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(1148)

Podcast 813: Pulse Oximetry

Podcast 813: Pulse Oximetry

Contributor: Travis Barlock, MD Educational Pearls: Most oxygen in the body is bound to hemoglobin, forming oxyhemoglobin. Less than 1% of the oxygen in the body is dissolved in plasma.  Pulse Oximet...

13 Syys 20224min

Podcast 812: PO Medications

Podcast 812: PO Medications

Contributor: Nick Tsipis, MD Educational Pearls: PO medications are less frequently used in the ED due to their longer onset of action The position the patient is in when given PO medications ...

12 Syys 20223min

Podcast 811: Ketamine for Pain

Podcast 811: Ketamine for Pain

Contributor: Lessen, Aaron MD Educational Pearls: Ketamine can be given at 0.2-0.3 mg/kg as subdissociative doses for pain control in the ED Ketamine coadministered with Haldol may reduce agitation...

7 Syys 20223min

Podcast 810: Tooth Replantation

Podcast 810: Tooth Replantation

Contributor: Jarod Scott, MD Educational Pearls: There is a 1-hour window for tooth replantation in ED Cold milk is often best transport media unless there is access to specialized solutions (Hank's ...

5 Syys 20224min

Podcast 809: Achilles Tendon Rupture

Podcast 809: Achilles Tendon Rupture

Contributor: Aaron Lessen, MD Educational Pearls: Achilles tendon rupture usually presents in younger, healthy patients after a sports injury Patients typically present complaining of an abrupt onset...

30 Elo 20224min

Podcast 808: BVM and PEEP Valve

Podcast 808: BVM and PEEP Valve

Contributor: Dylan Luyten, MD Educational Pearls: Positive End Expiratory Pressure (PEEP) is positive pressure within the lungs and maintained throughout the entire respiratory cycle. It is the press...

29 Elo 20224min

Podcast 807: Ring Removal Tricks

Podcast 807: Ring Removal Tricks

Contributor: Jared Scott, MD Educational Pearls: If a patient is in significant pain, a digital block can be helpful. Pain management alone may allow for manual ring removal.  Ring cutters and trauma...

23 Elo 20224min

Podcast 806: Normal ECGs

Podcast 806: Normal ECGs

Contributor: Jared Scott, MD Educational Pearls: Physicians are typically advised not to trust computer interpretation of ECGs Retrospective study was done of computer interpreted normal ECGs to eva...

22 Elo 20223min

Suosittua kategoriassa Tiede

rss-mita-tulisi-tietaa
rss-poliisin-mieli
utelias-mieli
tiedekulma-podcast
docemilia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-duodecim-lehti
rss-tervetuloa-tervemenoa
rss-ylistys-elaimille
rss-tervetta-skeptisyytta