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(1146)

Podcast # 415: Myofascial Pain Syndrome & Fibromyalgia

Podcast # 415: Myofascial Pain Syndrome & Fibromyalgia

Author: Ryan Circh, MD Educational Pearls: Myofascial pain syndrome (MFPS) is typically unilateral with discrete points of palpable pain Often secondary to repeated use and poor posture. MFPS typical...

10 Joulu 20182min

Podcast # 414: Acute Limb Ischemia

Podcast # 414: Acute Limb Ischemia

Author: Dylan Luyten, MD Educational Pearls: Symptoms of acute limb ischemia are the 5 P's: Pulselessness, pain, pallor, paresthesias, and poikilothermia Sudden onset of non-traumatic extremity pai...

8 Joulu 20184min

Podcast # 413: Fascia Iliaca Block

Podcast # 413: Fascia Iliaca Block

Author: Katie Sprinkle, MD Educational Pearls: The fascia iliaca block is useful for hip and proximal femur fractures. Typically involves injecting 40-60 mL of diluted bupivacaine (0.25%) under the...

6 Joulu 20186min

Podcast #412: tPa Mission Creep

Podcast #412: tPa Mission Creep

Author: Aaron Lessen, MD Educational Pearls: Patients with "minor" strokes with NIHSS 0 to 5 can still end up having poor long-term outcomes Recent study compared use of alteplase vs. aspirin for th...

3 Joulu 20182min

Podcast #411: Mass Casualty Incident

Podcast #411: Mass Casualty Incident

Author: Dylan Luyten, MD Educational Pearls: Early recognition that the current situation is a mass casualty incident (MCI) is essential with establishing a sole provider/nurse to oversee Team memb...

30 Marras 20184min

Podcast #410: FAmbulance

Podcast #410: FAmbulance

Author: Aaron Lessen, MD Educational Pearls: Retrospective study looking at type of transportation and mortality outcomes for patients with penetrating trauma Mortality was 2.2 % for those brought in...

28 Marras 20182min

Podcast #409:  Acute CHF Second Liners

Podcast #409: Acute CHF Second Liners

Author: Nick Hatch, MD Educational Pearls:   Quick review on typical treatments for acute CHF: Nitrates are a mainstay to reduce preload Furosemide has fallen out of favor in regards to urgency but ...

26 Marras 20183min

Podcast #408:  Go the hell to sleep

Podcast #408: Go the hell to sleep

Author: Don Stader, MD Educational Pearls: Recent study showed efficacy 5mg IM midazolam > 10mg IM olanzapine > 10mg IM haloperidol for quickly sedating an agitated patient If you have access, ketami...

23 Marras 20183min

Suosittua kategoriassa Tiede

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