November 2017
-
Nov 18 2017
Canadian C-spine Rule for Clinical Clearance
The Canadian C-spine rule has high sensitivity for c-spine injury and higher specificity than the NEXUS rule. It allows clinical clearance of more people.
-
Nov 17 2017
Myth – MRI the Back and They Won’t Return to the ED
Getting an MRI for back pain does not reduce recurrent patient visits within a week. The only time we should get an MRI for back pain in the ED is if there is a clinical concern that the findings may prompt emergent surgery, such as for cauda equina, epidural abscess, or impinging mass (may need radiation), etc.
-
Nov 16 2017
Capnography Flatline Beats Gestalt for Paralysis in RSI
Using loss of wave capnography rather than gestalt assessment of relaxation after paralytic administration for RSI in the ED led to shorter time to intubation and increased first-pass success.
-
Nov 15 2017
Morphine Harmful in CHF
Morphine was associated with worse short-term mortality all other known variables being equal: 20% vs. 12.7%.
-
Nov 14 2017
D-Dimer for Excluding the Diagnosis of PE
In this systematic review, the D-Dimer was 100% sensitive in low risk Geneva (0-3), intermediate-risk Geneva (4-10), and Wells non-high risk (≤4) for detecting PE. Specificity dropped (more false-positives) as age increased in the Wells non-high risk patients.
-
Nov 13 2017
She’s My Surgeon – Female vs. Male Surgical Outcomes
Female surgeons had small but significantly improved 30-day mortality and other surgical outcomes over male surgeons, all other factors being equal.
-
Nov 11 2017
CRASH-2 Tranexamic Acid in Trauma
Tranexamic acid (TXA) decreased mortality from bleeding in trauma patients. But there are a few caveats to note.
-
Nov 10 2017
TMP-SMX Better For Abscesses Across the Board
Dermatology, Emergency Medicine, Infectious Disease, Pediatric Emergency, Pharmacy/Pharmacology, Retail/Urgent CareWe can't draw firm conclusions from this paper, since it was not designed or powered to detect differences in subgroups with skin abscesses. But it was notable that patients who received TMP/SMX did better than those who received placebo across all subgroups, including those with larger abscesses; especially those with fever, history of MRSA, or MRSA positive culture.
-
Nov 09 2017
Cool! Ice Therapy to Reduce Pain from Laceration Repair
Applying an ice cube (inside a sterile glove) to the skin over a laceration for 2 minutes significantly reduced pain from local anesthetic injection.
-
Nov 08 2017
Ibutilide for A-fib in Real World Practice
Ibutilide worked to chemically cardiovert rapid atrial fibrillation in just over half of cases but was associated with the feared complication, ventricular tachycardia, in 2 patients (0.6%).