Steroids in Sepsis - ADRENAL and APROCCHSS Included in New Review

Steroids in Sepsis - ADRENAL and APROCCHSS Included in New Review

This rapid review by BMJ included ADRENAL and APROCCHSS along with 40 other RCTs and made a weak recommendation to use corticosteroids (CCS) for patients with sepsis. You’ll want to pull up the free full text with some great infographics.

Inhaled Tranexamic Acid for Hemoptysis?

Inhaled Tranexamic Acid for Hemoptysis?

For patients with hemoptysis, inhaled tranexamic acid was associated with significantly reduced expectorated blood volume, hospital length of stay, need for invasive interventions, and hemoptysis recurrence rate at one year.

#ThisIsOurLane - Physicians and Gun Violence

#ThisIsOurLane - Physicians and Gun Violence

The physician response to an incendiary tweet by the NRA last week has been striking. It has led to the hashtag #ThisIsOurLane, as the NRA admonished physicians to “stay in their lane” regarding gun policy. This is a review of the position statement by the American College of Physicians on reducing firearm deaths and injuries that sparked it all.

Does This Patient Have Pertussis? Bedside Clues to Diagnosis

Does This Patient Have Pertussis? Bedside Clues to Diagnosis

Adults with cough <3weeks or 3-8 weeks with post-tussive vomiting or whooping should be treated for pertussis; those with fever or without paroxysmal cough should be considered to have an alternate diagnosis. Children with <4 weeks of cough and post-tussive vomiting may have pertussis, but it was much less clear than in adults.

Do We Write Antibiotic Rx Because It's Just Easier?

Do We Write Antibiotic Rx Because It's Just Easier?

It took an extra 67 seconds when not prescribing an antibiotic to patients with acute respiratory infection compared to visits in which an antibiotic was prescribed.

Dealing With the ESBL Threat - Extended Spectrum β-lactamase Enterobacteriaceae

Dealing With the ESBL Threat - Extended Spectrum β-lactamase Enterobacteriaceae

Highly resistant, extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae in the urine are becoming increasingly common in unexpected patients in the ED.

Vancomycin/Piperacillin-Tazobactam and AKI

Vancomycin/Piperacillin-Tazobactam and AKI

The combination of vancomycin plus piperacillin-tazobactam (VPT) was associated with increased risk of acute kidney injury (AKI) compared to either drug as monotherapy or other vancomycin - β-lactam combinations, NNH = 11.

Predicting Severe Alcohol Withdrawal

Predicting Severe Alcohol Withdrawal

Individual risk factors associated with the development of severe alcohol withdrawal syndrome (SAWS) included a history of delirium tremens and baseline BP ≥ 140mmHg but no individual symptoms or signs associated with exclusion of SAWS. Composite measures fared better, such as the Prediction of Alcohol Withdrawal Severity Scale; a score ≥ 4 had a LR of 174 (95% CI 43-696).

Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage

Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage

The table below summarizes the recommendations for adult patients on anti-thrombotic agents with intracranial hemorrhage (both spontaneous and traumatic). This will be focused on ED management.

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