Intro to drugs used in Rapid Sequence Intubation
This post reviews the drugs used in rapid sequence intubation - including pre-medication, sedatives and paralytics.
Briefs: Dealing with acute agitation in the Pediatric Emergency Department
Take a look at this post to learn more about medical management of the agitated child and adolescent. Both oral and IM options are suggested.
Stress dose steroids in the ED
Stress dose steroids are vexing for some reasons. They don't have to be. Initial dosing can be simpler than it seems. Read/watch for more.
Narcan you dose it?
Given the increased prevalence of opiate abuse I felt that it was important to discuss some of the nuances of Narcan dosing.
PSA: Ask parents the specific dose of ibuprofen/acetaminophen
This is a public service announcement: Ask parents exactly how much acetaminophen or ibuprofen they are giving. The results may surprise you.
A podcast on strep pharyngitis? Sure!
This may be a bit hard to swallow, but not every disease process in the Emergency Department is exciting. Streptococcal pharyngitis is an incredibly common condition, especially in the Pediatric Emergency Department and I wanted to take this opportunity to answer some common questions. Who knows, perhaps after listening to this edition of PEM Currents you too will start treating [...]
Oral versed dose for anxiolysis is more than 0.5 mg/kg
Another quick hit - when dosing oral midazolam for anxiolysis - like when you're doing a procedure - you can dose above the listed limit of 0.5 mg/kg. In fact, you can dose up to 1 mg/kg! For the child who is preschool and under I will typically give the following dose: 0.7 to 0.8 mg/kg
Rectal Acetaminophen dosing is higher than you think
Though 15mg/kg for acetaminophen are firmly ingrained in your brain, remember that initial and subsequent dosing for the rectal suppository is higher. Rectal Acetaminophen Per Birmingham et al in 2001 the "loading" dose of rectal acetaminophen is 40 mg/kg followed by 20 mg/kg doses every 6 h. The risk of significantly high levels or drug accumulation was not seen over a subsequent 24 hour [...]
Three reasons why you should not give diphenhydramine as pretreatment in migraines
If you're a regular reader of the blog you know that I've posted on migraines before. For instance, you can check out the "Why We Do What We Do" on antiemetics (prochlorperazine and metoclopramide). Other excellent Pediatric Emergency Medicine educators have posted on the topic recently as well - see Sean Fox's recent post on PedEMMorsels. I wanted to take [...]
Briefs: Fentanyl at a glance
If you had a Mount Rushmore of Emergency Department drugs fentanyl would make a pretty solid case for its inclusion. This synthetic opioid is roughly 100x more potent than morphine. The onset is rapid - two to three minutes. This is in contrast to morphine, which can take up to 20 minutes. The duration of action is relatively short - [...]
