EMplify - April 2021

Announcements

Traumatic Hemorrhage in the ED- with Dr Scott Weingart - April 13th, 8pm EST Free ! Register now: https://www.crowdcast.io/e/traumatic-hemorrhagic/register

Pandemic Preparedness publication is coming soon.

Mt Sinai COVID-19 Treatment Protocols have been updated and are available for free here: https://www.ebmedicine.net/topics/COVID-19/Protocols

The Clinical Decision Making in the Emergency Department conference is June 23-27 live and virtual. More information here: https://clinicaldecisionmaking.com

 

Management of Suspected Rabies Exposure in the Emergency Department - An Interview with Dr. Bess Storch

Epidemiology:

Fatality rate of over 99%

Half of cases occur in children

95% of cases are in resource limited countries, 35% in India

99% caused by infected dogs (worldwide)

In the US, cases are predominantly bat variant

Why this topic?

"In a recent survey of licensed physicians, less than half could identify rabies transmission routes, the correct PEP schedule, and the correct anatomic administration sites."

Pathophysiology:

What causes it? The RNA virus Lyssavirus

How is it transmitted?

How does it reach the brain?

ED Evaluation:

What does it look like clinically?

5 stages- incubation, prodrome, acute neurologic phase, coma death

Why doesn’t everyone just get vaccinated?

What patient medical history is important ? Steroids, chloroquine

What animals are high risk?

What about pets and quarantine?

What about rodents ?

Is there any role for labs or imaging ?

What is the treatment regimen for those who are unvaccinated? And vaccinated?

What about people who are immunosuppressed?

Children?

Pregnant?

Recently traveled?