EMRAP and AIR (Psychosocial) (Sept 2020)
AIR: https://aliemu.com/courses/psychosocial-2020/
EM:RAP for Asynchronous Learning! For credit, first, listen to the entire podcast. Your participation in the discussion board here is your attestation that you have listened and engaged with the content in a meaningful way.
https://www.emrap.org/episode/emrap20194/september1
When you have finished listening to the podcast, answer the following questions:
1. Please list three things you learned from this podcast that you were not aware of before.
2. Are there any areas of your practice that you would change after listening to this podcast? If so, what would you do differently?
3. What topic mentioned in this podcast is considered too “bleeding edge” (ex. too new, lacks enough evidence, not ready for prime time). Are there any practices mentioned in this podcast that you would consider to not be applicable to our practice setting here at BMC?
One comment
1. 1) For black box warnings related to Fluoroquinolones; I was aware of the risk of tendon rupture and aortic disease, however not the risk of peripheral neuropathy, QT prolongation, neuropsych effects, and hypoglycemia even in patients without diabetes.
2) I was not aware that the leaves in common indoor broad leaf plants contain calcium oxalate crystals, which is the cause of pain when children try to eat them. Also even though the children look uncomfortable, they often just need some cold milk or a popsicle.
3) I knew that people use “sweeties” or sucrose for infants undergoing procedures, but did not realize that in a lot of places sucrose is used without any other analgesia for these patients, which seems crazy.
2. Based on the discussion of black box warnings especially as they relate to fluoroquinolones, I plan to avoid using this class of medications as much as possible, unless there is no adequate alternative for the patient. Also, although at this point I have yet to prescribe tramadol, review of the black box warnings makes me even more hesitant to ever use this medication; especially given its unpredictable metabolism and affinity to interact with other drugs. Lastly, I am probably a little to generous in the amount that I prescribe NSAIDs to patients and this review of black box warnings reminds me to be more thoughtful in who I give NSAIDs to and for how long.
3. I think the discussion not yet applicable to our practice at BMC is the return of Droperidol. After listening to this episode I had a discussion with one of our pharmacists, who also shares enthusiasm for this drug, but told me that we could not get it on formulary due to a national shortage. We get a lot of agitated, patients in our department and the faster onset of droperidol vs haldol and Ativan would seem to make it a much better medication choice. It would also be great to use in patients with headaches, nausea/vomiting and some forms of chronic pain. I would definitely use droperidol if it was available in the department.