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Emergency Medicine Cases
EM Quick Hits 58 – HIV PEP and PrEP, PREOXI Trial, Blast Crisis, Nitrous Oxide Poisoning, Vasopressors in Trauma
Jul 30, 2024
Andrew Petrosoniak discusses the complexities of using vasopressors in trauma resuscitation. Megan Landes talks about implementing HIV PEP and PrEP in emergency settings, tackling challenges and risk assessments. Justin Morgenstern and George Kovacs delve into the PREOXI trial, shedding light on innovative pre-oxygenation techniques. Brit Long focuses on blast crisis management in leukemia patients, while Leah Flanagan and Liam Loughrey address the rising concerns of nitrous oxide toxicity in recreational users. A blend of critical insights awaits!
01:11:42
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Quick takeaways
- Understanding the importance of timely initiation of HIV PEP within 72 hours can significantly reduce transmission risks after exposure.
- HIV transmission risk varies by exposure type, necessitating careful evaluation of source risks before administering PEP in emergency settings.
Deep dives
Understanding HIV Post-Exposure Prophylaxis (PEP)
Post-Exposure Prophylaxis (PEP) is an effective method to reduce the risk of HIV transmission after potential exposure. It must be initiated within 72 hours of exposure and typically consists of a 28-day course of antiretroviral therapy (ART), which can decrease the likelihood of infection by up to 80%. The risk from a single exposure can be quantified; for instance, percutaneous exposure to HIV-positive blood has a transmission risk reduced to 0.3%, while mucocutaneous exposure is lowered to 0.09%. Understanding PEP's significance and prompt administration is crucial for emergency department practitioners.
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