loader from loading.io

Podcast 744: Glucagon for Beta Blocker Toxicity

Emergency Medical Minute

Release Date: 01/04/2022

Podcast 845: Hyperkalemic Cardiac Arrest show art Podcast 845: Hyperkalemic Cardiac Arrest

Emergency Medical Minute

Contributor: Aaron Lessen, MD Educational Pearls: Hyperkalemia may cause cardiac arrest  Treatment of suspected hyperkalemic cardiac arrest begins with typical management of cardiac arrest including high-quality CPR, defibrillation if appropriate, and resuscitation medications  Administer calcium products to stabilize cardiac membrane and potassium shifting medications  If ROSC is achieved, initiate dialysis  There are several case reports of patients being dialyzed while CPR is ongoing, with some success   Dialysis during resuscitation may be an appropriate...

info_outline
Podcast 844: Dental Infections show art Podcast 844: Dental Infections

Emergency Medical Minute

Contributor: Meghan Hurley, MD Educational Pearls: Educational Pearls: Dental infections can be categorized into two main groups Infections of the gums Pericoronitis Tooth eruption leading to inflammation/irritation Can progress to an infection Requires pain control, no antibiotics Gingivitis Inflammation of the gums Can lead to an infection requiring antibiotics Abscess (gums) If an infection develops in the gums it can progress to an abscess May require drainage Acute necrotizing ulcerative gingivitis (ANUG) aka Trench Mouth Filmy, grayish discoloration of the gums with “punched...

info_outline
Podcast 843: Commotio Cordis show art Podcast 843: Commotio Cordis

Emergency Medical Minute

Contributor: Jared Scott, MD Educational Pearls: Commotio cordis is sudden ventricular fibrillation precipitated by direct impact to the chest  A national registry, US Commotio Cordis Registry, reports an average of 10-20 cases annually  95% of reported cases occur in males, indicating possible genetic component  Average age of patient in registry is 15  Most cases occur during sporting events (baseball in particular), in addition to physical altercations and industrial accidents  Treatment is high quality CPR and early defibrillation  Survival rate is...

info_outline
Podcast 842: “History of Wound Care” show art Podcast 842: “History of Wound Care”

Emergency Medical Minute

Contributor: Chris Holmes, MD Educational Pearls: Through world history, there have been various interesting approaches to wound care Ancient Egyptians applied honey, lint, and grease which provided antimicrobial, absorptive and moisturizing properties, respectively  Ancient Greeks irrigated wounds with clean water and applied wine and vinegar which may have been antimicrobial  One of the first synthetic topical antimicrobials was a dye researched by scientist and later produced by Bayer under the name Prontosil  Some current wound care methods include wet-to-dry dressings,...

info_outline
Podcast 841: Wound Care show art Podcast 841: Wound Care

Emergency Medical Minute

Contributor: Aaron Lessen, MD Educational Pearls: Wound care in the emergency department aims to prevent future infection Copious wound irrigation is the important step in preventing wound infection Studies have shown that irrigation with tap water is just as effective, if not superior,  to  irrigation with saline or other solutions Several studies have shown no reduction in wound infection rates when using sterile gloves during wound care Recent study in the Netherlands compared infection rates between patients undergoing wound repair with and without sterile gloves Receiving...

info_outline
Podcast 840: Abnormal Pediatric Vitals at Discharge show art Podcast 840: Abnormal Pediatric Vitals at Discharge

Emergency Medical Minute

Contributor: Aaron Lessen, MD Educational Pearls: Pediatric patients frequently have vital signs considered abnormal for age at discharge Large multicenter study recently evaluated if pediatric patients discharged with abnormal vital signs have worse outcomes  97,824 pediatric discharges were included in the study 18.1% were discharged with vitals considered abnormal for age No significant difference in readmission rates at 48 hours (2.28% in abnormal cohort vs. 2.45% in normal cohort) No significant adverse outcomes in those discharged with abnormal vital signs (4 total PICU admissions...

info_outline
Podcast 839: Causes of Pancreatitis show art Podcast 839: Causes of Pancreatitis

Emergency Medical Minute

Contributor: Travis Barlock, MD Educational Pearls: The causes of pancreatitis can be remembered with the mnemonic: “GET SMASHED”  G: Gallstones (Most common cause of pancreatitis overall)  E: Ethanol (Alcohol consumption is the most common cause of chronic pancreatitis) T: Trauma  S: Steroids M: Malignancy A: Autoimmune  S: Scorpion Sting H: Hypertryglyceridemia  E: ERCP D: Drugs (e.g. Valproate, Antiretrovirals)    References Beyer G, Habtezion A, Werner J, Lerch MM, Mayerle J. Chronic pancreatitis. Lancet. 2020;396(10249):499-512....

info_outline
Podcast 838: Sternoclavicular Septic Arthritis show art Podcast 838: Sternoclavicular Septic Arthritis

Emergency Medical Minute

Contributor: Aaron Lessen, MD Educational Pearls: Septic arthritis of the sternoclavicular joint is uncommon accounting for <1% of septic arthritis cases Immunosuppression and IV drug use increases the risk  Can account for up to 17% of septic arthritis cases in patients who use IV drugs Symptoms are typically vague with pain presenting around where the sternum meets the clavicle Consider imaging with CT or MRI and draining/analyzing the fluid if possible Antibiotics are the mainstay of treatment, but surgery may be required to wash out joint and resect infected bone As septic...

info_outline
Podcast 837: Snakebites show art Podcast 837: Snakebites

Emergency Medical Minute

Contributor: Meghan Hurley, MD Educational Pearls: Venomous snakes in the United States include species from the family Elapidae and subfamily Crotalinae In prehospital setting, elevate the bitten extremity and transport to hospital immediately Do not attempt interventions with the bite site  Monitor for progression of swelling past any joint line, systemic symptoms or lab abnormalities for 8-12 hours  Symptoms may present up to hours after bite   Crotalinae venom has heme toxicity and may present with lab pattern of DIC  Treatment for all symptoms is antivenom ...

info_outline
Podcast 836: Humming to get EJ show art Podcast 836: Humming to get EJ

Emergency Medical Minute

Contributor: Jared Scott, MD Educational Pearls: Two conventional ways to aid in external jugular vein (EJ) catheter placement are Trendelenburg’s position and Valsalva’s maneuver by patient  One study compared ultrasound visualization of cross sections of EJ and common femoral vein at baseline and with patients in Trendelenburg's position, Valsalva's maneuver, and while humming The study found all three conditions distended the veins from baseline, but there was no significant difference in diameter between the conditions   Humming may be a viable technique in distended EJ...

info_outline
 
More Episodes

Educational Pearls:

  • Glucagon can be used to treat hypoglycemia and esophageal foreign body, but it can also be used in beta-blocker toxicity to bypass cardiac beta-blockade
  • The superior option for treating bradycardia due to beta-blocker toxicity is glucagon
  • Glucagon has decreased efficacy in patients with heart failure, so increased doses up to 10 mg might be required in the event of beta-blocker toxicity

References

Khalid MM, Galuska MA, Hamilton RJ. Beta-Blocker Toxicity. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448097/

Rotella JA, Greene SL, Koutsogiannis Z, et al. Treatment for beta-blocker poisoning: a systematic review. Clin Toxicol (Phila). 2020;58(10):943-983. doi:10.1080/15563650.2020.1752918

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

 

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account. 

Donate to EMM today!