Biomarker for Pneumonia
Procalcitonin predicted the risk for subsequent intubation or pressors in adults with community-acquired pneumonia.
November 2016
Surgery or antibiotics for appendicitis
Surgery is a definitive treatment for appendicitis with a low complication and failure rate. Medical therapy is an option, though >25% of patients will eventually need surgery.
Basilar Skull Fracture in Kids – PECARN
If a child has exam findings concerning for basilar skull fracture, do a head CT. If they have isolated BSF and a completely normal neurological exam after a period of ED observation, they have a low risk of adverse outcome and could be considered for discharge.
Why We Delay Volume Expansion in Penetrating Trauma
Patients with penetrating torso trauma do better when volume expansion is delayed until the time of definitive operative repair, rather than trying to give immediate prehospital volume to normalize BP.
Narcan take-home pack
Two-thirds of opiate abusing patients were willing to accept take-home naloxone. This could save lives.
Best knock-down for agitated patients
Midazolam 5 mg/droperidol 5 mg IV was better and faster onset than droperidol 10 mg IV and olanzapine 10 mg IV for agitation.
It’s Scribe Time
Scribes made ED doctors happier and slightly increased patients seen per hour and RVUs generated.
Fluid cocktails and contrast nephropathy
IV fluids with NS + bicarb or NS + NAC or plain NS did not prevent contrast nephropathy in patients getting CTPA.
One or four-view POCUS for PTX
Single view POCUS was just as good as 4-view in detecting clinically significant PTX.
Why We Use Low Tidal Volume for ARDS
This landmark article changed the way we ventilate patients with acute lung injury – now using low tidal volumes.