Vitamin C. . . The Holy Grail for Sepsis Treatment?

Vitamin C. . . The Holy Grail for Sepsis Treatment?

It is hard not to get excited about a new treatment for sepsis,  a disease that kills over 300,000 people each year in the US.  However, there have been so many false promises in the past, it is appropriate to be skeptical.  A recent study published online by the journal Chest is turning heads . . . not only because it appears extremely effective, but also because it is a simple, inexpensive treatment.  Could this be the silver bullet we have all been looking for?

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Get down that K-Hole! Ketamine for Control of the Agitated Adult Emergency Department Patient

Get down that K-Hole!  Ketamine for Control of the Agitated Adult Emergency Department Patient

Emergency physicians regularly encounter agitated patients that are a risk to both health care providers and themselves.  The onset of many traditional medications is relatively slow and often requires additional doses.  Although there haven’t been large numbers of studies, the use of ketamine to control the acutely agitated patient has been increasing both in the prehospital and ED settings. Its characteristics such as rapid onset, preservation of respiratory drive, and minimal hemodynamic effects make it potentially desirable as a first-dose control agent.  In this post, we walk through some of the literature on the use of ketamine for the acutely agitated patient.

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Vision Loss in the Emergency Department Patient

Vision Loss in the Emergency Department Patient

Hi guys!  Sorry it has been so long since our last post.  We were busy preparing for our Winter Symposium Conference last week in Sugarloaf, Maine. We had a fantastic line up of speakers and hope to share them with you over the coming months.  Here is a sample from one of our guest speakers, Jacob Avila, MD.  He spoke to us about vision loss in the emergency department patient. 

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Fluoroquinolones, Your Lawyer and You

Fluoroquinolones, Your Lawyer and You

Fluoroquinolones are a widely used class of antibiotics that are effective in treating a wide variety of infections. Despite their popularity there is increasing concern regarding the potential complications associated with these agents. Here we discusses the current evidence regarding the risks associated with fluoroquinolone use.

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Grandma Is Stoned! - Unintended Emergency Department Patients after Marijuana Legalization

Grandma Is Stoned! - Unintended Emergency Department Patients after Marijuana Legalization

Currently, 25 states and Washington, DC have varying degrees of legalization of marijuana. Most are medical marijuana but some have legalized recreational marijuana. This has led to a rise in certain unexpected health concerns. With the reality of Maine legalizing recreational marijuana, we thought this was a good time to look at some of the early literature coming out of Colorado.  

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Liver Failure Patients - Ten Simple Tips for Complicated Patients

Liver Failure Patients - Ten Simple Tips for Complicated Patients

Whether it is from alcoholic cirrhosis, acetaminophen overdose, or chronic hepatitis, liver failure patients are complicated.  Their exams are difficult, multiple organ systems are affected and they have complex pathophysiology.  Here are ten simple tips for these complicated patients. 

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"It starts with a K . . . " - Low Dose Ketamine for Pain Control

"It starts with a K . . . " - Low Dose Ketamine for Pain Control

Pain control in the emergency department is an important part of patient care and a key reason patients seek our help. Current pharmacologic methods include opiates, non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and regional anesthesia. Opiates often produce inadequate pain control in both opiate tolerant and opiate naïve patients and have adverse effects such as over-sedation, respiratory depression, nausea, hypotension, tolerance, and dependence [1]. NSAID use can be complicated by nephrotoxicity, gastropathy, and cardiac toxicity and have been implicated in 11% of adverse drug reaction related hospital admissions [2]. 

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