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 604: Baclofen Withdrawal

Podcast 604: Baclofen Withdrawal

Contributor: Erik Verzemnieks, MD Educational Pearls: Baclofen is used to treat muscle spasms or spasticity. Baclofen comes in two forms: oral and intrathecal Withdrawal is much more common with thos...

13 Okt 20202min

Podcast 603: Don't Sedate. Block.

Podcast 603: Don't Sedate. Block.

Contributor: Don Stader, MD Educational Pearls: Fractures and dislocations that require reduction do not necessarily require sedation Nerve blocks are an effective alternative that can provide analg...

12 Okt 20203min

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 tradit...

6 Okt 20204min

Podcast 601: Droperidol

Podcast 601: Droperidol

Contributor: Sam Killian, MD Educational Pearls: Droperidol (Inapsine) is an antipsychotic drug with efficacy for nausea, vomiting, headaches, and treating agitation In the early 2000's, Droperidol ...

5 Okt 20204min

Pediatric Emergencies Brewcast: Pediatric Fever

Pediatric Emergencies Brewcast: Pediatric Fever

Emergency Medical Minute collaborated with CarePoint Health in early March for a night of education on Pediatric Emergencies geared towards mid-level providers at a local Denver brewery for our latest...

30 Sep 202013min

Podcast 600: Penicillin Allergy?

Podcast 600: Penicillin Allergy?

Contributor: Aaron Lessen, MD Educational Pearls: True allergies to penicillin compared to reported allergies from patients ranges around 10% Recent study took patients undergoing sensitivity tests a...

29 Sep 20202min

Podcast 599: Facial Blocks for the Win

Podcast 599: Facial Blocks for the Win

Contributor: Don Stader, MD Educational Pearls: Local anesthetics injected directly into wounds can cause distortion - especially important in facial lacerations Several blocks can be helpful to help...

28 Sep 20205min

UnfilterED #10: Debi Smith

UnfilterED #10: Debi Smith

General Counsel attorney, Debi Smith, joins Dr. Nick Tsipis to discuss the ins and outs of healthcare law. Many people forget that a subpoena only compels attendance to a court date, it does not compe...

23 Sep 202024min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
villmarksliv
forskningno
sinnsyn
fjellsportpodden
rss-paradigmepodden
nevropodden
rss-nysgjerrige-norge
tidlose-historier
vett-og-vitenskap-med-gaute-einevoll
diagnose
smart-forklart
pod-britannia
dekodet-2
hva-er-greia-med