SEMily, Char.D.

I will always die on this hill

Large doses cause an extended duration of action and greatly increase risk of awareness with paralysis. If you haven’t read the ED-AWARENESS Study, please do so. Rocuronium should be dosed at 1 mg/kg IBW (roc is hydrophilic) with the rare crash airway exception.

Rocuronium has a dose-dependent onset AND duration. While it is appropriate to give a dose at the higher end of the range for faster onset (up to 1.6 mg/kg IBW) in the setting of a crash airway, the practice of “blanket dosing” 100 mg for all patients should be reconsidered.

@codebluememes @BCB_PharmD I am deceased @ this 😂

i know travel nurses in texas hate to see me coming

@PharmacyAcute This is excellent! Consider adding epinephrine potentially causing lactic acid elevation by increasing glycolysis and anaerobic metabolism. Can cloud the picture in post-arrest resuscitation!

💉 Norepinephrine vs Epinephrine — Know the Difference. From dosing ranges to key adverse effects and clinical considerations, understanding these vasopressors is critical in post-cardiac arrest care. Save this for quick reference and keep it ready when seconds matter. 📚 See the full Pharmacy Pearl: pharmacyacute.com/pharmacy-frida… #PharmacyPearls #PharmacyEducation #ClinicalPharmacy #CriticalCarePharmacy #EmergencyMedicine #PostCardiacArrest #MedEd #PharmacistLife #MedicationSafety

@ant_trauma_cop @IM_Crit_ And pharmacists!

@IM_Crit_ Create a mechanism for experienced emergency, critical care, hospitalist nurse practitioners & PAs as well as CRNAs to advance into a physician role specifically through a very well regulated but distance solution and you could solve a huge part of the physician shortage

A 2-year may be even better?

@PharmD_intheED Also, why no cath after? Thrombolytics are not a contraindication

@PharmD_intheED STrEMI! 25 mg tenecteplase

100-kg patient with both an active STEMI and an ischemic stroke (NIHSS 7). •Cards: “No cath if lytics given.” •Neuro: “In window, no contraindications — give lytic.” 👉 What’s your next move? 💊 If you choose meds, which drug + what dose? #EMRx #twitteRx

The 2025 AHA/ACC Hypertension Guidelines are out, and the changes are significant. Here are the key takeaways for pharmacists & clinicians: "Hypertensive Urgency" is now "Severe Hypertension" for BP >180/120 w/o target organ damage. Move away from IV meds for asymptomatic severe HTN. Oral initiation is key. New, specific BP targets for ICH & post-reperfusion ischemic stroke. The PREVENT risk calculator is in, setting new thresholds (≥7.5% risk) for starting meds at BP ≥130/80. Swipe through the carousel for a full visual breakdown of these practice-changing updates!

💡 Need one more reason to love your friendly EM pharmacist? Check out this @EMPHARM_NET SR/MA: ⏰ EMP presence was associated with reduced mean DTN time by 14.6 minutes (95 % CI -18.1, −11.1 min) Time for @American_Stroke @American_Heart to take notice?

Norepi all day

It’s time, once again, to enter the realm of TXA (tranexamic acid) in trauma! Recent updates mean we can often give this powerhouse with a quick 1-2 gram IV push, instead of a long, resource-intensive, 8-hour drip. Talk about efficiency! Plus, at typical trauma doses, you don't need to worry about the "prothrombotic" villain—those studies used a whopping 4g, way more than our heroic doses! So whether you're following the Tactical Combat Casualty Care's 2g guidance or NAESP's 1-2g, remember: TXA is on your side, helping to keep things clotted in all the right places! #TraumaTalk #TXAFunFacts #emergencymedicine #trauma #EMRAP

@jtrebach 😂😂😂

Which antibiotic is most likely to make a huge bid at an auction? Macrobid!!!!

Emergency medicine and critical care pharmacists play an integral role in trauma resuscitation/MTP. Our article sums up key information in the management of this patient population. @ASHPOfficial @accpemedprn @SCCM_CPP @EMpharmacists @SAEM_AEMP pubmed.ncbi.nlm.nih.gov/40580496/

Check out our new segment on anti-amyloid mABs to learn why you need to be aware of these meds in the ED 👇 🧠 ADEs called ARIAs are non-specific, typically require MRI & can mimic stroke ⛔ Concomitant thrombolytics/anticoagulants are contraindicated annemergmed.com/article/S0196-…

New SRMA in-press with 6 studies comparing re-arrest rates post-ROSC btwn epi and norepi gtts with NE showing lower re-arrest rates and a non-significant increase is survival to discharge   Should likely be doing NE gtts in most everyone post-ROSC at this point

🚨 @ACEPNation ED Accreditation Criteria are out and thanks to @SAEMonline & @SAEM_AEMP a pharmacist is now required for all Level 1 & Level 2 sites - THIS is the work we're doing to advance EM pharmacy practice 👐acep.org/siteassets/sit…

@geodonhug @MeganARech @ACEPNation @SAEMonline @SAEM_AEMP @LRayRx @EmergPharm @bfaine1 @KyleWeant @AM_EM_PharmD @EMPoisonPharmD I second this

🔥New @EMPHARM_NET DONT EXPAND Study: 💊Propensity-matched, 11 EDs: desmopressin (n=35) vs. controls (n=140) 😷Desmo patients had higher baseline ICH volumes 🧠No difference in good or excellent hemostatic efficacy assessed via hematoma volume measures sciencedirect.com/science/articl…

@johnson8707 @accpemedprn Best pharmacokinetic profile, fastest control, shortest duration if you overshoot a little bit. Also low fluid burden. We have a lot of CKD and HF where I practice

What is your first line antihypertensive used in the setting of ICH?