22 04, 2014

Atypical Antipsychotic Medication Re-initiation in the Emergency Department

By |April 22nd, 2014|Psychiatry, Tox & Medications|0 Comments

PillsThe acute episode of intoxication and agitation has subsided and your patient is calm. She has been medically cleared and is ready to be moved to a less acute, less monitored portion of the ED to await further assessment and treatment for her underlying psychiatric conditions. As a well-intentioned emergency medicine practitioner, you wish to give your patient the tools she needs to maintain this calm status by restarting her home atypical antipsychotic medication. What is the best way to go about doing this?

19 04, 2014

Self-Regulated Learning and Forgetting

By |April 19th, 2014|Medical Education|0 Comments

Young man with a book We go through school without realizing if our learning strategies are inefficient even more so when some assessments support these practices as opposed to discourage it. Unfortunately, exams and graduation run the risk of giving us a sense that learning is over, that what we have learned does not change, or that there are not more effective ways of learning. There is no way of unlearning what we have learned in the past, so it’s always a sensible practice to reassess our knowledge on a constant basis. 

17 04, 2014

Trick of the Trade: Making your own homemade ultrasound gel

By |April 17th, 2014|Expert Peer Reviewed (Clinical), Tricks of the Trade, Ultrasound|1 Comment

UltrasoundKenyaExpertPeerReviewStamp2x200You are spending a month in rural Kenya, doing an ultrasound teaching course. Your enthusiastic participants have been ultrasounding every chance they get. Unfortunately, this has caused your ultrasound gel supplies to dwindle. It will be a month before a new shipment of gel arrives from Nairobi. This gel will cost about $5 per bottle, which is a considerable expense for the local hospital’s budget.

15 04, 2014

Understanding Phenytoin Equivalents

By |April 15th, 2014|Tox & Medications|2 Comments

fosphenytoin image 1 (1)Sometimes, in an effort to make things simpler, we actually make them more confusing. Such is the case with phenytoin equivalents. 

Fosphenytoin is a water-soluble prodrug of phenytoin. After IV administration, much of the fosphenytoin is metabolized to phenytoin within 15 minutes. Advantages over phenytoin include the option for IM administration and less cardiotoxicity allowing for faster infusion rates. Even the potential for hyperphosphatemia from the release of phosphate is generally inconsequential. 

14 04, 2014

Neuraminidase Inhibitors for Influenza – The Truth, The Whole Truth, and Nothing But the Truth Finally

By |April 14th, 2014|Infectious Disease, Tox & Medications|7 Comments

InfluenzaOver the last 5 years, the use of neuraminidase inhibitors for the treatment of influenza has skyrocketed. Emergency physicians have been pushed to prescribe these medications under the belief that they reduced symptoms, the risk of complications, hospitalizations, and transmission. However, the recommendation for the use of these drugs has never sat on firm evidence-based ground. So what did we know then, and what do we know now?