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reuben strayer
Emergency medicine updates of interest to emergency clinicians. Discussion requires more than 140 characters; post comments/Qs to
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reuben strayer Mar 29
CDC reports today that overdose deaths climbing, still. ED providers are well-placed to intervene on opioid harms because the ED is where opioid-harmed patients are. Strategies for managing patients along the continuum of misuse in this treatment map.
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reuben strayer Mar 23
When discharging a patient with an opioid prescription, you must counsel them on opioid harms. Here are opioid discharge instructions, copy and paste as needed.
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reuben strayer Mar 23
The need for vigilance is the hallmark of latent error, which is an error the system predisposes the user to make. When a safety expert hears "be careful" she thinks, how can I improve the system so that users are led to success. To rely on vigilance is to authorize mistakes.
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reuben strayer Mar 19
Know the child, know the family, know the physiology. The latest chapter is 's comprehensive and authoritative guide to assessing and treating pain at all levels of development.
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reuben strayer Feb 17
ACEP Policy Statement on Subdissociative-Dose Ketamine for Analgesia: monitoring is not required. Subdissociative is any dose less than 0.5 mg/kg given intravenously in a 30 minute span.
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reuben strayer Feb 12
Thanks to for not endorsing the latest ASA moderate sedation guidelines, which prioritize anesthesiologists' financial interests over the interests of patients. And thanks to these three leaders for their thoughtful response.
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reuben strayer Feb 3
Replying to @JohnCSakles
The less often you intubate, and the more likely you are to not have VL available*, the more likely you should use a bougie on every intubation. *Do you have a 2nd VL when your primary VL breaks? We have glidescope and a CMAC, one of them goes down every month or two, it seems.
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reuben strayer Feb 2
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reuben strayer Feb 1
Do you inherit more than a few positive D-dimers? Thank you, YEARS investigators.
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reuben strayer Jan 31
If you are attending in San Diego this year and are interested in best practice management of pain, opioid addiction, regional anesthesia, and buprenorphine, join , , and myself for the pre-conference.
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reuben strayer Jan 22
I give every med student I work with a handout at the start of the shift, which lays out my strategy for seeing patients in the ED. After listening to 's latest ercast with , I've added this paragraph. Full handout is here:
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reuben strayer Jan 15
Replying to @emergencypdx
From the acid-base chapter in the latest edition of Rosen's. A chapter written with extraordinary clarity, filled with surprising insights and sparkling humor.
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reuben strayer Jan 4
Neither. From the following letter to the editor: "In the absence of a documented beneficial effect on outcome, CP appears to be more a ritual than an effective measure."
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reuben strayer Dec 30
After thousands of years of variability in the treatment of epistaxis, I feel like we're coming to a consensus.
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reuben strayer Dec 25
For christmas, I asked santa for a universal patient algorithm.
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reuben strayer Dec 22
“We are not the problem, leave us alone” is the wrong message. It’s not about total # Rx. ED prescribes more to opioid naive patients–every time, a roll of the dice: a small % will be harmed and the harms can be devastating. Always weigh benefit:harm.
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reuben strayer Dec 21
The Harms of Opioids. Every time you consider discharging a patient with an opioid prescription, weigh the likelihood of benefit and harm, as you would with an anticoagulant, antibiotic, or anything else. Every patient discharged with an opioid Rx must be counseled on harms.
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reuben strayer Dec 19
Ketamine wound irrigation very effective vs. systemic ketamine and placebo in 90 thyroidectomy patients. In the ED: Bartholin's abscess, large lacs/avulsions, other particularly painful wounds, maybe bad burns? No psychoperceptual effects in this cohort.
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reuben strayer Nov 25
I estimate the incidence of confusion among emergency clinicians regarding nystagmus and central vs peripheral vertigo is approximately 100%. or maybe it's just me and I'm projecting. anyway thank you, Dr. Edlow, for this.
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reuben strayer Nov 16
The Fourteen Year Old and Her Red Tablet a tale of agitation, with commentary.
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