Is There Such Thing as a Black Cloud?

Is There Such Thing as a Black Cloud?

There is no such thing as a "black cloud."  Those who self-identified as a black-cloud were also identified as such by their peers, but a look at the actual PED metrics showed no statistical difference except higher admission rate.  I'm not sure I believe this, but there you go...

Canadian CT Head Rule to Reduce CT Use

Canadian CT Head Rule to Reduce CT Use

The Canadian CT Head Rule was 100% sensitive for ruling out clinically important brain injury.  It had higher specificity than the New Orleans Criteria, which meant fewer people would need a CT scan by using the Canadian rule.

No Cruising? No Bruising - Outcome of Bruising in Premobile Infants

No Cruising? No Bruising - Outcome of Bruising in Premobile Infants

Bruising in premobile children means trouble.  The most important take home is: "More than half of premobile infants with initially unexplained bruises were found to be abused."  Bruising before they're cruising needs a workup and DCS referral.

Testicular Torsion Salvage at 24 Hours?

Testicular Torsion Salvage at 24 Hours?

Consider testicular torsion a surgical emergency even if it is past the usual 6-8 hour mark, which is traditionally taught as the outer limit of testicular viability.  This study found that the testicle could still be salvaged over half the time from 13-24 hours from onset.

Ultrasound For Abscess in Children - The MRSA Era

Ultrasound For Abscess in Children - The MRSA Era

Sonographically occult perineal abscess in children was surprisingly common, 28% (61/217).  More than half had I&D within 4 hours of a "negative" radiology-obtained ultrasound.  Symptoms < 4 days, age < 4 years, and history of MRSA were all associated with false negative ultrasound.

Ketamine and Long-term Behavioral Change in Children

Ketamine and Long-term Behavioral Change in Children

After using ketamine for pediatric procedural sedation, 22% of children experienced negative behavioral symptoms measured 1-2 weeks after ED discharge. The most common symptoms were apathy/withdrawal and separation anxiety. Pre-procedural anxiety was the greatest predictor of negative behavioral changes.

Treatment of Massive PE in Pregnancy

Treatment of Massive PE in Pregnancy

Treatment with lytics for acute PE (mostly massive or with arrest) in pregnancy out to 6 weeks postpartum was associated with 94% overall maternal survival and 88% fetal survival.  Major bleeding occurred in 17% of pregnant women and 58% of those in the postpartum period.

How Aortic Dissection Presents

How Aortic Dissection Presents

Sudden-onset, severe ("worst-ever"), sharp chest pain was the hallmark type A and B aortic dissection.  Ripping or tearing pain was present in only half of patients.  Classic features of aortic regurgitation murmur and pulse deficit were frequently lacking.

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