Ultrasound or CT for Nephrolithiasis
An ultrasound-first strategy, especially for recurrent kidney stones, was a good way to reduce radiation exposure in patients presenting to the ED with renal colic.
December 2017
Sudden Cardiac Arrest in Athletes – Can We Prevent It?
Sudden cardiac arrest (SCA) is very rare during sports activities 0.76/100,000. They found only 3 cases that could have been identified by a sports physical prior to competition. NNT = 146,000.
Hold the Z-Pak for Pediatric Pneumonia
Young children with community acquired pneumonia seemed to do fine with a beta-lactam antibiotic only and didn’t appear to benefit from adding a macrolide.
What’s Faster Than CCTA? You Are
This retrospective dredge of the ROMICAT-II trial found that clinical evaluation alone had decreased length of stay (LOS) and appeared to be just as safe with respect to major adverse coronary events as those who had non-invasive testing, with lower cost and radiation exposure.
130/80 Is Hypertension? Our Take on New HTN Guidelines
The AHA has published new guidelines replacing the JNC guidelines for management of hypertension. Here is what you need to know.
When Is ED Thoracotomy Futile
Patients who had blunt trauma with CPR > 10 minutes, penetrating trauma with CPR > 15 minutes, or asystole without tamponade should not undergo resuscitative thoracotomy in the ED as it would be futile.
Ectopic Pregnancy Myths Addressed
Several myths surround the diagnosis of ectopic pregnancy. This review debunks them.
Pan-CT for Trauma – More Evidence Against
This retrospective study echoes REACT-2: pan-scan is low yield. The proportion of patients with clinically significant injury (CSI) involving at least 2 simultaneous body regions – head/neck| chest| abdomen/pelvis was 1 to 3%; 0.6% had CSI simultaneously in all 3 regions.
Any Troponin Is a Bad Troponin
Among patients with no alternative medical explanation, a measurable yet stable high sensitivity troponin (hsTn-T) was a prognosticator for mortality, MI, and hospitalization for heart failure.
How to Tell VT From SVT with Aberrancy – Mattu, Brady, Tabas, Ferguson Teach Us
The differential of wide complex tachycardia (WCT) includes ventricular tachycardia (VT) and supraventricular tachycardia with aberrant conduction (SVT-AC). The summary below provides some tips for differentiating the two. However, if you are unsure it is always prudent to assume VT until proven otherwise.