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?
Last Updated on January 25, 2023
Sam Ashoo, MD, FACEP, is board certified in emergency medicine and clinical informatics. He serves as EB Medicine’s editor-in-chief of interactive clinical pathways and FOAMEd blog, and host of EB Medicine’s EMplify podcast. Follow him below for more…
