Scott Dietrich

My take is that for medical patients with a positive shock index, standard etomidate dosing results in fewer BP drops than std ketamine. Can likely be mitigated with dose reductions though

I also wonder what #’s would look like if the CV endpoint was extended to 10-15 minutes instead of 2 min

Why, why, why did we not report any data based on the dose?

We know ketamine is more likely to induce BP reductions in pts with a +shock index

Baseline SI was 0.93 and 65% of the ket group got >1.5 mg/kg. I bet the #’s are diff for low dose vs high

pubmed.ncbi.nlm.nih.gov/27130803/

Fair, but cant get a chance survive if dont get ROSC

New ED pharmD study on lytics for PE-arrest with both tPA and TNK pt's

ROSC seen in 9/21 with tPA vs only 2/11 with TNK. Not a huge study, but super interesting to see if another study comes out with similar tPA > TNK results

bit.ly/4mbUqYG

So funny b/c a pt with this past culture is in the ED today. Very timely posts

if your lab DOES report ESBL specifically, would you still follow the resistance to ceftriaxone = no cefepime logic?

New SRMA in-press with 6 studies comparing re-arrest rates post-ROSC btwn epi and norepi gtts with NE showing lower re-arrest rates and a non-significant increase is survival to discharge

Should likely be doing NE gtts in most everyone post-ROSC at this point

We're trying steroids and vasopressin again in IHCA

Small pilot study showing benefit, remains to be seen on a larger scale if the results hold up or not, but 38% vs 16% ROSC looks good

www.sciencedirect.com/science/arti...

Any idea on how much FFP that group got? Since they got more PRBCs than the PCC arm, is it just the amount of volume replacement (FFP+PRBC) that maybe resuscitated better than just PCC+PRBC?

Comparison of anticoagulation reversal strategies for warfarin associated acute gastrointestinal bleeding Gastrointestinal bleeding (GIB) is a common complication associated with warfarin use. However, the optimal approach for anticoagulation reversal—whet…

⁉️Which patients require reversal in warfarin associated GIB? We lack large RCTs to guide treatment.

Check out our retrospective study evaluating treatments in GIB

www.sciencedirect.com/science/arti...

New (open access) study testing non-specific reversal agents against milvexian (a factor XI inhibitor). Looks like aPCC would be the early front runner in terms of effectiveness in vitro

bit.ly/41NO0Im

$97

New pediatric study in press by Colorado PharmDs showing no diff in pain relief for ketorolac doses >15 mg (avg 0.44 mg/kg) vs capped doses of 15 mg (avg 0.26 mg/kg) aligning with adult literature

I think we all already knew this, but new study showing benzo + olanzapine just as safe as olanzapine monotherapy in acutely agitated ED patients with low rates of cardiorespiratory depression

bit.ly/3Zqdf0D

👋 Hello new (and old) friends!

Can’t wait to connect with you all here as our EM Pharmacotherapy community grows!

In the mean time follow the link in our Bio to learn more about #EMPRx25 - Registration is OPEN (🎲Vegas anyone 👀)

#PharmSky #SkyRx #EMSky

a store front with a sign that says pet shop ALT: a store front with a sign that says pet shop

Looks like I’ve made a lot of new friends here across med/pharm/bio/eco!

I’m Thom Mack, a Clinical Toxicologist☠️ & EM PharmD in the SW🏜️. During ☠️-fellowship I was fascinated by rattle-🐍s & stayed for a 2nd fellowship in 🐍 envenoming.

So let’s talk about SNAKES! #MedSky #ToxSky #RxSky

Fab2 better than Fab?

Events occurring 3.5 days vs 16 days is a HUGE difference.

Idk why all this is coming out now though? Was it knowingly hidden/withheld? It’s not like there’s been another study completed

Wonder what’s going to happen in the end

Were people really not giving any pyelo pts a cephalosporin? We’ve been doing cefuroxime for YEARS. I guess I thought that was standard practice by now?

What do you think they’ll decide? Some of that newer (to me) data doesn’t look good but I find it hard to believe they’ll be able to say AA is “inferior” to PCC?

t.co/HSLNubSOxU

This just came up on that other place with more/new data from Annexa-I that does not look good….

x.com/gilbertpharm...

Dead = push

Alive/stable = 10 min

Somewhere in between = somewhere in between (ie. ~5 min)

For those of you in copperhead country, are you doing maintenance dosing for Crofab after control?

Anywhere between 0.5-1 mg/kg. Lower if hypotensive or obtunded, 1 if the NE is going and pt is awake/alert

levophed, ketamine, roc

My favorite is obv PCC!