who continues to be a lifelong learner. I can be simultaneously confident in my practice while humble enough to recognize what I don't know. I deserve to be where I am at, and I will continue to flourish in my position.

a man in a plaid shirt sits at a picnic table with the words " settle down " on the bottom ALT: a man in a plaid shirt sits at a picnic table with the words " settle down " on the bottom

Skytorial: Five pearls on olanzapine 😁

Between agitation and nausea/vomiting, olanzapine has a wide range of use.

Olanzapine is generally not a front-line agent (e.g., haloperidol or ondansetron often are). But sometimes, it really comes in clutch....

Also, your "agitated" patient.

Are they delirious due to infection, or are they in pain and unable to communicate it clearly?

Give simple analgesia if they haven't had any before running to sedatives.

Analgesia FIRST. Always.
#MedSky

A thread 🧵 on trials I think have changed or will change ICU practice (at least my own). #emimcc

In theory, if there were a class of medications that, with regular use and *especially* at higher doses, caused patients to become horribly ill when the drugs were stopped, we'd be very, very careful about starting them, continuing them, increasing the dose, and stopping them.

Hypertensive "urgency" is so very rarely urgent... and treatment has real consequences.

Treat pain, withdrawal, anxiety, and delirium. Stop mIVF. Help patients sleep.

No more IV hydral. #medsky

Comparison of Oral Ibuprofen at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial - PubMed Oral ibuprofen administered at doses of 400, 600, and 800 mg has similar analgesic efficacy for short-term pain relief in adult patients presenting to the ED with acute pain.

“Oral ibuprofen administered at doses of 400, 600, and 800 mg has similar analgesic efficacy for short-term pain relief in adult patients presenting to the ED with acute pain.”

👉 pubmed.ncbi.nlm.nih.gov/31383385/

#medsky #pharmsky #EMsky #GPsky #nursesky 2/2

Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial - PubMed Ketorolac has similar analgesic efficacy at intravenous doses of 10, 15, and 30 mg, showing that intravenous ketorolac administered at the analgesic ceiling dose (10 mg) provided effective pain relief...

Less is sometimes more! 💪🏻🔥

NSAIDs have a ceiling dose. Ketorolac 10 mg may be just as effective as 30 mg but side effects like bleeding are dose-related. #medsky #pharmsky #EMSky #SkyRx

pubmed.ncbi.nlm.nih.gov/27993418/

Every single day I’m on service, no matter how tough it is, I remind myself that I get to go home and my babies are there and we all have our health and aren’t staying the night in the hospital.

Perspective is everything.

the number of times polypharmacy goes unrecognized as a cause of “altered mental status” is astounding

What an achievement vaccines are. What a monument to our love for each other it is to stare straight into the face of something as horrific and unstoppable as smallpox or measles or polio or cervical cancer and say “You know what, it doesn’t have to be like this.”

HUMANS!

I will die on this hill:
Every level 1-3 emergency room in the country should have a pharmacist and social worker staffed 24/7. I’ve been in ERs that don’t, and the differences are crystal clear.