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