Podcast 549:  Just Use Epineprhine

Podcast 549: Just Use Epineprhine

Contributor: Sam Killian, MD

Educational Pearls:

  • Classic dogma teaching that epinephrine should not be used in the fingers, nose, penis, and toes when performing local anesthesia due to concerns for ischemia is wrong
  • This has been well documented in multiple literature reviews
  • A prospective, randomized double-blind study compared lidocaine vs lidocaine with epinephrine for finger injuries and the use of epinephrine was associated with less bleeding and better anesthesia

Editor's note: in the lidocaine without epinephrine group, 5 (not 7) needed additional dosing of local anesthesia. The groups were also split 29 for lidocaine alone and 31 for lidocaine with epinephrine but we're in a pandemic so who is noticing anyways

References

  1. 1. Wilhelmi, B.J., et al. Do not use epinephrine in digital blocks: myth or truth? Plast Reconstr Surg. 2001 Feb;107(2):393-7.
  2. 2. Ilicki, J. Safety of Epinephrine in Digital Nerve Blocks: A Literature Review. J Emerg Med. 2015 Nov;49(5):799-809. doi: 10.1016/j.jemermed.2015.05.038. Epub 2015 Aug 4.
  3. 3. Walsh, K., Baker, B.G., Iyer, S. Adrenaline Auto-injector injuries to digits; a systematic review and recommendations for emergency management. 2020 Feb 8. pii: S1479-666X(20)30016-0. doi: 10.1016/j.surge.2020.01.005.

Summarized by Jackson Roos, MS3 | Edited by Erik Verzemnieks, MD



Episoder(1145)

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 Sep 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 Aug 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 Aug 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 Aug 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 Aug 20223min

Podcast 805: Tunneled Peritoneal Catheter

Podcast 805: Tunneled Peritoneal Catheter

Contributor: Aaron Lessen, MD Educational Pearls: Patients with recurrent ascites may need frequent outpatient or emergency department paracentesis which can be time consuming and uncomfortable for p...

16 Aug 20223min

Podcast 804: Brugada Criteria for V Tach

Podcast 804: Brugada Criteria for V Tach

Contributor: Peter Bakes, MD Educational Pearls: Tachycardia describes a heart rate of >120 beats per minute Wide Complex describes a QRS duration of >120 ms or 3 small boxes on a standard EKG The ma...

9 Aug 20226min

Podcast 803:  Sedation During Intubation

Podcast 803: Sedation During Intubation

Contributor: Aaron Lessen, MD Educational Pearls: Awareness with recall of paralysis can occur in intubated and ventilated patients receiving paralytic medications  Patients who suffer from this eff...

8 Aug 20223min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-rekommandert
rss-nysgjerrige-norge
villmarksliv
forskningno
sinnsyn
rss-paradigmepodden
fjellsportpodden
vett-og-vitenskap-med-gaute-einevoll
nordnorsk-historie
smart-forklart
rss-overskuddsliv
diagnose
abid-nadia-skyld-og-skam
abels-tarn
tomprat-med-gunnar-tjomlid
aldring-og-helse-podden