Podcasts about Lidocaine

BLS & ACLS's Adult Cardiac Arrest algorithm makes it easier to act as team leader during a code by following an If/Then methodology.Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest.If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm.If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm.An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered.We will follow the algorithm until the patient has ROSC or we call the code.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

As little as 3000 steps per day can slow progression to Alzheimer's Disease; Self-reports of memory impairment soaring among young people; New study vindicates unprocessed red meat—and even often-vilified processed red meat—for cancer and overall health. Prostate artery embolization (PAE) offers new non-invasive option for men's age-related urinary problems; Targeting the mitochondria and the microbiome for Parkinson's Disease; Popular prostate and hair loss prevention drugs linked to depression and suicide—while Cialis for urinary symptoms may stave off cardiovascular disease; Discovery that a safe, cheap medication may increase survival after breast cancer surgery. 

Reach out and touch us: shiftlesslive@gmail.comThe Unconventional Justin Carey Pushes the Limits: Insights and Future EndeavorsIn this episode, Justin Carey shares his latest experiences, including his remarkable FKT (Fastest Known Time) on the 'Rat 1000'—a grueling 1000-mile bikepacking race. The conversation delves into his preparation strategies, nutrition intake, and lessons learned about managing sleep and dealing with extreme conditions. He discusses his plans for future ultra-distance races like the Tour Divide and strategies for potentially cutting down his time on races like the Rat 1000. The episode also touches on his approach to bike maintenance, upcoming race goals, and ambitions to inspire others through coaching and his nutritional products. Throughout the discussion, there's a blend of humor, personal anecdotes, and valuable insights that make for a compelling listen.00:00 Audio Sync and Episode Introduction00:26 Welcome to Shiftless: Bicycles and Power Tools01:02 Introducing the Guests01:41 Reflecting on Past Podcasts03:24 Race Across Texas: The Journey Begins06:42 Chasing the Pack: Strategy and Challenges10:26 Nutrition and Hydration Strategies19:41 Technical Issues and Sleep Deprivation34:57 Post-Race Reflections and Recovery36:48 Saddle and Arrow Bars Adjustments37:07 Training for Big Sugar37:20 Comfort and Acclimation Challenges38:17 Hand and Foot Issues40:09 Shammy Cream and Saddle Sores40:32 Lidocaine and Pain Management43:39 Recovery and Physical Issues45:33 Age and Recovery Discussion49:43 Mountain Lion Encounter53:39 Nutrition and Hydration Strategies01:09:21 Bike Setup and Mechanical Issues01:13:34 Future Bikepacking Goals01:15:08 The Benefits of a Dynamo Hub01:16:54 Preparing for the Tour Divide01:18:20 Strategies for Long-Distance Races01:19:32 Dealing with Wildlife on the Route01:21:16 Bike Choices and Equipment01:24:48 Training and Local Races01:34:35 Future Race Plans and Goals01:46:44 Nutrition and Coaching Services01:49:47 Concluding Thoughts and Upcoming Events

Review of antiarrhythmic medications Amiodarone & Lidocaine for use in ACLS's Adult Cardiac Arrest, Post Arrest, and Tachycardia algorithms.The two first-line ACLS antiarrhythmics that are generally used.Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy.Amiodarone use & dosing for stable patients in V-Tach with a pulse.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

My guest is Dr. David Fajgenbaum, MD, professor of translational medicine and human genetics at the University of Pennsylvania. He explains how, unbeknownst to most doctors, many approved medications can successfully treat or even cure diseases other than the ones they are typically used to treat. He shares his story of escaping death from Castleman's disease by discovering a life-saving treatment using repurposed drugs that were approved for other purposes. Our conversation explores how researchers, physicians, and you—the general public—can explore novel treatments and cures to conditions the medical profession has deemed untreatable, including cancers. We also discuss the crucial role of mindset in battling diseases and the lesser-known use of compounds to promote health and longevity. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AGZ by AG1: https://drinkagz.com/huberman Eight Sleep: https://eightsleep.com/huberman Rorra: https://rorra.com/huberman David: https://davidprotein.com/huberman Function: https://functionhealth.com/huberman Timestamps (0:00) David Fajgenbaum (4:06) Self-Agency in Healthcare; New Uses for Old Medicines (6:44) Other Uses of Aspirin & Viagra; Drug Development & Approved Use (8:53) Lidocaine & Breast Cancer; Pharmaceutical Companies & Incentives (11:36) Sponsors: Eight Sleep & Rorra (14:16) Pharmaceutical Companies, Patents & New Uses; Lithium (18:40) Tools: Finding Reliable Health Sources, Asking Questions & Disease Organizations; DADA2 Treatment (21:53) Medical Community & Connections; Integrated Medical Databases (24:36) Drug Repurposing, Thalidomide, Pembrolizumab (28:45) Medical Research Databases, Mapping Disease Connections (33:51) Every Cure Database & Programs, Bachmann-Bupp Syndrome; Colchicine & Heart Disease (37:57) Sponsors: AGZ by AG1 & David (40:41) David's Medical & Career Journey, Glioblastoma, Castleman Disease (49:10) Autoimmune Disease, Driven Personality, Stress & Immune System (52:52) Castleman Disease, Treatment, Chemotherapy (55:54) Physician Continuing Education, Santa Claus Theory of Civilization; Science Collaboration (1:03:32) Medical School, Relapse & “Overtime”, Finding a New Treatment, Rapamycin (1:12:46) Sport, Football & Resilience; Challenge & Personal Growth, Family (1:18:41) Sponsor: Function (1:20:29) Social Support; “Overtime”, Gratitude (1:23:19) Business School, Castleman Disease Treatment; Repurposing Drugs & AI (1:28:29) Drug Repurposing, POEMS Syndrome; Mitigating Risk (1:35:32) Nicotine, Compounds for Preventive Health; GLP-1 Agonists (1:40:51) Bioprospecting, Drug Development; AI, Prioritization & Novel Connections (1:46:18) Healthcare & Children; Hope, Action & Impact Circuit; Challenge & Super-Agers (1:52:50) Get Involved with Every Cure (1:56:20) Zero-Cost Support, YouTube, Spotify & Apple Follow, Reviews & Feedback, Sponsors, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

From dealing with a shortage of lidocaine across the country to answering questions about supplements for skin, hair, and nails, dermatology NP/PAs find themselves continually adapting. Jayme M. Heim, MSN, FNP-BC and Sandri Johnson, MSN, FNP-BC respond to questions from colleagues. Plus, updates on biologic treatment selection from Jennifer Soung, MD, and insights from David E. Cohen, MD, MPH on a new treatment for chronic hand eczema.Like what you're hearing? Want to learn more about the Dermatology Education Foundation? Explore assets and resources on our website.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog If you ever doubted your doctor because she wrote a script that you later “Googled” and found was not FDA approved, I hope you trusted your doctor enough to realize that she wouldn't recommend any medication that would hurt you…. What is an unapproved use of a drug, also called “off-label”? Unapproved use of an approved drug is often called “off-label” use. This term can mean that the drug is: Used for a disease or medical condition that it is not approved to treat, such as when a chemotherapy is approved to treat one type of cancer, but healthcare providers use it to treat a different type of cancer. The drugs that are not approved by the FDA, yet are commonly used, have been used for decades before the 1964 law that required new drugs to go through extensive and very expensive testing before their release to the public. The operative word is NEW DRUGS AFTER 1964. Today I will talk about the safety of non-FDA approved drugs because they are: Older cheaper drugs used for many diseases and conditions before 1964 and are still used Drugs that are approved for one use, or one condition, but not for other conditions that it is effective and safe for. Drugs made by compounding pharmacies for diseases that the FDA has not approved a drug for, but there is research backing the drug and years of safe use. First, before we discuss the non-FDA approved drugs, I will discuss the safety/risks of FDA approved drugs, and why FDA approval doesn't mean a drug will do no harm or even that it is effective for the use it is approved for. A little background will help you understand the problem and the reason an FDA approval does not necessarily mean a drug is safe.  Since 1964, a law was passed that established testing prior to a drug being approved by the FDA became mandatory.   Since that time several drugs that survive FDA approval and are released but are later removed or banned after their FDA release when the public finds side effects that the FDA didn't discover in their trials. One such drug is Fen-Phen, Fenfluramine/Phentermine. This drug was released during my time practicing medicine and was withdrawn after one study claimed it caused heart valve disease…In the end the “one post approval study” that claimed that heart valves were affected by this drug that caused its bann was found to be false. The withdrawal of the drug followed one study by a single cardiologist from Kansas City had reviewed all of the cardiac valve echo tests and falsified the results to make Fen-Phen appear dangerous to heart valves, when in reality it wasn't.  She lost her license, but the FDA never put Fen-Phen back on the market!  The FDA hates to be wrong twice, so they never allowed this drug back on the market after its removal. Other mistakes made by the FDA include not allowing women in the studies to approve a drug before 2014 which ignores or misses all of the side effects or lack of effectiveness for a drug when taken by women.  Despite all the expensive testing before the release of a drug by the FDA, many drugs not tested on women were later often found to have severe side effects only on women. A few examples follow: You might have heard of the FDA approved drug Ambien that causes many women to experience “night eating”, sleepwalking, and night terrors, while their male counterparts were not affected, so because they only tested men the drug was approved. In retrospect it should have been tested on women as well, and then either not passed through the FDA or should have had a black box warning for women. It takes years get action from the FDA, notifying doctors of these side effects. Women were not included in testing for any drugs except female hormones until 11 years ago, but no other drugs.   Before 2014 all (non-hormonal) drugs that passed the FDA were not tested on women so the effect on women was unknown until it was tested on the public. The FDA left women out of drug-trials because it viewed women as “mini men”, or they didn't consider us important enough to test new drugs on…OR worse, they believed we were too complicated to easily test us because of pregnancy, menopause and other hormonal swings that normal healthy women have.  In any case, we are now suffering their decisions, when a medication works one way for men and another way for women! Finally, we are tested when drugs are being evaluated for approval by the FDA. Professional women have achieved a level of authority in medicine and pharmacology (2025) and are weighing in on the inequity. Women in the medical profession and the public are pulling back the curtain on the side effects of FDA approved drugs that are experienced by women only! Slowly, study by study investigators are now publishing the side effects and problems for women with FDA approved drugs….yet these findings are not included in the warnings on most of these drugs, even now over 15 year after they became obvious to the doctors who treat women! Drugs that either don't work for women, or that have severe side effects include that were approved before 2014. All statin drugs for high cholesterol (Crestor, rosuvastatin, atorvastatin, etc.) cause women to have muscle breakdown and muscle pain. Synthroid (levothyroxine), doesn't cure the symptoms of hypothyroidism in 80% of women, but just makes the TSH lower, so it appears as if it is working! This leads doctors to tell women that their symptoms are all in their heads!! Wrong.  It is the wrong medicine. Women have enzymes that differ from men that make it difficult for them to convert the inactive form (T4) into the active form (T3), so we can't convert Synthroid (all T4) into the active form. Synthroid, the FDA approved drug for hypothyroidism, shouldn't be given to most women. Women should be given the non-FDA approved drug Armour Thyroid or NP thyroid that have both T3 and T4 in them! Ambien Prednisone and other oral steroids We have reviewed the lack of testing on women before 2014, now we will discuss safe drugs that have been used for decades even before 1964 when the FDA required testing for FDA approval? Older, yet effective and inexpensive drugs have been tested by the public, some for almost 100 years that have saved thousands of lives, yet they are not given the FDA stamp of approval!  In fact, the FDA tries to put these drugs out of circulation, replacing them with very expensive drugs that are new! Or they just shut them down, because they are not FDA approved.  Young doctors are told not to use them by their medical schoolteachers who rarely have experienced these medications in private practice…. These doctors in training don't know the history of older safer, cheaper drugs, or even why the FDA tells them avoid them. They comply not knowing why, so you are left with no drug that works for you, or you pay 3-10 times the amount for a newer FDA version of the older drug which may even have more side effects. Some of these older very effective and cheap drugs are Penicillin, Nitroglycerine for chest pain, Morphine (pain), Phenobarbital (seizures), Codeine, Armour Thyroid, hormone injections including estradiol injections and testosterone, Thorazine for psychiatric use, (Pitocin) oxytocin for labor, lactation support and Autism Colchicine:Used to treat and prevent gout. Progesterone in oil (IM) Estradiol in oil (IM) B12 for injection Testosterone Cypionate for injection Compounded Estradiol in any form Compounded Testosterone for women These drugs have been used for so long that any safety risks or side effects have been found through the use of these drugs in the population. Yet the FDA won't grandfather them in and approve them based on their history! What do doctors do when the drug the FDA has approved a drug that doesn't work for a group of their patients (gender, race, blood type, etc.)?  What happens when a doctor can't find a drug that is FDA approved needed to treat a condition she is faced with? Why do we as citizens, allow the government to have power over doctors who are already controlled by their state licensing boards as to what medications they?  Lastly Why do taxpayers allow a government agency that they fund with tax dollars control their health by banning, or not approving drugs, or banning one drug so an outrageously expensive drug is put in its place? Compounded Medications/ Compounding Pharmacies: These drugs are made by mixing ingredients to meet individual patient needs and are not subject to premarket review for safety, effectiveness, or quality. However, they ARE subject to the success or failure for which they were prescribed. If a doctor prescribes a compounded drug that doesn't work, she is apt to be confronted by her patient who is not getting the expected results.  Compounding pharmacies usually don't get paid by insurance, so patients are more invested in getting a drug that works and that is one of the big reasons that Compounded medicines are at least as good or better than big pharma or generic drugs. I absolutely could not successfully treat the thousands of women and men that I have without compounding pharmacies.  They compound hormones/drugs that are safe and effective, mostly hormones that can't be patented because they occur in nature and won't ever be made by big pharma. More than that, big producers of drugs can't produce in mass quantities many doses of a certain hormone like compounding pharmacies do.  Compounding pharmacies provide what people need and they continue to do so because patients prefer their dosing and quality.  FDA approved Generic Drugs can be legally 25 % lower dose than what they say they are.  That would be a big problem if my compounded pellets had that kind of variability. People might need pellets every 2months or every 5 months instead of every 4 months..it would be like guessing what you need ahead of time…..I believe dedicated compounding pharmacists are more accurate than any generic on the market. Compounding pharmacies: Unsung Heros Compounding pharmacies serve the public when big pharma fails and hasn't developed a safety net for production if they have a problem and the FDA shuts them down. That situation leaves patients who take their medications, without an alternative. Compounding pharmacies step into the breech when big pharma has a problem with a particular drug and stop making a drug (e.g. Lidocaine, B12 injectable, IV Fluids, to name a few shortages and no production that have occurred in the recent past). What if patients couldn't get the meds they need, and if there were no compounding pharmacies—Chaos and suffering and dying patients would closely follow! The FDA is Fickle and is not on your side! For years the FDA did not approve of Bioidentical estrogen and testosterone in any form, and just a few months ago all of a sudden, long after they scared women from taking the hormones they needed to improve their length of life and quality of life, they decided bioidentical hormones are better than the FDA approved hormones!!!  That is a little too late.  Some of us will never forget the stress lack of approval of compounded hormones caused for doctors and patients alike.  Other doctors criticized us and now most of them aren't even in practice anymore.  Maybe the FDA read my blog!!! Compounded hormones have been approved by the masses of women who have taken them under my signature! Compounded BI hormones are medications with a long track record and should not have to be tested with the bloated expense required of testing for the FDA. For Gynecological Disorders that don't have an FDA approved hormone drug because testosterone and estradiol have been used for so long that they don't need testing. If there was a significant problem with them their history of use of over 5-7 decades has proven the efficacy and safety of the female hormones for treatment and hormone replacement. For Psychiatric Disorders: Some patients need compounded ketamine products for conditions like severe depression, despite lacking FDA approval for these uses and potential risks, yet it has been used for this purpose for decades and was used for childbirth for almost a century, until epidurals and saddle blocks took their place. Testosterone for women still is not recognized as a female hormone even though women produce over twice as much Testosterone as Estradiol when they are in their fertile years.   Replacement of T with bioidentical T pellets offers a treatment for dozens of symptoms women face after age 40, and it prevents the diseases of aging: osteoporosis, heart disease, sarcopenia, frailty, diabetes and more that have not been addressed by mainstream medicine and the FDA. Over a decade ago, the FDA turned down the approval of testosterone patch after over 3 years of positive research studies, the FDA said they didn't approve T for women is because the side effect of T for women, facial hair, was dangerous for women.…I cry B—–S—-!  That is really men not wanting to share testosterone replacement with women. I say leave us alone and let women and their doctors determine what they need.  It is proven that only 5% of all professionals in any profession are not trustworthy, so give doctors their due and trust that we are looking for answers to our patients' problems that you don't even know about! The FDA is paid for by us…everyone in this country. I say hands off! Speed up the approval process or forget it for older drugs and BI hormones! ~

How can AI really help advance medicine? Should patients and care teams be seeking second opinions from LLMs? This week, Reid and Aria sit down with physician-scientist Dr. David Fajgenbaum, who repurposes existing drugs to save lives—including his own. David shares his journey from receiving last rites as a young medical student to co-founding Every Cure, a nonprofit using AI to come up with ways existing drugs can be repurposed to treat every disease and every patient possible. On this special episode, filmed live in New York City, David, Reid, and Aria explore the circuit of hope, action, and impact that drives medical discovery; the technical and ethical challenges around accelerating AI in healthcare; “agent optimization” as the new “search engine optimization;” and what a future of faster diagnoses and treatment could look like. The result is a conversation about resilience, innovation, and unlocking cures that are already within our reach. For more info on the podcast and transcripts of all the episodes, visit https://www.possible.fm/podcast/  Topics: 3:00 - Hellos and intros 3:29 - A promise to his mother and the origin of AMF 6:23 - From grief support to medical school 9:18 - Near-death experiences and founding a research network 14:38 - What kept David going at death's door 16:19 - Discovering a potential treatment and testing it on himself 19:42 - Why drug repurposing is a faster, cheaper complement to drug discovery 22:14 - Co-founding Every Cure and scaling discovery with AI 25:20 - Demo: Building MATRIX and how the algorithm makes predictions 28:41 - Breast cancer and Lidocaine as a case study 30:07 - Why human review is essential in AI for medicine 34:08 - Car exhaust fumes example and FDA pathways 37:31 - Reid's surprise million-dollar donation for Every Cure compute 39:24 - What AI can unlock across healthcare 41:46 - Building an impact team to close the repurposing loop 47:32 - Improving systemic incentives for generics 54:58 - FDA approval pathways and label change challenges 57:21 - Three life-saving repurposing stories 1:02:20 - Rapid-fire questions Select mentions:  Hidden Potential by Adam Grant Chasing My Cure by Dr. David Fajgenbaum Every Cure  David's TED Talk: https://youtu.be/sb34MfJjurc?si=GcVleWHZuJ9MqLgS Manas AI Possible is an award-winning podcast that sketches out the brightest version of the future—and what it will take to get there. Most of all, it asks: what if, in the future, everything breaks humanity's way? Tune in for grounded and speculative takes on how technology—and, in particular, AI—is inspiring change and transforming the future. Hosted by Reid Hoffman and Aria Finger, each episode features an interview with an ambitious builder or deep thinker on a topic, from art to geopolitics and from healthcare to education. These conversations also showcase another kind of guest: AI. Each episode seeks to enhance and advance our discussion about what humanity could possibly get right if we leverage technology—and our collective effort—effectively.

High Yield Antiarrhythmic Drugs Review:Class I (Sodium Channel Blockers)Class II (Beta Blockers)Class III (Potassium channel blockers)Class IV (Calcium Channel Blockers) for your PANCE, PANRE, Eor's and other Physician Assistant exams.Review for your PANCE, PANRE, Eor's, Physician Assistant exams, Medical, USMLE, Nursing Exams.►Paypal Donation Link: https://bit.ly/3dxmTql (Thank you!)Included in review: Pathophysiology of antiarrhythmics, cardiac action potential, phases 0–4, Phase 0 depolarization, Phase 1 initial repolarization, Phase 2 plateau, Phase 3 repolarization, resting membrane potential, cardiomyocytes, pacemaker cells, funny current (If), L-type calcium channels, T-type calcium channels, effective refractory period (ERP), conduction velocity, reentry, rate control, rhythm control, AV node, SA node, QT prolongation, torsades de pointes, post-MI arrhythmias, structural heart disease, supraventricular tachycardia, atrial fibrillation, atrial flutter, ventricular tachycardia, ventricular fibrillation, ACLS, catecholamines, cAMP, PKA, beta-1 receptors, calcium influx, nodal blockade, non-dihydropyridine vs dihydropyridine, Disopyramide, Quinidine, Procainamide, Lidocaine, Mexiletine, Flecainide, Propafenone, Metoprolol, Atenolol, Bisoprolol, Betaxolol, Esmolol, Acebutolol, Propranolol, Carvedilol, Labetalol, Nadolol, Pindolol, Timolol, Sotalol, Amiodarone, Dronedarone, Ibutilide, Dofetilide, Verapamil, Diltiazem, Amlodipine, Nifedipine, Nicardipine, Amiodarone adverse effects, blue-gray skin discoloration, interstitial lung disease, thyroid dysfunction, corneal microdeposits, hepatotoxicity, beta-blocker contraindications, asthma caution, bradycardia, AV block, cardiogenic shock, diabetes caution, CCB adverse effects, constipation, AV block, bradycardia.Become a supporter of this podcast: https://www.spreaker.com/podcast/cram-the-pance--5520744/support.

Feminist Buzzkills is officially BACK! WHEEEEE! Lizz is still out meeting with activists and speaking at screenings of the AAF documentary, “No One Asked You,” at The Colombia International Human Rights Festival (dopeness alert). And HUZZAH—joining Moji is AAF's inimitable Head Writer, Alyssa “Dooks” Al-Dookhi to guest co-host! They're diving into abortion providers handling IUD insertion pain like pros, the rollercoaster of Planned Parenthood's Medicaid funding, and fake clinics sneaking into telehealth. GUEST ROLL CALL!Moji and Dooks chat with real-life clinic superstar, Ali Kliegman, Co-Founder and Executive Director of Care for All Clinic, a brand-spanking-new nonprofit abortion clinic in the heart of Milwaukee. Ali spills the tea about going from concept to real-ass clinic in basically one year, the violence and harassment Care for All has already faced, and how their community model can be a blueprint for healthcare clinics! PLUS! Get your serotonin boost courtesy of comedian, matchmaker, and lawyer Yasmin Elhady! She yaps with us about her dating reality show on Hulu, “Muslim Matchmaker,” figuring out she's funny AF, and the deets on diversity in the Muslim Ummah. She's bringing it ALL. Scared? Got Questions about the continued assault on your reproductive rights? THE FBK LINES ARE OPEN! Just call or text (201) 574-7402, leave your questions or concerns, and Lizz and Moji will pick a few to address on the pod! Times are heavy, but knowledge is power, y'all. We gotchu.  OPERATION SAVE ABORTION: WE DID A THING IN AUGUST! The Feminist Buzzkills took some big patriarchy-smashing heat to The Big Easy and recorded a live workshop that'll train you in coming for anti-abobo lawmakers, spotting and fighting against fake clinics, AND gears you up on how to help someone in a banned state access abortion. You can still join the 10,000+ womb warriors fighting the patriarchy by listening to our past Operation Save Abortion pod series and Mifepristone Panel by clicking HERE for episodes, your toolkit, marching orders, and more. HOSTS:Moji Alawode-El @MojiLocksAlyssa Al-Dookhi @TheDookness SPECIAL GUESTS:Ali Kliegman IG: @careforallwiYasmin Elhady IG: @yasminelhahahady TikTok: @yasmin_elhady GUEST LINKS:Care for All WebsiteVOLUNTEER: Care for AllDONATE: Care for AllName Care for All's New Aspiration MachineYasmin's WebsiteYasmin's Youtube Find Love, Muslim Matchmaking Website NEWS DUMP:Amy Coney Barrett: Reports of a Constitutional Crisis Have Been Greatly ExaggeratedJudge: Planned Parenthood Clinics Can Remain Medicaid Providers While Lawsuit ContinuesUPDATE: Planned Parenthood's Medicaid Funding Can Be Blocked for Now, Appeals Court RulesTrump Loses Bid to Overturn $83.3m E. Jean Carroll Defamation JudgmentDigital Deception: Beware the Rise of Fake Telehealth Abortion ClinicsWant an IUD, but You're Afraid of the Pain? Try an Abortion Provider. EPISODE LINKS:Plan C PillsI Need an AAbortion FinderExpose Fake Clinics ADOPT-A-CLINIC: Care for All Community Clinic Amazon WishlistBUY AAF MERCH!SIGN UP 8/9: Operation Save AbortionEMAIL your abobo questions to The Feminist BuzzkillsAAF's Abortion-Themed Rage Playlist SHOULD I BE SCARED? Text or call us with the abortion news that is scaring you: (201) 574-7402 FOLLOW US:Listen to us ~ FBK Podcast Instagram ~ @AbortionFrontBluesky ~ @AbortionFrontTikTok ~ @AbortionFrontFacebook ~ @AbortionFrontYouTube ~ @AbortionAccessFront TALK TO THE CHARLEY BOT FOR ABOBO OPTIONS & RESOURCES HERE!PATREON HERE! Support our work, get exclusive merch and more! DONATE TO AAF HERE!ACTIVIST CALENDAR HERE!VOLUNTEER WITH US HERE!ADOPT-A-CLINIC HERE!EXPOSE FAKE CLINICS HERE!GET ABOBO PILLS FROM PLAN C PILLS HERE! When BS is poppin', we pop off! 

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.Indications for use of an antiarrhythmic after ROSC.Determining which antiarrhythmic to use post cardiac arrest.Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.**American Cancer Society (ACS) Fundraiser This is the seventh year that I'm participating in Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission.I hope you'll consider contributing.Every donation makes a difference in the fight against breast cancer! Paul Taylor's ACS Fundraiser Page: http://main.acsevents.org/goto/paultaylorTHANK YOU for your support! Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

BLS & ACLS's Adult Cardiac Arrest algorithm makes it easier to act as team leader during a code by following an If/Then methodology.Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest.If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm.If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm.An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered.We will follow the algorithm until the patient has ROSC or we call the code.**American Cancer Society (ACS) Fundraiser This is the seventh year that I'm participating in Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission.I hope you'll consider contributing.Every donation makes a difference in the fight against breast cancer! Paul Taylor's ACS Fundraiser Page: http://main.acsevents.org/goto/paultaylorTHANK YOU for your support! Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Review of antiarrhythmic medications Amiodarone & Lidocaine for use in ACLS's Adult Cardiac Arrest, Post Arrest, and Tachycardia algorithms.The two first-line ACLS antiarrhythmics that are generally used.Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy.Amiodarone use & dosing for stable patients in V-Tach with a pulse.**American Cancer Society (ACS) Fundraiser This is the seventh year that I'm participating in Men Wear Pink to increase breast cancer awareness and raise money for the American Cancer Society's life-saving mission.I hope you'll consider contributing.Every donation makes a difference in the fight against breast cancer! Paul Taylor's ACS Fundraiser Page: http://main.acsevents.org/goto/paultaylorTHANK YOU for your support! Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Free Prescription Discount Card - Get your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Other ACLS-related resources: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

In this episode of Grade 1 View, we had the privilege of speaking with Tom Baribeault, DNP, CRNA, a pioneer in the field of opioid-free anesthesia. As the president and founder of the Society of Opioid Free Anesthesia, Tom has dedicated his career to advancing pain management techniques that prioritize patient safety and comfort. Today he'll share how his own clinical curiosity led him to abandon intraoperative opioids altogether, and what happened next. From reducing postoperative nausea to improving respiratory safety, this conversation will challenge you to question the status quo and expand your definition of what anesthesia can look like. Here's some of what we discuss in this episode:

The 2017 NEJM study, ALPS, compared amiodarone, lidocaine, and placebo for refractory shockable rhythms in adults with out of hospital cardiac arrest. They found no significant difference in survival to hospital discharge or functional survival between any of the arms. If that study has left you confused, you're not alone. And you're in luck. Tanner Smida joins us again to discuss his latest paper using something called target trial emulation to assess the difference in ROSC and survival to discharge between amiodarone and lidocaine. This is a great discussion of his paper, the methodology, and how we can put his results into the context of ALPS.Citations:1.Smida T, Crowe R, Price BS, Scheidler J, Martin PS, Shukis M, Bardes J: A retrospective ‘target trial emulation' comparing amiodarone and lidocaine for adult out-of-hospital cardiac arrest resuscitation. Resuscitation. 2025;March;208:110515.2. Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, et al.: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016;May 5;374(18):1711–22.3.Hernán MA, Robins JM: Using Big Data to Emulate a Target Trial When a Randomized Trial Is Not Available: Table 1. Am J Epidemiol. 2016;April 15;183(8):758–64.

Listen as Michael S. Benninger, MD, describes his approach to the diagnosis and management of chronic cough and refractory chronic cough in the context of a clinically relevant case.PresenterMichael S. Benninger, MDProfessor of Otolaryngology-Head and Neck SurgeryLerner College of MedicineThe Cleveland ClinicPresident, International Association of PhonosurgeryCleveland, OhioLink to full program:https://bit.ly/4kweynG

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.Indications for use of an antiarrhythmic after ROSC.Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Listen to the commentary of Dr. Eric Sarkissian on the article "Mixture of Lidocaine and Ropivacaine as a Local Anesthetic in WALANT Surgery: A Prospective Randomized Study" that appears in the July 2025 issue of The Journal of Hand Surgery.

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest.If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm.If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm. An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered. We will follow the algorithm until the patient has ROSC or we call the code.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn Other Pass ACLS episodes mentionedObjective Measures of Good CPR https://passacls.com/bls/objective-measures-of-good-cpr

In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine.The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine.Review of Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Review of Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy.Amiodarone use & dosing for stable patients in V-Tach with a pulse.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Show notes at pharmacyjoe.com/episode1030. In this episode, I’ll discuss adding dexmedetomidine to lidocaine for topical application to prevent cough during extubation of thyroidectomy patients. The post 1030: Adding dexmedetomidine to lidocaine for topical application to prevent cough during extubation appeared first on Pharmacy Joe.

There are defining moments that split your life into before and after. Moments when everything you thought you knew gets stripped away, leaving only what truly matters. For Dr. David Fajgenbaum, that moment came not once, but five times, each bringing him closer to death and, paradoxically, teaching him how to live.This week's episode explores what happens when the system fails you and you refuse to accept failure. When David was diagnosed with Castleman disease at 25, a rare condition where your immune system turns against your own body, traditional medicine reached its limits. But David didn't. Instead of surrendering, he became both patient and researcher, ultimately discovering the treatment that would save not just his life, but potentially thousands of others.In our conversation, David reveals the mindset shifts that kept him fighting when hope felt impossible, how AI is revolutionizing our approach to drug discovery, and why the cure for your condition might already exist in a pharmacy right now. His story challenges everything we think we know about medicine, healing, and what's possible when you refuse to take no for an answer.What struck me most about our conversation wasn't just David's survival story, but how he turned personal crisis into a mission that's reshaping medicine. His ability to stay curious even when doctors said there was nothing left to try, and his belief that the answers we need might already exist, just waiting to be discovered. David showed me that breakthrough thinking isn't always about creating something new, but seeing what's already there differently.About Dr. David Fajgenbaum:Dr. David Fajgenbaum is a physician-scientist, bestselling author of Chasing My Cure, and co-founder of Every Cure, a nonprofit on a mission to unlock the full potential of every approved drug to treat every disease it possibly can. Recently named to TIME's 100 Health list for 2025, he's revolutionising medical research by repurposing existing drugs to treat rare diseases. His TED Talk has inspired millions, and his nonprofit work continues to unlock life-saving treatments hidden in plain sight.Connect with Dr. David Fajgenbaum:Website: https://everycure.orgInstagram: @dfajgenbaumFacebook: David FajgenbaumTwitter: @DavidFajgenbaumBook: Chasing My Cure – Available on AmazonLove,Sarah Ann

Can lidocaine… mess up your brain?!

Researchers Find the Mechanism Behind Potential AnticancerProperties in LidocaineBy Today's RDH ResearchOriginal article published on Today's RDH: https://www.todaysrdh.com/researchers-find-the-mechanism-behind-potential-anticancer-properties-in-lidocaine/Need CE? Start earning CE credits today at ⁠⁠⁠⁠⁠https://rdh.tv/ce⁠⁠⁠⁠⁠Get daily dental hygiene articles at ⁠⁠⁠⁠⁠https://www.todaysrdh.com⁠⁠⁠⁠⁠ Follow Today's RDH on Facebook: ⁠⁠⁠⁠⁠https://www.facebook.com/TodaysRDH/⁠⁠⁠⁠⁠Follow Kara RDH on Facebook: ⁠⁠⁠⁠⁠https://www.facebook.com/DentalHygieneKaraRDH/⁠⁠⁠⁠⁠Follow Kara RDH on Instagram: ⁠⁠⁠⁠⁠https://www.instagram.com/kara_rdh/

Adult Performer Brickzilla Joined The Bougie Show For The Second Time And He Talks About Female Performers Not Knowing How To Perform Oral Sex On Him Without Their Teeth Scrapping His Cock. Brick Also Responds To Adult Film Star Connie Perignon "Energies Don't Match" Comment. Zilla Also Informs Xay That He's Changed His Diet And Now Reminding Females Prior To Performing With Him To Warm Up With A Toy Before They Get Destroyed (LOL) And So Much More!! Make Sure To Subscribe To The Page And Get Notifications On All New Releases.The Bougie Show Merchandise Is Finally Here And Going Nowhere! Now Available To Be Delivered To Your Front Door! "It Is Time 2 Stop The Fuckery" U Know We "Friieed" Out Here! Shout Out To The "Bonafied Freaks". We "Wear Bougie" ⁠https://bougieshow.com

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.Indications for use of an antiarrhythmic after ROSC.Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn Discover medical podcasts with CE at https://conveymed.io

- What OMFS Programs Look For In A Resident- Trust But Verify: The #1 Rule That Could Save Your Dental Career- The Truth About Sedation Safety: Why Dental Assistants Should Be DANCE CertifiedYouTube Link:https://youtu.be/haD0ReGjZRw Podcast Link:https://spotifycreators-web.app.link/e/8PolF4NrxSb Quotes & Wisdom:“Taking a year off was the hardest decision I've ever made—but I don't regret it for a minute.” – Benji“Sometimes you've got to evaluate and say, ‘I need to give 120% to this priority right now.'” – Brendan“Confidence and self-awareness. That's what directors are really looking for.” – Brendan“Pick up the hose and hold it. That taught me to always be doing something, and that stuck with me through everything.” – Benji (on working with his dad)“Nothing is beneath any of us—turning over chairs, cleaning, setting trays—do it all. Especially when no one's watching.” – Brendan“Trust but verify—every single thing.” – Brendan“You don't know where sabotage can come from. It's not always personal, but you need to be ready.” – Brendan“People love to be taught. When you provide structure and knowledge, the whole profession gets safer.” – Benji“Life is life. If you have the time to speak with others, share ideas, and learn from great people—you grow more than you realize.” – BenjiQuestions:06:33 – "How's the CBSE studying going?"08:25 – "Are you going to be working during that time?"08:54 – "What did they say about that?"09:25 – "Did any of them say don't work and solely study for the CBSE?"10:37 – "What about your roommate? What does your roommate do?"11:46 – "Did you see the stats of LECOM? How many students matched into OMFS?"15:50 – "Any interest in head and neck, or fellowship?"18:33 – "How important do you think it is to have a competent anesthesia team?"29:43 – "What would you say program directors are looking for in residents to interview?"Now available on:- Dr. Gallagher's Podcast & YouTube Channel- Dose of Dental Podcast #139- 4.2025#podcast #dentalpodcast #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #doctorlife #dentistlife #oralsurgeon #doctorgallagher

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest.If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm.If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm. An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered. We will follow the algorithm until the patient has ROSC or we call the code.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine.The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine.Review of Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Review of Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy. Amiodarone use & dosing for stable patients in V-Tach with a pulse.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vip/savePass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC. Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting. Donations at Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated and will help ensure others can benefit from these tips as well.Good luck with your ACLS class!Helpful Listener Links:Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/*FREE to anyone in the U.S. Save $$ on prescription medications for you and your pets with National Drug Card - https://nationaldrugcard.com/ndc3506 *Indicates affiliate links. I may get paid a small commission if you purchase products or memberships using my link. It doesn't affect the price you pay.Discover medical podcasts with CE at https://conveymed.io

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest. If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm. If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm. An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered. We will follow the algorithm until the patient has ROSC or we call the code.Objective Measures of Good CPR https://passacls.com/bls/objective-measures-of-good-cprConnect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting. Donations at Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated and will help ensure others can benefit from these tips as well.Good luck with your ACLS class!Helpful Listener Links:Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/*FREE to anyone in the U.S. Save $$ on prescription medications for you and your pets with National Drug Card - https://nationaldrugcard.com/ndc3506 *Indicates affiliate links. I may get paid a small commission if you purchase products or memberships using my link. It doesn't affect the price you pay.

In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine.The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine. Review of Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Review of Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy. Amiodarone use & dosing for stable patients in V-Tach with a pulse.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting. Donations at Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated and will help ensure others can benefit from these tips as well.Good luck with your ACLS class!Helpful Listener Links:Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/*FREE to anyone in the U.S. Save $$ on prescription medications for you and your pets with National Drug Card - https://nationaldrugcard.com/ndc3506 *Indicates affiliate links. I may get paid a small commission if you purchase products or memberships using my link. It doesn't affect the price you pay.

In this throwback episode Dr. Russell Schafer joins Kevin and Zach to talk about his second love in dentistry...pediatrics!  Key Topics & Discussion Points: Early Childhood Exams (Under 5): Importance of parent/caregiver relationship and communication. Lap-to-lap/Knee-to-knee exam technique. Focus on diet (sugar intake) and sleep (snoring). Identifying early signs of demineralization. Goal: Creating a safe dental home. Older Children (5-6 and up): Expectation of tolerating bitewing and PA radiographs. Addressing parent's anxieties and managing expectations. Importance of behavior management with both child and parent. Interproximal Decay: Varying treatment philosophies (aggressive vs. conservative). Stainless steel crowns vs. composite restorations. When to refer to a pediatric dentist. Pulpotomies: Different techniques and materials (Formocresol, Ferric Sulfate, MTA). Discussion on necrotic pulp and treatment options (extraction). Pulpotomies for diagnosis vs. therapy. Nitrous Oxide: Benefits of nitrous oxide for pediatric patients. Dosage and administration techniques. Anesthesia: Choice of anesthetic (Lidocaine vs. Septocaine). Techniques for minimizing discomfort during injections (e.g., shaking, "cold water" analogy). Importance of adequate anesthesia for procedures. Sealants: Concerns about over-prescription and improper technique. Discussion on the effectiveness of sealants. Alternative approach: Occlusal composites. Silver Diamine Fluoride (SDF): Use of SDF for caries management. SDF as a "time-buying" strategy. When to use SDF vs. restorative treatment. Very Clinical is brought to you by Zirc Dental Products, Inc., your trusted partner in dental efficiency and organization. The Very Clinical Corner segment features Kate Reinert, LDA, an experienced dental professional passionate about helping practices achieve clinical excellence.  Connect with Kate Reinert on LinkedIn: Kate Reinert, LDA  Book a call with Kate: Reserve a Call  Ready to upscale your team? Explore Zirc's solutions today: zirc.com  

Here's another great podcast from early '24. This was a great conversation and finished the year at #9. In this podcast episode, Winston and I delve into the intricate world of pain and its pathways. They explore the nervous system's role in pain transmission, the different types of pain including nociceptive, neuropathic, and nociplastic pain, and the significance of sensitization in chronic pain conditions. The discussion also highlights practical approaches to pain management, including the use of multimodal therapies and the impact of neuroplasticity on pain perception, particularly in cases like phantom limb pain. In this conversation, Dennis discusses the complexities of pain management, emphasizing the importance of understanding the patient's history and the trajectory of their pain. He highlights the shift from opioid reliance to a multimodal approach that includes various analgesics such as acetaminophen, NSAIDs, lidocaine, capsaicin, cannabinoids, and ketamine. Dennis also covers the role of anticonvulsants and antidepressants in managing chronic pain, providing practical recommendations for healthcare practitioners. Takeaways Understanding pain pathways can enhance treatment effectiveness. Pain transmission involves complex processes in the nervous system. There are three main types of pain: nociceptive, neuropathic, and nociplastic. Peripheral and central sensitization play crucial roles in chronic pain. Ketamine is effective in reducing central sensitization. The placebo effect can significantly influence pain management. Recognizing nociplastic pain is essential for proper treatment. Mirror therapy can help alleviate phantom limb pain. Neuroplasticity affects how pain is perceived and treated. A multimodal approach is necessary for effective pain management. History taking is crucial in understanding pain types. The goal of pain management is to improve function and quality of life. Acetaminophen can be as effective as opioids in certain cases. Lidocaine should be used with caution due to potential side effects. Capsaicin is a natural option for neuropathic pain relief. Opioids have significant side effects and should be used carefully. Cannabinoids are gaining popularity but require more research. Ketamine offers a new avenue for pain management. Anticonvulsants can help with neuropathic pain but take time to work. Amitriptyline is a cost-effective option for chronic pain management. Thank you to Delta Development Team for in part, sponsoring this podcast. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠deltadevteam.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠ Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, shares valuable insights into pain management, anesthesia protocols, and best practices in veterinary dentistry. The episode discusses the cautious use of lidocaine in cats, the role of bupivacaine for effective local blocks, and the potential applications of Renia for managing chronic pain in refractory stomatitis cases. Packed with actionable advice, this episode is a must-listen for veterinarians and technicians looking to elevate patient care in their practice.     Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM     Key Highlights Topic 1: Lidocaine Use in Cats Question: Should lidocaine be used with caution in cats? Answer: Yes, lidocaine can potentially cause seizures in cats, especially when used as a continuous rate infusion (CRI). Recommendation: Replace lidocaine with bupivacaine for local nerve blocks to ensure longer-lasting analgesia (6-10 hours). Use lidocaine sparingly and with proper discretion. Topic 2: Lidocaine for Intubation Discussion: Historically, lidocaine was applied to the larynx for intubation in cats. Dr. Beckman and his team now prefer using a blunt cannula for safer intubation without the risks associated with lidocaine.     Topic 3: Pain Management for Chronic Cases Case Example: Use of Renia (NK1 antagonist) in refractory stomatitis Mechanism: Blocks Substance P at the postsynaptic membrane to prevent ascending pain signals. Clinical Context: Effective for managing chronic pain when combined with ketamine (NMDA receptor antagonist). Outcome: While Dr. Beckman's team hasn't used it extensively, anecdotal feedback from the veterinary community is positive.     Topic 4: Local Blocks with Bupivacaine Best Practice: Use 0.5% bupivacaine for local nerve blocks in cats and small animals. Dosage: 0.2 mL per foramen ensures safety and efficacy. Rationale: Provides prolonged analgesia compared to lidocaine, minimizing the risk of complications.     Actionable Takeaways Transition to bupivacaine for local nerve blocks to enhance patient comfort and safety. Consider using Renia for managing chronic pain in severe stomatitis cases. Adopt safer intubation techniques, such as using blunt cannulas, to mitigate risks in feline patients. Leverage evidence-based pain management protocols to improve patient outcomes.     Sponsor Mention: This episode is brought to you by the Veterinary Dental Practitioners Program. Learn more and request an invitation at ivdi.org/inv. Closing Note: "I hope you enjoyed this episode filled with actionable items to elevate your dentistry practice. Implement these tips today and see the long-term benefits for your patients and practice!"     If you're ready to take your dentistry skills to the next level, visit ivdi.org/inv to join the Veterinary Dental Practitioners Program!  

Editor's Summary by Preeti Malani, MD, MSJ, and Chris Muth, MD, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from November 23-December 6, 2024.

We've reviewed several papers in the past that suggest there might be an advantage to using IV access compared to IO access for medications in cardiac arrest. Is that really a thing? Wouldn't it be great if we had some randomized controlled trials to help answer the questions?  Funny you should mention RCTs. Dr Jarvis reviews three (THREE!) new RCTs that compare IV to IO access in out of hospital cardiac arrest to try to shed some of that bright light of science on this question!Citations:1. Vallentin MF, Granfeldt A, Klitgaard TL, Mikkelsen S, Folke F, Christensen HC, Povlsen AL, Petersen AH, Winther S, Frilund LW, et al.: Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest. N Engl J Med.2. Smida T, Crowe R, Jarvis J, Ratcliff T, Goebel M: A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care. 2024;28(6):1–23.3. Nielsen N: The Way to a Patient's Heart — Vascular Access in Cardiac Arrest. N Engl J Med. doi: 10.1056/NEJMe2412901 (Epub ahead of print).4. Ko Y-C, Lin H-Y, Huang EP-C, Lee A-F, Hsieh M-J, Yang C-W, Lee B-C, Wang Y-C, Yang W-S, Chien Y-C, et al.: Intraosseous versus intravenous vascular access in upper extremity among adults with out-of-hospital cardiac arrest: cluster randomised clinical trial (VICTOR trial). BMJ. doi: 10.1136/bmj-2024-079878 (Epub ahead of print).5. Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, Leroux B, Vaillancourt C, Wittwer L, Callaway CW, et al.: Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016;May 5;374(18):1711–22.6.Daya MR, Leroux BG, Dorian P, Rea TD, Newgard CD, Morrison LJ, Lupton JR, Menegazzi JJ, Ornato JP, Sopko G, et al.: Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Circulation. 2020;January 21;141(3):188–98.7. Nolan JP, Deakin CD, Ji C, Gates S, Rosser A, Lall R, Perkins GD: Intraosseous versus intravenous administration of adrenaline in patients with out-of-hospital cardiac arrest: a secondary analysis of the PARAMEDIC2 placebo-controlled trial. Intensive Care Medicine. doi: 10.1007/s00134-019-05920-7 (Epub ahead of print).

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC. The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC. Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!Discover medical podcasts with CE at https://conveymed.io

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest. If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm. If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm. An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered. We will follow the algorithm until the patient has ROSC or we call the code.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!Other Pass ACLS episodes mentioned:Objective Measures of Good CPR at https://passacls.com/bls/objective-measures-of-good-cpr

In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine.The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine. Review of Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Review of Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy. Amiodarone use & dosing for stable patients in V-Tach with a pulse.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!

In the patient populations treated by neurologists, central neuropathic pain develops most frequently following spinal cord injury, multiple sclerosis, or stroke. To optimize pain relief, neurologists should have a multimodal and individualized approach to manage central neuropathic pain. In this episode, Lyell K. Jones Jr, MD, FAAN, speaks with Charles E. Argoff, MD, author of the article “Central Neuropathic Pain,” in the Continuum October 2024 Pain Management in Neurology issue. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Argoff is a professor of neurology and vice chair of the department of neurology, director of the Comprehensive Pain Management Center, and director of the Pain Management Fellowship at Albany Medical College in Albany, New York. Additional Resources Read the article: Central Neuropathic Pain Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Full episode transcript available here Dr Jones: This is Doctor Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, which features conversations with Continuum's guest editors and authors who are the leading experts in their fields. Subscribers to the Continuum Journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME. Dr Jones: This is Doctor Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today I'm interviewing Dr Charles Argoff, who recently authored an article on central neuropathic pain in the latest issue of Continuum covering pain management. Dr Argoff is a neurologist at Albany Medical College where he's a professor of Neurology, and he serves as vice chair of the Department of Neurology and program director of the Pain Medicine Fellowship Program there. Dr Argoff, welcome. Thank you for joining us today. Why don't you introduce yourself to our listeners?  Dr Argoff: I'm Charles Argoff. It's a pleasure to be here and thank you so much for that kind introduction. Dr Jones: I've read your article. Many of our listeners are going to read your article. Wonderful article, extremely helpful. Closes a lot of gaps, I think, that exist in our field about understanding central neuropathic pain, treating central neuropathic pain. You now, Doctor Argoff, you have the attention of a huge audience of mostly neurologists. What's the biggest point you would like to make to them, or the most important practice-changing advice that you would give to them? Dr Argoff: I think it's at least twofold. One is that central neuropathic pain is not as uncommon as you think it might be, and it occurs in a variety of settings that are near and dear to a neurologist's heart, so to speak. And secondly, although we live in an evidence-based world and we want to practice evidence-based medicine - and I'm proud to have formerly been a member of the Quality Standard subcommittee, which I think has changed its name over time. And so, I understand the importance of, you know, treatment based upon evidence - the true definition of evidence-based medicine is using the best available evidence in making decisions about individual patients. And so, I would urge those who are listening that, although there might not be as robust evidence currently as you'd like, please don't not take the time to try to treat the patient in front of you o r at least acknowledge the need for treatment and work with your colleagues to address the significant neuropathic pain associated with that central neurological disorder. Because it can be life-changing in a positive way to make even a dent and to really work with somebody, even though not clear-cut always what's going to work for an individual patient. Dr Jones: Well said. I'm glad you brought that up. So, to put it a different way, absence of evidence is not an excuse for absence of treatment. Right? Dr Argoff: Exactly. And I think that, I hope that we would agree that especially in neurology, what we do is about as far from, ‘Yep, you've got strep throat, here's that antibiotic that's going to work for you and all you have to do is take the medicine.' I mean, most of what we do is nowhere near that.  Dr Jones: It's complicated stuff. And this is a complicated topic. And I'll tell you, I learned a lot reading your article. I think most of us in neurology and medicine, when we hear the term neuropathic pain, it feels roughly synonymous with peripheral generators of that pain, such as diabetic neuropathy or posttraumatic neuralgia. But as you mentioned, there's central mechanisms for pain generation. How is it defined? What is central neuropathic pain? Dr Argoff: It's defined as pain caused by a lesion or disease of the central somatosensory system . Though neuropathic pain in general is pain associated with the lesion of the somatosensory system; and to your point, that can be peripheral, which of course is outside the spinal cord, or brain or central, which is within the spinal cord or brain. And central neuropathic pain is defined specifically as pain caused by a lesion or disease of the central somatosensory system. That's either brain or spinal cord. But there's an interesting follow-up, and I'm going to ask if you could remind me because I know we're talking about definitions now, but I'll just bring something up and we can come back to it. What's interesting about that is that my - whoever 's listening, that's not to say that they're not connected. And in fact, they are very much connected. And there's very new work, which I included in the article, down at Washington University in Saint Louis, that suggests you can actually affect central neuropathic pain by addressing peripheral input to the central nervous system. If you remember Ken Casey at the University of Michigan at the World Pain Congress in Vancouver, British Columbia many years ago, he ended his talk on pain with a limerick, of which the last line was, Remember, there ain't no such thing as pain without a brain. And so that kind of summarizes that. Dr Jones: Well, and it goes both ways too, right? We know that there's some central sensitization that can happen with peripheral generators, right? So we really have to think about the whole circuit. Dr Argoff: Yes. And that's been sometimes the bane of my existence as a colleague of others and a sometimes debater. Is the pain central? Is it peripheral? Well, it's everything. And it's important to know as many of the mechanisms and many of the targets that you could use for treatment so that you can affect the best outcome for your patients. Dr Jones: Yeah, so - and you mentioned in your article what some of the common causes of central neuropathic pain are. What are the big ones in your experience?  Dr Argoff: So, the biggest ones are spinal cord injury-related pain, MS-related pain - and I'd like to come back to a point and just if I do the third one - and central poststroke pain. And what struck me, I think Tim Vollmer published a survey about the incidence, the prevalence of ongoing pain in patients with multiple sclerosis. And it blew my mind several years ago because it was incredibly high. Like in this survey of MS patients who, you never hear about pain, you hear about these modifying treatments, all the wonderful expanses that have been made. I mean, like seventy something percent of people say they have moderate to severe pain. And when you think about how sensory processing occurs, it makes perfect sense that a demyelinating disorder is going to interrupt the flow of information for a person to feel normal.  Dr Jones: Yeah, I think it's a good example of, there are things that we tend to focus on as clinicians where we worry about deficit and function and capacity. But if we're patient-centered and we ask patients what they care about, pain usually moves up higher on the list. And so, I think that's why we, it's maybe underrecognized with some of those central disorders, right? Dr Argoff: I think so, and I and I think you hit the nail on the head that - and we're also trained that way. I tell this to my patients very often so that they are reassured when I examine them and I say, and I tell them that everything looked pretty OK. It's not a medical term, I understand that. Because what we do in a typical neurological exam, even if it's detailed, doesn't really address all the intricacies of the nervous system. So it's really a big picture and sensory processing and especially picking up sensory deficits; you know, we use quantitative sensory testing and research studies and things like that, but bedside testing may not reveal the subtle changes. And when we don't see overt changes, we often think - that can lead someone to think that everything is OK and it's not. Dr Jones: So, when you when you see a patient who you've diagnosed with a central mechanism, so central neuropathic pain, how do you approach the management of those patients, Dr Argoff? Dr Argoff: I always review what treatments and what approaches have been addressed already. And I see if - a handful of time, we actually just submitted a paper for publication regarding this in a group of patients with pelvic pain who had untreated, difficult-to-treat chronic pelvic pain, seen all the urological kinds, gynecological things. Look, we picked up two patients who had unknown MS. So, it's just interesting when it comes down to that level. And we also picked up some patients who had subacute combined degeneration. So that's another central kind of disorder as well. Again, the neurologist in us says to make sure that we have specific diagnosis that underlies the central neuropathic pain. And so interestingly, of course, for somebody with MS - or even though it's uncommon, it could be more than one. Somebody with MS might have a stroke, somebody with MS might have a cord injury due to cervical, you know, joint disc disease. Not to overcomplicate things. Know the lay of the land, know the conditions, know what you're battling and lay out so that you can treat the treatable; you want to treat whatever you can correct? So, for MS you simply want to have the best disease-modifying treatment on board, tolerable and appropriate for that person, and so on. And then you really want to take a history of past treatments - and your treatments can be everything and anything, including behavioral modification, physical rehabilitative approaches, as well as pharmacologic management. That's - as I think I put in my article, we concentrated in the article on pharmacologic management because honestly, that's what most patients are looking for, is ‘what can we, what can you do to help me now, in addition to what I can do myself.' And that's what we typically think of. There are also some more interventional approaches, invasive options, that have developed over time. And of course, those are the ones, some of them, especially in neuromodulation, that we have the least information about, but it appears somewhat promising.  Dr Jones: No, that's exactly what we need to hear. And you also mentioned something that I think is important. This is a common theme throughout the issue because I think it's true for the management of many different types of pain and interdisciplinary approach. In other words, not just honing in on pharmacotherapy or neuromodulation as a one-size-fits-all magic pill, right? So, that - tell us a little bit more about that interdisciplinary approach and how that's important for these patients. Dr Argoff: So, let me back up and give an example. Let's look at Botox for chronic migraine. So, the pre-M studies that led to the approval of Botox for chronic migraine: two treatment sessions versus two random, two placebo session in different patients. The mean headache frequency was, let's say, fifteen to twenty in each group. It was like seventeen, eighteen, something like that. But the mean pain headache day reduction was somewhere between four and five after two treatments compared to a lesser, a lower number in the placebo group. So, if you think about that, that means that you went from nineteen, let's say, to fourteen, thirteen, or twelve. Want to be generous, eleven or ten. But that means that person, everyone 's happy. We use treatment. We have better data than that because the longer you use it, the better it gets in general, but it means that people are still going to be symptomatic. So that drives home in a different painful disorder the importance of yes, treatment can be effective, but it's not the only treatment that a person is going to likely need. And so, I think that's what's so important about multidisciplinary approach. I- we may affect positive changes, reduction in pain intensity with a particular pharmacologic agent, but we don't anticipate it's like taking an antibiotic or a strep throat, not curative. And so, we want to, early on, to explain that logically, methodically, step by step. There are many options for you and we're going to, you know, systematically go through them. And I may need to call in some colleagues to help because I don't do everything. No one does everything, right? But don't feel as if there isn't any hope because there is. If we were to use intraspinal Baclofen for someone who has painful spasticity following a stroke or a spinal cord injury, combining that with physical therapy might give more effect, maybe synergistic. Some targeted muscles, some local muscles may not respond as well to the intraspinal Baclofen, so is that - what can we do? Well, we could use oral agents or we might be able to target that with botulinum toxin, and so on and so forth. So it's limitless, virtually, in what you can do. Dr Jones: There's kind of setting expectations and letting people know that you, you're going to need a lot of different approaches, right? To sort of get them the best possible outcome. Dr Argoff: Yeah, I think that's so important. And of course, no matter what we try to set out, there are going to be individuals - for those of you who are listening, we all know - who expect to be cured yesterday. That might be challenging for us not only to actually complete, but also, it's challenging for some individuals to appreciate that we're with them, we're going to work with them. It'll be a process, but we've got your back. Dr Jones: Great. And you know, this is a question that I get all the time from patients and from other clinicians is, you know, what about cannabinoids? What's the role of cannabinoids for the management of central neuropathic pain? Dr Argoff: First, I'll say that the short answer to that is we don't know. The second part of my response would be, there is new evidence that it might be helpful in the acute treatment of migraine. And I'm happy to say that the editor of this edition of Continuum is the person who developed that evidence, and it's been recently presented at the American Headache Society. But the challenge and the conundrum that we all face is, everywhere within our nervous system where there's pain being processed, there are endocannabinoid receptors. There also happen to be opioid receptors, but that's a separate issue. And the endocannabinoid system, the peripheral or central, you know, CB1, CB2, is very, very important, but we haven't figured out a way of harnessing that knowledge in developing an analgesic, an effective analgesic. And part of that is that there are so many chemical agents that have cannabinoid properties and there are different… the right balance has not yet been found. But even the legalization, the available of medical cannabis, hasn't led to a standardized approach to evaluating if a preparation does help. And that's part of the conundrum. It's like saying, ‘does medicine work?'Well, yeah, sometimes. But which medicine? Which receptor? How do you harness the right ratio between TBD, THC, other active agents, et cetera? And I think maybe as we go forward in the future, we'll be able to do that with - more precise. I mentioned Dr Schuster's study in which he had defined ratios of THC effect and CBD and was able to clearly show effect based upon that. But the average person going into a dispensary doesn't really get that. We don't get to study that. Each person's an NF1  and it's not very helpful to understand how to do that. I would say, as I'm sure you remember, there was a practice parameter that was published probably over a decade ago about using cannabis symptomatically in different neurological disorders. And I believe that it was what they studied or what they reviewed was helpful in MS-related urinary discomfort and spasticity, but not necessarily pain.  Dr Jones: And we're still in the early days of studying it, right? Dr Argoff: Yes.  Dr Jones: That's part of the point, as we got started late and we're still waiting for high-quality evidence. And I guess, if you look at the horizon, Dr Argoff, or the future of management of central neuropathic pain, what's going to be the next big thing?  Dr Argoff: One of the joys of being asked to get involved in a project like this is that inevitably we learn so many new things because, you know, that's when anyone says, oh, you must be an expert, I say, I don't know anything because I'm always learning something new. One of the reasons why I moved to Albany Medical College about seventeen years ago was to be able to further my interest in studying why people benefit from topical analgesics by working with a scientist at Albany Med who studied keratinocyte neurochemistry and its impact on pain transmission. And that's a separate issue, but it indicates my love for the peripheral nervous system. And one of my thoughts historically, that is, what the central nervous system processes is what it processes and it might get input, as you mentioned earlier, from the peripheral nervous system, so that topical agents could be dampening central mechanisms. And lo and behold, as I was doing research for this article, I learned that people doing peripheral nerve blocks - so blocking peripheral input at the into the spinal cord - at Washington University, Simon Guterian and colleagues, demonstrate that they could give prolonged benefit from central pain by blocking peripheral input. And that's wild because certainly the nervous system is a two-way street. It's an understatement. What I really found amazing was that, again, blocking input helped the injured central nervous system to behave better.  Dr Jones: That is kind of cool to think about. And I'll tell you, as editor of the journal, one of the funnest things is getting to learn all about neurology, including pain and including central neuropathic pain, when in the end you're doing all the work, I just get to sit here and enjoy it. And you're a program director of a pain fellowship. What's the pipeline look like? Are neurologists more interested in pain than they used to be?  Dr Argoff: I'm happy for this. We are seeing more and more applicants from neurology into our pain management programs. I would say… I was going to say tragically. If I say tragically, it's because what specialty better understands how to diagnose, figure out, assess, come to a conclusion? You can't have pain without your brain. It's always amazed me that more neurologists weren't interested, and I understand the background and such. Just like in migraine, it's only advances in understanding mechanisms of migraine that allow neuroscientific advances that are leading to great therapeutics - that's happening and increasing in ‘pain.' Today, as program director, we had our fellowship interviews earlier today and three of the nine applicants that we interviewed were neurologists. Last week, I think we interviewed two or three also. That would not have happened five years ago or six years ago. And if you think about it, we can not only diagnose, quote-unquote figure out what's happening, but we now, with pain management training, we can offer people a variety of both invasive and noninvasive options, all while understanding what we're doing with respect to the nervous system in a way that's different than the other specialties that typically go into pain med. And that's such - for me, it's a beautiful experience and something I really enjoy doing. There isn't a neurological condition in the most part that either doesn't have pain associated with it or doesn't have mechanisms that overlap. If you think about epilepsy, and please don't think I'm crazy, but epilepsy is associated with disinhibited hyper-excitatory behavior, just to put it loosely, among certain neurons. That's what pain and neuropathic pain is about too. And you, in fact, we know that several mechanisms since now what medicines are used for both. But what was interesting since, if I may just go back to another point, one of the advances since I brought up the migraine that's very exciting is the whole story about sodium channels. Dr Harouthounian at WashU and his group used lidocaine injection. Lidocaine's a more generalized sodium channel blocker, but some of the newest treatments for treating neuropathic pain. Our NAV specific sodium channel blocker's trying to match up mechanism to treatment. Not exactly the way that we do with migraine, but still a step forward to not just generally treat but really target different neuronal mechanisms. It's an exciting time.  Dr Jones: So, the pipeline is doing better because we're getting better understanding of disease, and hopefully that pulls in more interest because obviously there are big gaps in caring for patients with pain. And again, thank you, Dr Argoff, for an amazing article. Thank you for joining us and thank you for such a fascinating discussion. I enjoyed the article. I read the article, I learned from our conversation today. So, thank you for joining us to talk about central neuropathic pain. Dr Argoff: Thank you for having me. Dr Jones: Again, we've been speaking with Dr Charles Argoff, author of an article on central neuropathic pain in Continuum 's most recent issue on pain management. Please check it out, and thank you to our listeners for joining today. Dr Monteith: This is Doctor Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at Continpub.com/AudioCME. Thank you for listening to Continuum Audio.

Send us a Text Message (please include your email so we can respond!)We are LIVE at CHEST2024! Thank you to the organizers of the conference for inviting us do a live show and thank you to everyone who came out to listen! We talk about a few articles that were recently published in CHEST - "Prophylactic Minocycline for Delirium in Critically Ill Patients: A Randomized Controlled Trial" published by Dal-Pizzol et al and then "Comparative Effectiveness of Amiodarone and Lidocaine for the Treatment of In-Hospital Cardiac Arrest" by Wagner et al.We then touch briefly on some articles being presented later at the conference which we might cover soon (stay tuned)!Minocycline for Delirium (pubmed): https://pubmed.ncbi.nlm.nih.gov/38043911/Minocycline for Delirium (CHEST): https://journal.chestnet.org/article/S0012-3692(23)05833-6/abstractAmio vs Lido (pubmed): https://pubmed.ncbi.nlm.nih.gov/36332663/Amio vs lido (CHEST): https://journal.chestnet.org/article/S0012-3692(22)04039-9/abstractIf you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Welcome back to the St. Emlyn's podcast. This episode covers some of the most important developments in emergency medicine and critical care from July 2024. Whether you're practicing on the frontlines or keeping up with the latest research, this episode has something for you. From coronary risk scoring tools to cutting-edge AI in ECG interpretation, and the management of non-fatal strangulation, it's packed with insightful updates. Here's a breakdown of the key topics: The Manchester Acute Coronary Score (MACS Rule) is a valuable tool for risk-stratifying patients presenting with chest pain in the emergency department (ED). MACS uses both clinical characteristics and biomarkers like troponin to assess a patient's likelihood of experiencing an acute coronary event. A recent systematic review found that the T-MACS model (which uses troponin) has a sensitivity of 96%, making it highly effective at ruling out serious coronary events. Though the specificity is lower, MACS's real strength lies in its ability to drive clinical decisions and patient referrals. This tool is already integrated into the Electronic Patient Record (EPR) in Manchester, where it helps streamline the decision-making process for patients with chest pain. If you're looking for a reliable method to quickly and accurately stratify risk, MACS could be the answer. Artificial intelligence (AI) is revolutionizing healthcare, and its application in ECG interpretation is particularly exciting for emergency medicine. In this episode, Steve Smith joins us to talk about how AI can enhance the detection of occlusive myocardial infarction (OMI)—a concept that might one day replace the traditional ST-elevation and non-ST-elevation classifications. By integrating AI into rapid assessment areas (like pit-stop zones in the ED), clinicians can benefit from real-time ECG analysis. This reduces the burden of interruptions and helps detect subtle abnormalities that might be missed in high-pressure environments. AI-driven ECG tools could dramatically improve patient outcomes, particularly in cases of high-risk cardiac events. Non-fatal strangulation (NFS) is an often underdiagnosed condition in emergency medicine, but it carries significant risks, including carotid artery dissection. A new guideline from the Faculty of Forensic and Legal Medicine emphasizes the importance of detecting these cases and suggests that clinicians use contrast angiography to rule out vascular injuries. Beyond the medical consequences, non-fatal strangulation is also a major indicator of future violence, including homicide. The guideline highlights the ethical challenges clinicians face when deciding whether to involve law enforcement, especially when patient consent is lacking. Safeguarding and appropriate referrals are essential for these high-risk patients. REBOA has been evolving in recent years, and now it's moving from the emergency department into the pre-hospital setting. In the latest advancements, partial REBOA—which allows for some blood flow below the balloon—is being used to resuscitate patients in traumatic cardiac arrest. This partial occlusion technique may be more effective in maintaining coronary perfusion, essentially resuscitating the heart in cases of extreme hemorrhage. Early data from a feasibility study shows promise, with an 18% survival rate in patients who otherwise would have had little chance of survival. REBOA could become a life-saving pre-hospital intervention for trauma patients in the near future. Paediatric eating disorders, particularly anorexia and diabulimia, remain under-recognized in emergency medicine. In this episode, we explore some of the red flags—such as rapid weight loss, bradycardia, and postural hypotension—and why emergency clinicians need to be more attuned to the signs of eating disorders. Of all mental health disorders, anorexia has the highest mortality rate, and in cases of diabulimia, patients intentionally stop taking insulin to induce ketosis and lose weight. Given the severity of these conditions, it's crucial that we recognize them early and respond appropriately, especially when young diabetic patients present with unusual symptoms. The advent of hybrid closed-loop insulin pumps is transforming the care of type 1 diabetes. These pumps act as an artificial pancreas, continuously monitoring blood glucose levels and adjusting insulin delivery automatically. The latest guidelines from NICE recommend these devices for all patients with type 1 diabetes in the UK. However, these pumps come with their own set of challenges, especially in the emergency department, where clinicians need to know how to troubleshoot common problems, such as cannula blockages or starvation ketosis. In this episode, Nicola Trevelyan walks us through the essential steps for managing patients who use these devices. Lidocaine patches have long been used as a low-risk intervention for managing pain in elderly patients with rib fractures, particularly when nerve blocks or NSAIDs aren't viable options. But how effective are they? A recent feasibility study compared lidocaine patches with standard care and found that while the pulmonary complication rate remains high, the patches may offer some benefit for pain relief. While more research is needed, lidocaine patches continue to be a low-harm option that might provide relief in certain patient populations, particularly where other pain management strategies are contraindicated. Button battery ingestion remains one of the most dangerous emergencies in pediatric medicine. Francesca Stedman, a pediatric surgeon, explains the dangers of battery-induced burns, which can occur within hours of ingestion. Time is of the essence in these cases, and quick identification through radiographic imaging followed by rapid removal is critical to prevent long-term damage. Even when batteries are lodged in places like the nose, they can cause significant tissue damage in a short time, making early intervention absolutely vital. That's a wrap for our July 2024 podcast update! From life-saving interventions like REBOA and AI in ECG analysis to the everyday challenges of managing pediatric emergencies and coronary risk, this month's highlights offer a wealth of knowledge for clinicians. Be sure to check out the full blog posts and podcasts for more in-depth discussions on each of these topics. Thanks for listening and stay tuned for more cutting-edge insights from St. Emlyn's!

In 1992, 23-year-old Michael Hunter was found deceased in his northwest Raleigh apartment. When police take a closer look, they realize a lethal injection of Lidocaine caused his death, and his roommate, medical student Joseph Mannino, admits to injecting him with antihistamines to ease migraine symptoms. But the investigation reveals a motive for murder within a contentious love triangle. We also take a look at the hit-and-run death of Ruth Buchanan in 1989 and how the Charlotte-Mecklenburg Police recently solved it. Renee's Digital Course on Podcasting: https://www.wow-womenonwriting.com/classroom/ReneeRoberson_Podcasting.php Skincare by SkinxErin: https://shopxerin.com/collections/fit-rocker-chick-skin Use code MISSINGCAROLINAS10 for 10 percent off your order

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest. If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm. If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm. An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered. We will follow the algorithm until the patient has ROSC or we call the code.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!Other Pass ACLS episodes mentionedObjective Measures of Good CPR https://passacls.com/bls/objective-measures-of-good-cpr

On this episode of the Real Life Pharmacology podcast, I continue my coverage with the Top 200 Drugs Podcast. Here's the list of medications we will cover. Lorazepam (Ativan) is a benzodiazepine well known for its anxiolytic and anti-seizure properties. Phenazopyridine (Pyridium) is a urinary analgesic that can change the color of the urine to a reddish/orange color as one of its adverse effects. Hydroxychloroquine (Plaquenil) is a DMARD used in rheumatoid arthritis and Lupus. One highly testable and unique nugget to remember is that it can cause retinopathy. Lidocaine patch (Lidoderm) is used topically to help with various types of pain including neuropathy and postherpetic neuralgia. Diclofenac (Cataflam) is an NSAID used as an analgesic and anti-inflammatory. It can increase the risk of GI bleed, edema, renal failure, and thrombosis.

Events of the day leads to thoughts of events of the past – with a little Lidocaine thrown in for good measure.

With the handful of local anesthetics at our fingertips, we seem to reach for Lidocaine and Articaine the most. Is one of these better than the other?  Tom Viola answers this fast fact! Be sure to check out what Tom Viola is up to by visiting Tomviola.com or email him - Tom@Tomviola.com

Join us as we review recent practice-changing articles on E-cigarettes for smoking cessation, Gabapentin and COPD exacerbations, lidocaine patches for mechanical neck pain, Cdiff risk by antibiotic type, and “dosing by clicks” for GLP1 agonists. Fill your brain hole with a delicious stack of hotcakes! Featuring Paul Williams (@PaulNWilliamz), Rahul Ganatra (@rbganatra), and Matt Watto (@doctorwatto). Claim CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Rahul Ganatra MD, MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Rahul Ganatra MD, MPH Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Introduction and disclaimer E-cigarettes for smoking cessation Gabapentinoids and COPD exacerbations Topical lidocaine for neck pain Association between specific antibiotics and C. diff infection Shortage of GLP-1 agonists and “dosing by clicks” Sponsor: Locumstory Tune in to The Locumstory Podcast on Spotify, Apple, or Google podcasts. Sponsor: Freed  You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month.