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The Toxic Shelf - High-Dose Buprenorphine Induction for Withdrawal

October 6, 2023

The Case:

A 48 yo M with a past medical history of hypertension and heroin use disorder presents to the Emergency Department (ED) with body aches and vomiting since this morning in the context of 14 hours since last heroin used. You note the patient is diaphoretic and restless with moderately dilated pupils, rhinorrhea, and a slight tremor. You are concerned the patient is in withdrawal. He is interested in getting into a medication-assisted treatment (MAT) program; however, he is currently undomiciled and does not know if he can follow up outpatient tomorrow. Here we discuss options to treat the patient's withdrawal and help bridge to outpatient MAT.

Taylor Wahrenbrock, MD and Michael Nelson, MD

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MS4 Infographic - Priapism

October 2, 2023

The emergency physician has clear, memorized algorithms for the most common ischemic events, such as in acute coronary syndromes or cerebrovascular accidents. Less frequent but requiring the same level rapid action is priapism, can result in penile ischemia and dysfunction. Here we cover an emergency physician approach to management priapism.

Kurt Frick, MS4

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The Cheese - Considerations in the Treatment of Urinary Tract Infections

September 25, 2023

Urinary tract infections are so commonly encountered. The algorithm can be simple, sick patients receive broad spectrum antibiotics and the remainder get oral therapy, usually antibiotics we are comfortable and familiar with.

Here, we aim to cover some quick pearls on information that could improve and inform your prescribing of oral antibiotics for the well-appearing patient.

Jose Reyes, MD

the County Consult