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Emergency Medical Minute


Apr 29, 2024

Contributor: Aaron Lessen MD

Educational Pearls:

  • Lorazepam (Ativan) is dosed at 0.1 mg/kg up to a maximum of 4 mg in status epilepticus

    • Some ED protocols only give 2 mg initially

  • The maximum recommended dose of levetiracetam (Keppra) is 60 mg/kg or 4.5 g

  • In one retrospective study, only 50% of patients...

Apr 22, 2024

Contributor: Travis Barlock MD

Educational Pearls:

Ketamine is an NMDA receptor antagonist with a wide variety of uses in the emergency department. To dose ketamine remember the numbers 0.3, 1, and 3.

Pain dose

  • For acute pain relief administer 0.3 mg/kg of ketamine IV over 10-20 minutes (max of 30 mg).

  • Note: There...

Apr 15, 2024

Contributor: Travis Barlock MD

Educational Pearls:

  • Thrombolytic therapy (tPA or TNK) is often used in the ED for strokes

  • Use of anticoagulants with INR > 1.7 or  PT >15

    • Warfarin will reliably increase the INR

  • Current use of Direct thrombin inhibitor or Factor Xa inhibitor 

    • aPTT/PT/INR are insufficient...

Apr 10, 2024

Contributor: Ricky Dhaliwal, MD

Educational Pearls:

  • Takotsubo cardiomyopathy, also known as "broken heart syndrome,” is a temporary heart condition that can mimic the symptoms of a heart attack, including troponin elevations and mimic STEMI on ECG.

  • The exact cause is not fully understood, but it is often triggered...

Apr 1, 2024

Contributor: Ricky Dhaliwal MD

Educational Pearls:

  • Primary adrenal insufficiency (most common risk factor for adrenal crises)

    • An autoimmune condition commonly known as Addison's Disease

    • Defects in the cells of the adrenal glomerulosa and fasciculata result in deficient glucocorticoids and mineralocorticoids