June 28, 2018

Journal Club February 2018 - Contrast-Associated Nephropathy. The Risk is …. Well, Maybe not as High as We Thought

June 28, 2018/ Tammi H. Schaeffer, DO, FACEP, FACMT

Computed tomography (CT) is a commonly used imaging modality in the US. In 2013, greater than 74 million CT scans were ordered. Although recently there has been a decrease in the need for contrast for certain diagnostic needs, contrast remains very important in the diagnosis of pulmonary embolus, aortic pathology, infectious processes, and other soft-tissue pathology. Acute kidney injury (AKI) has been a concern for many years and the teaching has been that contrast can increase the risk of acute kidney injury. Recent literature has addressed this issue and this month’s journal club offers a synopsis of these articles.

September 08, 2017

The 2-hr Acetaminophen Level and Other Tall Tales from our Favorite Analgesic

September 08, 2017/ Tammi H. Schaeffer, DO, FACEP, FACMT

In this issue of Tox Talk with Tammi, Dr. Tammi Schaeffer discusses common issues regarding the diagnosis and treatment of acetaminophen toxicity: select vs universal acetaminophen toxicity screening, the utility of the sub-four hour acetaminophen level, the decreasing repeat acetaminophen level, and using NAC for the patient with an undetectable acetaminophen level.

March 27, 2017

Get down that K-Hole! Ketamine for Control of the Agitated Adult Emergency Department Patient

March 27, 2017/ Tammi H. Schaeffer, DO, FACEP, FACMT

Emergency physicians regularly encounter agitated patients that are a risk to both health care providers and themselves. The onset of many traditional medications is relatively slow and often requires additional doses. Although there haven’t been large numbers of studies, the use of ketamine to control the acutely agitated patient has been increasing both in the prehospital and ED settings. Its characteristics such as rapid onset, preservation of respiratory drive, and minimal hemodynamic effects make it potentially desirable as a first-dose control agent. In this post, we walk through some of the literature on the use of ketamine for the acutely agitated patient.

February 12, 2017

Grandma Is Stoned! - Unintended Emergency Department Patients after Marijuana Legalization

February 12, 2017/ Tammi H. Schaeffer, DO, FACEP, FACMT

Currently, 25 states and Washington, DC have varying degrees of legalization of marijuana. Most are medical marijuana but some have legalized recreational marijuana. This has led to a rise in certain unexpected health concerns. With the reality of Maine legalizing recreational marijuana, we thought this was a good time to look at some of the early literature coming out of Colorado.