In critical care, we’ve been treating patients with opioid use disorder for a long time. If they’re intubated for intoxication, we extubate them and send them home. If they’re septic with endocarditis, we treat their sepsis. Unfortunately, this isn’t enough. We’re treating the complications of opioid use disorder, without addressing the underlying problem. Recently, medication-assisted […]
Thyroid storm is a bit of a zebra. It can mimic a variety of common conditions (e.g. sepsis, delirium, heart failure). Unfortunately, if you’re not looking for it, you probably won’t find it. Once identified, an organized multimodal treatment regimen will generally get the job done. But be careful – these patients may have varying physiology, so blindly following the same rubric for every single patient isn’t the answer.
by Dan Rusyniak At my poison center we have seen an increasing number of a calls related to a drug I had never heard of – Tianeptine. Tianewhat? Yes, I thought the same. Although I had not heard of it, this is a drug that has been around since the 1970’s. Synthesized in the 60’s […]
In October 2016 the Emergency Medicine community was faced with the publication of the now infamous PESIT trial, and the symbolic wrench its authors carelessly tossed into the already indecisive diagnostic work up of patients presenting to the Emergency Department following a syncopal event1. Published in the NEJM, Prandoni et al enrolled patients who were admitted […]