EMRAP (November 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/emrap202014/november
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?
There are no new ALIEM modules this month but you can go back and do the ones you haven’t already. Remember to adjust your profile if you haven’t done so since Dr. Welsh’s update:
“When you create your ALIEMU profile please list your last name as: Name BOSTON MEDICAL CENTER (So mine would be: Welsh BOSTON MEDICAL CENTER). Your first name can be normal and there are no changes to EMRAP.”
One comment
1.
A. The potential cross reactivity between penicillins and cephalosporins was due to side chains rather than the beta-lactam ring and that these side chains are only really an issue with 1st and 2nd generation cephalosporins
B. How much you want to avoid intubation in PE patient d/t the physiology of right heart strain and that you should start pressers early/possibly use inhaled pulmonary vasodilators as well
C. Dexamethasone can precipitate severe hypokalemia and lead to hypokalemic periodic paralysis; something I will need to add to my differential. Will also remember to do TSH testing in patients with hypokalemia
2. I appreciated the review on the benefits of high flow nasal cannula and especially given COVID plan to reach for it more often in patients with hypoxic respiratory failure that need more support than a non rebreather and to buy time before possible BIPAP or intubation
3. Conflicting evidence on whether or not Depo or other injectable progesterone birth control methods increase VTE risk. Given this evidence I will probably continue to count them as positive when considering using the PERC rule.
3.