happy holidays, everyone. and by holiday, I mean the 10 year anniversary of the Ketamine Brain Continuum.

emupdates.com/the-ketamine-b…

Because the trajectory of alcohol withdrawal is so unpredictable, effective treatment hinges on frequent reassessments. This is traditionally done based on the CIWA-Ar score, which is long/cumbersome. Using a short and easy scale encourages best practice.

emupdates.com/baws

unearthed a doctor bag I haven't seen for many years. I can't decide whether I miss carrying this stuff around or not. calculator still works somehow

Fantastic hyperthermia protocol buried in the letters of this month's Annals. Best practice translated to logistics-heavy, granular detail broken down by role and localized to department specifics. Bravo Bryan Feinstein et al.

annemergmed.com/article/S0196-…

emupdates.com/hot

Complete airway obstruction by food bolus. Attempted removal with Magill forceps under VL visualization unsuccessful, so paramedic pushed the bolus aside to get an indirect view of the cords, which was navigated with a bougie. Damn fine work. #bougie

ncbi.nlm.nih.gov/pmc/articles/P…

EM expanded its scope to confront a new opioid addiction crisis, but we've done little to address alcoholism, despite always having front row seats to the saddest show on earth. Here is the first comprehensive guidance on the emergency management of AUD.

jem-journal.com/article/S0736-…

A DATA-Waiver registration is no longer required to treat patients with buprenorphine for opioid use disorder.

We've successfully X'd the X. Have a low threshold to administer and prescribe bup for OUD.

Fortunately for those of us who earn a living in patient-facing medicine, our job is as much judgment as knowing facts because my goodness are humans not needed for facts anymore.

Yale group shows ED-initiated nicotine replacement effective in smoking cessation. Patients won't remember your expert management of low-risk chest pain, but if you set them down the path to quitting, that ED visit was the best thing they've ever done.

annemergmed.com/article/S0196-…

Agitation Management in the Trauma Patient: Dissociation to prevent intubation

From the current EM Clinics issue on Trauma Emergencies, expertly edited by Kimberly Boswell and Christopher Hicks

authors.elsevier.com/a/1g7UE2ct6wsz…

Called to bedside for SUDDEN JUMP in heart rate. Very strange because patient remains perfectly calm, comfortable despite heart rate DOUBLING, monitor shows EXTREME TACHY and V-TACH. How can this be. Sounds like a case for Detective Pulse Oximeter.

Today's NEJM editorial reminds us that emergency clinicians are sometimes in between the patient and the law and provides specific strategies for those who feel vulnerable to legal action from prioritizing the patient's interest over law enforcement.

nejm.org/doi/full/10.10…

Lots of discussion around how to build resilience among health care practitioners. The answer, as usual, is ketamine.

ncbi.nlm.nih.gov/pmc/articles/P…

Reminder that ulipristal (Ella) is the preferred emergency contraceptive, not levonorgestrel (Plan B), especially in women with high BMI.

jamanetwork.com/journals/jama/…