A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
Figure 1. The four order set pathways for opioid and xylazine withdrawal. Based on severity of withdrawal, ability to gain IV access, and known or concern for prolonged QTc.
EMS brings in a patient who is reporting heroin withdrawal, so you reflexively give the patient an IV fluid bolus and Zofran, but he is now feeling worse. You try sublingual buprenorphine 8mg, and while the patient initially feels better, he is feeling even sicker a few hours later. What else may be going on? What other options are at your disposal to improve your patient’s symptoms?
Taylor Wahrenbrock, MD; Kathryn McGregor, MD; Eric Leser, MD; Michael Nelson, MD; Antonia Nemanich, MD
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EMS brings you a 38-year-old male patient from the street. He is obtunded, GCS 6, smells strongly of vodka, and was reportedly surrounded by liquor bottles at the scene. He is breathing comfortably with both stable and normal vital signs on assessment. What should be done?
Jorge Aceves, MD
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If you’ve taken care of a person who overdosed on beta blockers, the slower their heart rate is the faster yours goes. Here, we review the management of patients presenting with this syndrome to block some of that beta-adrenergic overload you may experience.
Katrina Hansen-Artache, MS4
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