Fentanyl overdoses with street drugs

[policemedic]

Going a little bit off topic here.
I was told by an ER doc buddy of mine that the N/V and itchiness associated with the "more natural" of opioids (ie morphine) is caused by a histamine reaction so he'll give morphine with 50mg of diphenhydramine (Benadryl) instead of 4mg of Zofran.

This is great for your hypotension patients in pain because the Benadryl will potentially mitigate any further hypotension caused by the morphine.

I would however stick to Zofran in chest pain/STEMI patients because a lot of the desired effects (reduction of preload and resultant decrease in myocardial O2 demand) are caused by the histamine response to morphine. That is unless your patient has a prolonged QT-interval. Little known fact, Zofran prolongs QT and should be avoided in patients with an already prolonged QT to avoid causing Torsades.

MS in NSTEMI/ACS? Bad mojo, in my view. Even in STEMI where the patient is bound for the cath lab MS inhibits oral anti platelet agents, and that's no bueno.

 

[AR Paramedic]

MS in NSTEMI/ACS? Bad mojo, in my view. Even in STEMI where the patient is bound for the cath lab MS inhibits oral anti platelet agents, and that's no bueno.

Yeah that makes sense. Our interventional cardiologists want IV heparin so it's no problem here at my shop.

 

[Muppet]

@Red Flag 1. Can we get C.M.E.'s for this thread doc?

M.

 

[DocIllinois]

@Red Flag 1. Can we get C.M.E.'s for this thread doc?

M.

@Red Flag 1 's lessons give me a fuzzy feeling in my belly.

If there's no conflict of interest and any instruction is put into a 'death by Powerpoint' format, a state board would be silly for not accepting this as CME. :-"

 

[Muppet]

@Red Flag 1 's lessons give me a fuzzy feeling in my belly.

If there's no conflict of interest and any instruction is put into a 'death by Powerpoint' format, a state board would be silly for not accepting this as CME. :-"

Almost gets me motivated to love medicine again. LMAO.

M.

 

[RackMaster]

I'm always in awe of how many SMRT Fuckers we have here.