Research and Reviews in the Fastlane 058
This study (n=60) randomized patients in the ED getting IV opioids to morphine (0.1 mg/kg) + placebo or morphine (0.1 mg/kg) + ketamine (group 1 0.15 or group 2 0.30 mg/kg). Patients in the ketamine arm had significantly decreased pain without significant adverse effects, although the group with the higher dose of ketamine had a seeming increase in side effects without added analgesic benefit. The literature is mounting that low dose ketamine has utility in the acute analgesia armamentarium but selecting the right population will likely be key (and more is not better).
Recommended by: Lauren Westafer
Further Listening: Cliff Reid shares his experience on “sub-dissociative” ketamine for analgesia -NeuroRAGE Special Edition (RAGE podcast)
Emergency Medicine, Cardiology, Neurology
Ge Coll-Vinent B et al. Stroke Prophylaxis in Atrial Fibrillation: Searching for Management Improvement Opportunities in the Emergency Department: The HERMES-AF Study. Ann Emerg Med 2014. PMID: 25182543
While it’s clear that atrial fibrillation raises the risk of stroke in patients, selecting the right prophylaxis regimen continues to be challenging. In this observational study performed in Spain, the authors found that many patients that were moderate to high-risk for stroke were not discharged on the appropriate prophylaxis. Whether this is the Emergency Providers role or not is debatable but it is vital for us to consider starting the right medications upon discharge or ensuring...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Soren Rudolph Tags: Education R&R in the FASTLANE Review Source Type: blogs
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