Fishing for Anaphylaxis Treatment

First up…a really bad pun to get your creative energy flowing: What was the cause of the tech-guru’s most recent seafood reaction?
A new shell-phone!

Log into CMES and scratch up the June 2017 EM:RAP podcast called The Case of the Funky Fish by Stuart Swadron MD and Billy Mallon MD for up-to-date information on the treatment of acute anaphylaxis.

Now challenge your colleagues with a similar case. Which drug do you reach for first? Is epinephrine given in the arm or thigh or doesn’t it matter? Do they use both H1 and H2 blockers and where is the evidence these work? Have steroids even been scientifically proven to help in acute allergic reactions?

The life of your patient may depend on your knowledge of these questions and how quickly you start treatment…hopefully faster than edema swells their airway shut.

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Mind the Migraines

A shift would not be complete without one headache patient. I would wager that is the same wherever you practice because I treated migraine headache patients from remote Himalayan villages to tropical islands in the Caribbean.

The worrisome causes of headaches such as pregnant + hypertension + headache; new onset after age 50; headache + fever, headache + altered mental status; abrupt onset headache; and headache + painful red eye to name a few should prompt investigation and immediate treatment.

But for the treatment of one of the most common types of headache, the migraine, check out the EM:RAP August Pharmacology Rounds: What Works for Acute Migraine? by Rob Orman MD and Bryan Hayes PharmD.

Migraines have been recorded in medical history for a long time, the first found documentation in the Ebers Papyrus written around 1500 BCE. For you language buffs the word migraine is derived from the Greek word hemikrania. This term was corrupted into hemigranea and the common word comes from the French translation, migraine.