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(1146)

Podcast 703: Fever in Infants

Podcast 703: Fever in Infants

Contributor: Neil Cella, MD  Educational Pearls: 10% of patients 100.4) have an serious bacterial infection Most of these are UTIs, but also consider pneumonia and meningitis Requires CXR, LP, lab...

10 Aug 20215min

Podcast 702: Paralytic Awareness

Podcast 702: Paralytic Awareness

Contributor: Aaron Lessen, MD Educational Pearls: Known risk factors for being awake and paralyzed in the OR include only receiving IV medications, long-acting paralytics, and no formal monitoring sy...

9 Aug 20212min

Podcast 701: Elevated Blood Pressure Readings

Podcast 701: Elevated Blood Pressure Readings

Contributor: Aaron Lessen, MD Educational Pearls: Recent retrospective cohort study looked at elevated BP readings in the ED and correlation to underlying hypertension Large cohort of over 30,000 pat...

3 Aug 20213min

Podcast 700: Analgesics for Acute Musculoskeletal Pain

Podcast 700: Analgesics for Acute Musculoskeletal Pain

Contributor: Aaron Lessen, MD Educational Pearls: Recent RCT compared pain relief in patients receiving five medications for acute musculoskeletal pain Acetaminophen 1000mg/ibuprofen 400 mg Acetam...

2 Aug 20212min

Podcast 699: Pediatric Fingernail Avulsions

Podcast 699: Pediatric Fingernail Avulsions

Contributor: Aaron Lessen, MD Educational Pearls: Traditionally, fingernails were replaced after avulsion using sutures Sometimes artificial material was placed when the fingernail was not available ...

28 Jul 20213min

Podcast 698: Empathy, Burnout, and Patient Satisfaction

Podcast 698: Empathy, Burnout, and Patient Satisfaction

Contributor: Aaron Lessen, MD Educational Pearls: Survey of EM physicians to self-report empathy and burnout levels and correlated with patient satisfaction scores Patient satisfaction was not affect...

27 Jul 20212min

Podcast 697: Kounis Syndrome

Podcast 697: Kounis Syndrome

Contributor: Aaron Lessen, MD Educational Pearls: Kounis syndrome is an allergic acute coronary syndrome Triggers include medications (antibiotics), insect bites, or other common allergens Believed t...

26 Jul 20213min

Podcast 696: ST Elevation and Differential Diagnoses

Podcast 696: ST Elevation and Differential Diagnoses

Contributor: Peter Bakes, MD Educational Pearls: ST elevation clinical guidelines for myocardial infarction include: 2.5 mm elevation for males 2 mm elevation in males >40 in V2 and V3 1.5 mm elev...

21 Jul 20214min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
villmarksliv
forskningno
rss-paradigmepodden
sinnsyn
fjellsportpodden
rss-nysgjerrige-norge
vett-og-vitenskap-med-gaute-einevoll
nevropodden
diagnose
smart-forklart
dekodet-2
abid-nadia-skyld-og-skam
tidlose-historier
nordnorsk-historie