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18 Dec 19, 4 tweets, 2 min read
More support for our friend succinylcholine. In our ED, sugammadex (also has its own ADRs) is not readily available, no EEG monitoring & HR/BP are nonspecific & unreliable markers of adequate analgosedation— sux should be used for RSI as often as possible!
jamanetwork.com/journals/jama/…
⏰ Here’s a little timeline to keep in mind for RSI...
...and a board sharing when succinylcholine is contraindicated, to be mindful of situations where roc would be preferred ⚖️
#twitterx #medtwitter #nursetwitter

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More from @ChillaPharmD

Chilla Profile picture
15 Sep
What do I love about my job as an emergency medicine pharmacist? 🥰 I’ll give you a top 5, no particular order:

🏷 @CLKo_PharmD @GinaM8585 @SilaSmallPharmD @baIDpharm @annaIDpharmD
1. You never know what’s going to come through our doors, anything imaginable: attacked with 🌵, ingested fireworks 🧨, surprise 👶 delivery, exercise induced anaphylaxis, cardiac arrest...what can I say, I 💜 to help & easily bored, couldn’t dream up a better career for myself.
2. I work with over 100 of my best friends 🧔🏾👨🏻👩🏼‍🦰👩🏽‍🦳👱🏼‍♂️👱🏽‍♀️🧑🏽👩🏻👩🏼👨🏿‍🦱👩🏾‍🦱I’m always happy to see them when I walk through the doors. We’re there for each other as we face the challenges that come through the doors of the ED 💪💪 Love my coworkers!
Read 7 tweets
Chilla Profile picture
11 Dec 19
🚨Emergency Medicine Pearls 2019
@ASHP_EMPharm

(Thread 3 of 3)

#twitterx #emergency #clinicalpearls #EMpearls #ASHP19
Naloxone for Clonidine Toxicity: Dosing & Administration Options (Katherine Ciampa) Image
Standard Treatments for Clonidine Toxicity- now we can consider naloxone too Image
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Chilla Profile picture
11 Dec 19
🚨Emergency Medicine Pearls 2019
@ASHP_EMPharm

(Thread 2 of 3)

#twitterx #emergency #clinicalpearls #EMpearls #ASHP19
RSI Induction Agents in the Setting of Shock: resuscitate before you intubate, optimize BP pre-intubation to buffer against further drops during & after RSI
@KayleighRx Image
Limited studies have found increased rates of hypotension with our traditionally “hemodynamically neutral” etomidate Image
Read 26 tweets
Chilla Profile picture
11 Dec 19
🚨 Couldn’t make it to @ASHPOfficial @ASHP_EMPharm Emergency Medicine Pearls 2019 session this morning? Don’t worry, I‘ll share my notes — it’s always my favorite session ☺️

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#twitterx #emergency #clinicalpearls #EMpearls #ASHP19 Image
IN lidocaine for migraines:
Many different doses of lidocaine have been found to be effective in the treatment of migraine

@hina_patel Image
Here is what you can expect from lidocaine intranasally for SPG nerve blocks Image
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Chilla Profile picture
8 Sep 19
🚨PSA: #iPhone users! Please set up #MedicalID on your phone-we can see your medical info even with your screen locked. This is SO HELPFUL when you come in and are unable to communicate with us after a terrible accident. 🚑😵 It can help save your life! (1/7)
You can put allergies on Medical ID, emergency contacts, medical conditions, medications you take, blood type, any random medical notes, even organ donation status (and if you aren’t registered, you can register super easily through the app! 🙌🏼) (2/7)
I look for it every time we get an unresponsive patient with an iPhone! Most people haven’t filled it out 😢💔 which is sad. Help us take the best care of you! Otherwise, we’re flying blind for quite a while when you first come in. (3/7)
Read 9 tweets
Chilla Profile picture
29 Jun 19
Part 5 #Tramadont #tweetorial
(in which #Tramadont remains a hilariously accurate descriptor of tramadol!)
@NarouzeMD @EMARIANOMD @toby_ashken @DavidJuurlink

CYP2D6 & tramadol is not overrated at all.
Here is a picture of the tramadol metabolism pathway (PMID 11454734) (1/7)
We can agree that M1 is the metabolite which provides opioid analgesic effects. (PMID 10961373) (2/7)
M1 is metabolized by CYP3A4 & CYP2B6 (not CYP2D6 as you suggested) to M5. (PMID 24849324) (3/7)
Read 7 tweets

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