June 2016

Short Attention Span Summary Ingredients and dose matter in oral contraceptives.  Lower dose estrogen –  20 vs. 30-40 micrograms  – was safer, with lower risk for PE, stroke, and MI.  Regarding the progestogen, desogestrel and gestodene, compared to levonorgestrel, were associated with ~2x the risk of PE but not stroke or MI.  Why does this matter?  The […]

Short Attention Span Summary Is it ever beneficial to do CPR longer than 10 minutes, as survival theoretically drops 10% per minute?  In this Danish study, an amazing 14% with CPR > 25 minutes survived at 30 days (18/19 able to live at home vs. nursing home). FOAM Report So it turns out we are […]

Short Attention Span Summary Tourniquets can save lives but could cause injury if not used appropriately.  In this retrospective review of civilian use of tourniquets, 56% were placed but no vascular injury ultimately identified.  Of tourniquets ultimately found to be unnecessary, authors concluded that no complications arose from tourniquet use. FOAM Report Twitter Abstract Prehosp […]

Short Attention Span Summary Detergent packets are dangerous when kids munch them.  And the number of exposures is increasing.  I would like to advocate for making the pods less eye appealing to kids.  If it was packed to look like a piece of broccoli, exposures would stop overnight.  In all seriousness, they look like candy […]

Short Attention Span Summary In neonates 28 days and under, rates of serious bacterial infection (SBI) were the same (11-15%) regardless of whether the patient was RSV + or not.  Don’t be reassured by a febrile neonate with a positive RSV test. FOAM Report LITFL MD Linx Abstract Pediatr Emerg Care. 2016 May;32(5):286-9. doi: 10.1097/PEC.0000000000000799. […]

Short Attention Span Summary If you are a little cray-cray before your concussion, you complain of symptoms longer than if you’re not.  Pre-injury somatization symptom score was the best predictor of post-concussive symptom duration. FOAM Report Twitter Facebook Med Page Today Abstract Neurology. 2016 May 17;86(20):1856-63. doi: 10.1212/WNL.0000000000002679. Epub 2016 Apr 20. Preinjury somatization symptoms […]

Short Attention Span Summary In this meta-analysis focusing on time since TIA, early use of aspirin after TIA reduced the incidence of recurrent stroke at 6 weeks by 60%, NNT = 72.  The hazard ratio for those receiving aspirin vs control from 0-2 weeks was 0.07, NNT = 269.  This is a dramatically reduced risk. […]

Short Attention Span Summary It makes sense that patients on antiplatelet agents with spontaneous ICH would benefit from transfusion of new, sticky platelets.  But this multicenter study found that it increased the odds of death or dependence at 3 months by 105% (Odds ratio 2.05).  And more in the transfusion group died while still in […]

Short Attention Span Summary Have you ever heard of C. difficile associated reactive arthritis in pediatric patients?  Me neither!  So I thought we could learn something with this article.  After C. difficile infection, a reactive arthritis may occur that can mimic septic arthritis.  Make sure to ask about preceding antibiotics and diarrhea in your next pediatric patient with […]

Short Attention Span Summary Single dose dexamethasone 0.3mg/kg, up to 12mg, was not inferior to multiple dose prednisolone in pediatric asthma exacerbation.  Fewer dex kids vomited, and more dex kids had additional steroids prescribed.  I covered this article last year. FOAM Report Emergency Medicine Cases First10EM PEM Playbook emeddoc Abstract Ann Emerg Med. 2016 May;67(5):593-601.e3. doi: […]