MRI Misses Stroke
False negative DWI MRI imaging happened in about 7% of cases. If you strongly suspect ischemic stroke clinically, especially posterior stroke, press to admit for further workup.
July 2017
Why We Use the PERC Rule
The PERC rule is a powerful diagnostic tool. If you determine a patient has low clinical gestalt for PE and all 8 PERC criteria are negative, then PE has been ruled out without checking a D-dimer or CT.
How A 5-Sentence NEJM Letter Caused the Opioid Epidemic
A 5 sentence letter to the NEJM editor in 1980 has been cited over 600 times to support opiate prescribing, which was not even the point of the original letter. We bought the line that opiates for legitimate pain were not addictive and didn’t consider the source.
Angioedema – Icatibant Rant
Icatibant did not improve outcome compared to placebo for ACE-I associated angioedema.
Nebulized Hot Salts – What Could Possibly Go Wrong?
Hypertonic saline nebulized treatments did not reduce hospitalization in children with bronchiolitis in this large RCT.
Antibiotics as Weapons of Mass Destruction
Adverse effects from antibiotics are very common, up to 20% of the time in hospitalized patients. Only use them when needed.
FAST Exam Useless in Stable Kids
FAST exam didn’t have an impact on the care of stable children with torso trauma.
Why Non-invasive Ventilation in CHF Saves Lives
Non-invasive ventilation makes a big impact on patients with acute pulmonary edema – fewer need intubation, and it may reduce mortality.
Prehospital Vent Management Matters
Prehopital ARDSnet ventilation strategies appear to reduce mortality, ICU length of stay, and days on the ventilator.
Two Tests to Rule Out PE? Nope
Patients with a “PE likely” pretest probability may be considered ruled out for PE after negative CTPA with no additional testing, assuming the same (or lower) prevalence of PE in your setting.