1. Our ED Pyxis doesn’t house a 4g bag of MgSO4. Ordering it from pharmacy delays treatment. Can I use the 2g bags? 

All pilot EDs have confirmed availability of the 2 gram bags of MgSO4 in the ED pyxis. Ordering 2 grams to be given twice consecutively (give 2 grams MgSO4 every 30 minutes x 2, run time 30 minutes each) or ordering 2 grams initially and then with a follow up 2 grams order after reassessment, are two strategies that may be effective.


2. How does RISTRA-AF work with multiple physicians caring for the same patient, either as a hand-off to an ED colleague or when working with an EM resident?

If you are using RISTRA-AF and have made it as far as the Modules screen, then sign the patient off to another emergency physician (or to a hospitalist who has RISTRA access), when they enter RISTRA-AF for this patient, the app will open at the Modules screen, and all of your data entry on the Patient and CHA2DS2-VASc screens will be preserved (though still editable, if needed). This saves the second doc from having to re-enter patient data and lets them get right to the clinical decision support of the Modules screen. This feature is handy too when an emergency medicine resident sees your AFF patient first and engages RISTRA-AF before you do.