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.

Do Antiarrhythmic Drugs Help In Cardiac Arrest?

Do Antiarrhythmic Drugs Help In Cardiac Arrest?

When considering 14 RCTs on use of antiarrhythmic drugs for shockable cardiac arrest, there was no benefit for survival to discharge or survival with good neurological outcome. Lidocaine improved ROSC vs placebo.

Initial Parenteral then Oral Antibiotic vs Oral Alone in Pediatric UTI

Initial Parenteral then Oral Antibiotic vs Oral Alone in Pediatric UTI

There was no reduction in children 29 days - 2 months in 72-hour repeat ED visit with subsequent admission for those given a single parenteral dose of antibiotic in the ED and then outpatient oral treatment vs simply starting on oral therapy.

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