July 2017
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Jul 31 2017
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.
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Jul 29 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.
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Jul 28 2017
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.
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Jul 27 2017
Angioedema – Icatibant Rant
Icatibant did not improve outcome compared to placebo for ACE-I associated angioedema.
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Jul 26 2017
Nebulized Hot Salts – What Could Possibly Go Wrong?
Hypertonic saline nebulized treatments did not reduce hospitalization in children with bronchiolitis in this large RCT.
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Jul 25 2017
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.
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Jul 24 2017
FAST Exam Useless in Stable Kids
FAST exam didn't have an impact on the care of stable children with torso trauma.
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Jul 22 2017
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.
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Jul 21 2017
Prehospital Vent Management Matters
Prehopital ARDSnet ventilation strategies appear to reduce mortality, ICU length of stay, and days on the ventilator.
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Jul 20 2017
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.