Podcast 602: Post-Narcan Observation

Podcast 602: Post-Narcan Observation

Contributor: Donald Stader, MD

Educational Pearls:

  • Not uncommon for patients presenting after opiate overdose and narcan administration to be observed for 4-6 hours
  • This has been based more on tradition than evidence
  • Observation periods for overdose may vary based on the opiate(s) used
  • Fentanyl and heroin have half lives of about 2 hours, while oxycodone and methadone have significantly longer half lives.
  • HOUR trial attempted to externally validate a scoring tool for stratification of low risk patients appropriate for discharge after 1 hour

References

Clemency BM, Eggleston W, Shaw EW, Cheung M, Pokoj NS, Manka MA, Giordano DJ, Serafin L, Yu H, Lindstrom HA, Hostler D. Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study. Acad Emerg Med. 2019 Jan;26(1):7-15. doi: 10.1111/acem.13567. Epub 2018 Dec 28. PMID: 30592101.

Summarized by Will Dewispelaere, MD | Edited by Erik Verzemnieks, MD



Jaksot(1145)

Podcast #270: Wound Botulism

Podcast #270: Wound Botulism

Author: Don Stader, M.D. Educational Pearls Wound botulism should be considered in patients with cutaneous lesions and neuromuscular weakness. The toxin produced by clostridium botulinum is the c...

10 Marras 20173min

Podcast #269: Tattoo Ink Complications

Podcast #269: Tattoo Ink Complications

Author: Michael Hunt, M.D. Educational Pearls Tattoo ink is applied below the skin, and because of this, they can lead to keloids, granulomas, tetanus, hepatitis B and C, and skin infections. Tattoo...

8 Marras 20174min

Podcast #268: Poiseuille's Law

Podcast #268: Poiseuille's Law

Author: Dave Rosenberg, M.D. Educational Pearls Poiseuille's Law addresses the flow of a fluid through a tube. Many common ED presentations involve alterations in flow: asthma, MI, ischemic stroke, ...

6 Marras 20176min

Podcast #267: Causes of Very High Lactate

Podcast #267: Causes of Very High Lactate

Author: Dylan Luyten, M.D. Educational Pearls Lactate is a byproduct of anaerobic metabolism, a sign of dying tissue. Dangerous causes of high lactates will not normalize with repeat labs. Crush inju...

3 Marras 20173min

Podcast #266: MI in Young Patients

Podcast #266: MI in Young Patients

Author: John Winkler, M.D. Educational Pearls Some risk factors for MI in the young are history of CAD, stimulant drug use, coronary spasm and diabetes. In those with diffuse ST elevations on EKG, th...

1 Marras 20171min

Podcast #265: The 2017 Flu Vaccine

Podcast #265: The 2017 Flu Vaccine

Author: Rachel Beham, PharmD, Advanced Clinical Pharmacist - Emergency Medicine Educational Pearls CDC recommends using the inactivated, injectable flu vaccine in those 6 months and older. The live a...

30 Loka 20174min

Podcast #264: Witnessed Cardiac Arrest

Podcast #264: Witnessed Cardiac Arrest

Author: Aaron Lessen, M.D. Educational Pearls For patients with in-hospital cardiac arrest, intubation in the 1st 15 minutes of resuscitation was associated with worse outcomes (mortality, neurologic...

27 Loka 20172min

Podcast #263: Early Antibiotics in Sepsis

Podcast #263: Early Antibiotics in Sepsis

Educational Pearls After the first hour, every 1 hour delay in antibiotics in a patient with septic shock patient is associated with a 4% increase in mortality. In patients with high suspicion for se...

25 Loka 20172min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
docemilia
radio-antro
filocast-filosofian-perusteet
rss-ammamafia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi
utelias-mieli
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa