Prescribing Opioids (2012)

Inclusion: Adult with acute non-cancer pain or acute exacerbation of chronic non-cancer pain Exclusion: Long term care of patients w cancer or chronic non-cancer pain Level A: Level B: Short-acting opioids such as oxycodone or hydrocodone for short term relief of acute musculoskeletal pain ‘Level C: Use of state prescription monitoring program may help identify patients at … Read more Prescribing Opioids (2012)

tPA for Acute Ischemic Stroke (2015)

Inclusion: Adult patients presenting to ED with acute ischemic stroke Exclusion: Children < 18 years Level A: None. Level B: Offer IV tPA to acute ischemic stroke patients who meet NINDS inclusion/exclusion criteria and can be treated within 3 hours after symptom onset. Consider increased risk of symptomatic intracranial hemorrhage in decision to administer tPA. (May consider … Read more tPA for Acute Ischemic Stroke (2015)

Asymptomatic Hypertension (2013)

Inclusion: Age ≥ 18 Symptomatic elevated BP Lack signs of symptoms of acute target organ injury. Exclusion: Acute hypertensive emergencies (acute stroke, cardiac ischemia, pulmonary edema, encephalopathy, CHF) Pregnant ESRD Emergent conditions that are likely to cause elevated BP not directly related to acute target organ injury Acute presentation of serious medical conditions associated with … Read more Asymptomatic Hypertension (2013)

Procedural Sedation (2013)

Inclusion: Patients of all age with emergent/urgent condition that require pain +/or anxiety management to accomplish interventional or diagnostic procedure High-risk patients (cardiopulmonary d/o, multiple/head trauma, CNS depressant) w understanding that these patients are at increased risk of complications from procedural sedation and analgesia. Exclusion: Inhalational anesthetics Analgesia for pain control without sedatives Sedation solely … Read more Procedural Sedation (2013)

Seizures (2014)

Inclusion: Adult ≥ 18 with generalized convulsive seizures Exclusion: Pediatrics Complex partial seizures Acute head trauma Multi-system trauma Brain mass or tumor Immunocompromised patients Eclampsia. Level A: Administer additional antiepileptic medication in refractory status epilepticus who have failed treatment with BZDs Level B: Administer IV phenytoin, fosphenytoin, or valproate in refractory status epilepticus who have failed BZD … Read more Seizures (2014)

Nontraumatic Thoracic Aortic Dissection (2014)

Inclusion: Adult ≥ 18 with suspected acute nontraumatic thoracic aortic dissection Exclusion: Traumatic aortic dissection, pediatric, pregnant Level A: None Level B: CTA to exclude thoracic aortic dissection (accuracy similar to that of TEE and MRA). Do not rely on abnormal bedside TTE result to definitively establish diagnosis Level C: Do not use clinical decision rules alone to … Read more Nontraumatic Thoracic Aortic Dissection (2014)

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