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  1. Article ; Online: Emergency Neuropharmacology.

    DeWitt, Kyle M / Porter, Blake A

    Emergency medicine clinics of North America

    2020  Volume 39, Issue 1, Page(s) 133–154

    Abstract: Management of acute neurologic disorders in the emergency department is multimodal and may require the use of medications to decrease morbidity and mortality secondary to neurologic injury. Clinicians should form an individualized treatment approach with ...

    Abstract Management of acute neurologic disorders in the emergency department is multimodal and may require the use of medications to decrease morbidity and mortality secondary to neurologic injury. Clinicians should form an individualized treatment approach with regard to various patient specific factors. This review article focuses on the pharmacotherapy for common neurologic emergencies that present to the emergency department, including traumatic brain injury, central nervous system infections, status epilepticus, hypertensive emergencies, spinal cord injury, and neurogenic shock.
    MeSH term(s) Anticonvulsants/therapeutic use ; Brain Injuries, Traumatic/drug therapy ; Central Nervous System Infections/drug therapy ; Emergencies ; Emergency Service, Hospital ; Humans ; Intracranial Pressure/drug effects ; Nervous System Diseases/drug therapy ; Neuropharmacology ; Status Epilepticus/drug therapy
    Chemical Substances Anticonvulsants
    Language English
    Publishing date 2020-11-05
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605637-4
    ISSN 1558-0539 ; 0733-8627
    ISSN (online) 1558-0539
    ISSN 0733-8627
    DOI 10.1016/j.emc.2020.09.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1919: Show issues Location:
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  2. Article ; Online: High-dose nitroglycerin infusion for the management of sympathetic crashing acute pulmonary edema (SCAPE): A case series.

    Stemple, Krisi / DeWitt, Kyle M / Porter, Blake A / Sheeser, Michael / Blohm, Eike / Bisanzo, Mark

    The American journal of emergency medicine

    2020  Volume 44, Page(s) 262–266

    Abstract: Sympathetic crashing acute pulmonary edema (SCAPE) describes the most severe presentation of acute heart failure (AHF). Immediate intervention is required to prevent hemodynamic decompensation and endotracheal intubation. Although high-dose nitroglycerin ...

    Abstract Sympathetic crashing acute pulmonary edema (SCAPE) describes the most severe presentation of acute heart failure (AHF). Immediate intervention is required to prevent hemodynamic decompensation and endotracheal intubation. Although high-dose nitroglycerin (>100 μg/min) has been described for this clinical scenario in limited case reports, the concern for adverse effects such as hypotension and syncope limit providers comfortability in initiating nitroglycerin at these doses. Described here is a case series of four patients who safely and effectively received high-dose nitroglycerin infusions for the management of SCAPE.
    MeSH term(s) Acute Disease ; Aged ; Female ; Heart Failure/complications ; Heart Failure/diagnosis ; Heart Failure/drug therapy ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Nitroglycerin/administration & dosage ; Pulmonary Edema/diagnosis ; Pulmonary Edema/drug therapy ; Pulmonary Edema/etiology ; Syndrome ; Vasodilator Agents/administration & dosage
    Chemical Substances Vasodilator Agents ; Nitroglycerin (G59M7S0WS3)
    Language English
    Publishing date 2020-04-02
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2020.03.062
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The Association of ICH Exclusion Criteria With Mortality and Disability Rates in ICH Patients Receiving 4F-PCC for Anticoagulation Reversal.

    Zaeem, Maryam / Porter, Blake A / Delibert, Samantha / Jones, Courtney M C / Acquisto, Nicole M

    The Annals of pharmacotherapy

    2020  Volume 55, Issue 5, Page(s) 605–610

    Abstract: Background: Intracranial hemorrhage (ICH) exclusion criteria in the landmark four-factor prothrombin complex concentrate (4F-PCC) trial have not been incorporated into clinical practice and incremental predictive ability is unknown.: Objectives: ... ...

    Abstract Background: Intracranial hemorrhage (ICH) exclusion criteria in the landmark four-factor prothrombin complex concentrate (4F-PCC) trial have not been incorporated into clinical practice and incremental predictive ability is unknown.
    Objectives: Evaluate the association of meeting at least 1 ICH exclusion criterion with the composite end point in-hospital mortality and modified Rankin Scale [mRS] score 5 or 6. Determine the number and combination of criteria associated with poor outcomes.
    Methods: Retrospective review of adult ICH patients who received 4F-PCC for anticoagulant reversal. Patient demographics, ICH exclusion criteria, in-hospital mortality, disability, and disposition were collected. χ
    Results: Data from 167 patients were analyzed: 103 (61.7%) met at least 1 ICH exclusion criterion. The composite end point occurred more in those with at least 1 ICH exclusion criterion (74.8% vs 39%;
    Conclusion and relevance: Patients meeting at least 1 ICH exclusion criterion had greater death/disability compared with those who did not. More ICH exclusion criteria were associated with higher rates of death, disability, and worse disposition. These data may aid in developing optimal 4F-PCC use criteria.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Anticoagulants/adverse effects ; Blood Coagulation Factors/administration & dosage ; Disabled Persons ; Female ; Hospital Mortality/trends ; Humans ; Intracranial Hemorrhages/chemically induced ; Intracranial Hemorrhages/drug therapy ; Intracranial Hemorrhages/mortality ; Male ; Middle Aged ; Retrospective Studies
    Chemical Substances Anticoagulants ; Blood Coagulation Factors ; prothrombin complex concentrates (37224-63-8)
    Language English
    Publishing date 2020-09-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1101370-9
    ISSN 1542-6270 ; 1060-0280
    ISSN (online) 1542-6270
    ISSN 1060-0280
    DOI 10.1177/1060028020962115
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: What is the Role of Sugammadex in the Emergency Department?

    Lentz, Skyler / Morrissette, Katelin M / Porter, Blake A / DeWitt, Kyle M / Koyfman, Alex / Long, Brit

    The Journal of emergency medicine

    2020  Volume 60, Issue 1, Page(s) 44–53

    Abstract: Background: Sugammadex is a medication newly available to many emergency physicians. It effectively, and within minutes, reverses neuromuscular blockade in patients who have received rocuronium or vecuronium. The role of sugammadex for the reversal of ... ...

    Abstract Background: Sugammadex is a medication newly available to many emergency physicians. It effectively, and within minutes, reverses neuromuscular blockade in patients who have received rocuronium or vecuronium. The role of sugammadex for the reversal of neuromuscular blockade after rapid sequence intubation in the emergency department (ED) is evolving, and limited emergency medicine-specific literature exists.
    Objective: This narrative review evaluates the role of sugammadex for the reversal of neuromuscular blockade in the ED.
    Discussion: The basic pharmacology, duration of action, adverse effects, and important medication and disease interactions specific to sugammadex are well described. Case reports suggest sugammadex can reverse neuromuscular blockade to facilitate an urgent, neurologic examination by an emergency physician or consultant. Multiple case reports of failure to improve airway patency with the use of sugammadex, even when neuromuscular blockade is completely reversed, and concern for added difficulty of definitive airway management in a patient with spontaneous movement suggest that sugammadex should largely be omitted from failed or difficult airway management strategies. Instead, it is important to focus on the ability to oxygenate and ventilate, including progression to surgical airway or jet ventilation if needed.
    Conclusion: Sugammadex is an effective, rapid reversal agent for rocuronium and has the potential use to facilitate an urgent neurologic examination shortly after administration of rocuronium. Its routine inclusion in a failed or difficult emergency airway is not supported by available literature.
    MeSH term(s) Androstanols/pharmacology ; Androstanols/therapeutic use ; Emergency Service, Hospital ; Humans ; Neuromuscular Blockade ; Neuromuscular Nondepolarizing Agents/pharmacology ; Neuromuscular Nondepolarizing Agents/therapeutic use ; Sugammadex/pharmacology ; Sugammadex/therapeutic use ; gamma-Cyclodextrins/pharmacology ; gamma-Cyclodextrins/therapeutic use
    Chemical Substances Androstanols ; Neuromuscular Nondepolarizing Agents ; gamma-Cyclodextrins ; Sugammadex (361LPM2T56)
    Language English
    Publishing date 2020-09-19
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/j.jemermed.2020.08.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Staying InformED: Top emergency Medicine pharmacotherapy articles of 2020.

    Zimmerman, David E / Sarangarm, Preeyaporn / Brown, Caitlin S / Faine, Brett / Flack, Tara / Gilbert, Brian W / Howington, Gavin T / Kelly, Gregory / Laub, Jessica / Porter, Blake A / Slocum, Giles W / Rech, Megan A

    The American journal of emergency medicine

    2021  Volume 49, Page(s) 200–205

    Abstract: The year 2020 was not easy for Emergency Medicine (EM) clinicians with the burden of tackling a pandemic. A large focus, rightfully so, was placed on the evolving diagnosis and management of patients with COVID-19 and, as such, the ability of clinicians ... ...

    Abstract The year 2020 was not easy for Emergency Medicine (EM) clinicians with the burden of tackling a pandemic. A large focus, rightfully so, was placed on the evolving diagnosis and management of patients with COVID-19 and, as such, the ability of clinicians to remain up to date on key EM pharmacotherapy literature may have been compromised. This article reviews the most important EM pharmacotherapy publications indexed in 2020. A modified Delphi approach was utilized for selected journals to identify the most impactful EM pharmacotherapy studies. A total of fifteen articles, eleven trials and four meta-analyses, were identified. This review provides a summary of each study, along with a commentary on the impact to the EM literature and EM clinician.
    MeSH term(s) Bibliometrics ; COVID-19/epidemiology ; Drug Therapy ; Emergency Medicine ; Humans ; Periodicals as Topic ; Randomized Controlled Trials as Topic ; SARS-CoV-2
    Language English
    Publishing date 2021-06-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2021.05.061
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2005: Show issues Location:
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  6. Article ; Online: Pharmacist involvement in trauma resuscitation across the United States: A 10-year follow-up survey.

    Porter, Blake A / Zaeem, Maryam / Hewes, Philip D / Hale, LaDonna S / Jones, Courtney M C / Gestring, Mark L / Acquisto, Nicole M

    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists

    2019  Volume 76, Issue 16, Page(s) 1226–1230

    Abstract: Purpose: A national survey performed in 2007 found that only 23% of American College of Surgeons (ACS) trauma centers involved pharmacists in trauma resuscitation. This study describes interval change in use, perceptions, and responsibilities from 2007 ... ...

    Abstract Purpose: A national survey performed in 2007 found that only 23% of American College of Surgeons (ACS) trauma centers involved pharmacists in trauma resuscitation. This study describes interval change in use, perceptions, and responsibilities from 2007 to 2017.
    Methods: Of the 419 trauma centers identified from the ACS website, contact information was available for 335. In March 2017, a survey assessing hospital demographics, pharmacist coverage and services, and perception of pharmacist value and use was emailed to the identified trauma representatives. Data were analyzed using descriptive statistics and chi-square analysis, as appropriate.
    Results: The response rate was 33% (110/335). Pharmacist involvement with trauma resuscitation increased significantly from 23% in 2007 to 70% (p < 0.001) and in 71% of trauma centers was provided by pharmacists practicing within the emergency department. Pharmacist involvement was greatest in the Midwest (p < 0.01), but with similar distribution with regards to ACS designation, institution type, and patient volume. Common bedside responsibilities include calculating dosages (96%), preparing medications (89%), and providing medication information (79%), while trauma program/administrative responsibilities (45%) include trauma team education, pharmacy operations, medication safety, quality improvement data collection, research, review of quality assurance cases, ACS accreditation preparation, and others. The primary reason for not considering pharmacist involvement was unfamiliarity with these roles/benefits.
    Conclusion: Pharmacists are an increasingly important component of the trauma team, as evidenced by growth over the last decade. In addition to clinical benefit at the bedside, pharmacists can support the regular activities of a trauma program in many meaningful ways.
    MeSH term(s) Adult ; Child ; Cross-Sectional Studies ; Emergency Service, Hospital/organization & administration ; Emergency Service, Hospital/statistics & numerical data ; Follow-Up Studies ; Humans ; Male ; Patient Care Team/organization & administration ; Patient Care Team/statistics & numerical data ; Pharmacists/organization & administration ; Pharmacy Service, Hospital/organization & administration ; Pharmacy Service, Hospital/statistics & numerical data ; Professional Role ; Resuscitation ; Surveys and Questionnaires/statistics & numerical data ; Trauma Centers/organization & administration ; Trauma Centers/statistics & numerical data ; United States ; Wounds and Injuries/therapy
    Language English
    Publishing date 2019-07-31
    Publishing country England
    Document type Journal Article
    ZDB-ID 1224627-x
    ISSN 1535-2900 ; 1079-2082
    ISSN (online) 1535-2900
    ISSN 1079-2082
    DOI 10.1093/ajhp/zxz124
    Database MEDical Literature Analysis and Retrieval System OnLINE

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