August 2017
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Aug 19 2017
Alteplase for Submassive PE
This early study of thrombolytics plus heparin for submassive PE showed no mortality benefit but did show a decrease in need for escalation of care compared with heparin alone. Subsequent studies call lytics for submassive PE into question, so take the current evidence into account.
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Aug 18 2017
Just Put the Clavicle in a Sling – Not Any More
More patients are having operative repair for displaced midshaft clavicle fractures. This meta-analysis of 6 RCTs found that the rate of nonunion was markedly reduced and final functional outcome was also improved (though not as strikingly) with operative management.
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Aug 17 2017
Ejection Fraction with an iPhone
Noninvasive measurement of ejection fraction with an iPhone app is possible and very accurate. When this becomes publicly available, it will be a game changer.
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Aug 16 2017
No Mag for You, Baby
Don't use IV magnesium for bronchiolitis. It doesn't work, and it may cause harm.
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Aug 15 2017
ED Oversedation May Cause ICU Harm
Excessive sedation of intubated adult patients in the ED was associated with increased in-hospital mortality. Aim for a RASS > -3.
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Aug 14 2017
Diarrhea Only – C. difficile
In a largely adult population, those presenting to the ED with diarrhea only and no vomiting had C. difficile colitis as the cause in 10%, and almost 40% lacked risk factors.
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Aug 12 2017
Why We Use Low Tidal Volume for Acute Lung Injury
Low tidal volume ventilation reduced mortality in patients with acute lung injury. If you want to learn more, see this post on Managing the Vent Like a Pro.
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Aug 11 2017
Coffee Could Save Your Life – New Evidence
Not only is coffee not bad for you, it could save your life! This study of over half a million people in 10 European countries found coffee consumption was associated with decreased overall mortality in men and women.
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Aug 10 2017
Ap-Ox Works – New Meta-analyses
Blasting nasal cannula oxygen (apneic oxygenation) during endotracheal intubation of ED patients led to higher O2 saturation, decreased episodes of desaturation, and improved first-pass success.
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Aug 09 2017
Sentinel Bleeds Are Bad Right?
Prior studies have shown that sentinel bleeds lead to worse outcomes if missed and subsequent aneurysmal subarachnoid hemorrhage (SAH) occurs, but this Kaiser Permanente case-control study suggests this may be a myth.