CT and Discharge Abdominal Stab Wounds?
Nine percent of patients with negative CT for anterior abdominal stab wound (AASW) subsequently required surgery. Negative CT for AASW was inadequate to consider patients safe for immediate discharge.
February 2018
Infant HSV Occurs Much Later Than We Thought
HSV was rare in infants under 60 days, <1%. However, 9% occurred in weeks 5-6 and 11% in weeks 7-9, which was a much later onset than previously thought.
New 2018 AHA Stroke Guidelines
The AHA released new 2018 guidelines, which are summarized for Emergency Physicians here. The new guidelines are great, but at 345 pages in length you may want to read the short version.
UA – Can You Trust It Under 60-Days?
Sensitivity for UA with any leukocyte esterase, nitrite, or >5 WBCs/hpf was 94% for UTI growing >50,000 colony forming units (CFU).
Post-op Rx for Opiates and Subsequent Abuse
Total duration of opioid use was the strongest predictor of misuse. Each refill and additional week of opioid use increased the hazard of misuse by 44% and 19.9% respectively. Shorter prescriptions (<2 weeks) of high vs low dosage prescriptions had a lower hazard.
Opioid Use Among Pediatric Patients After Surgery
In opioid naïve patients 13-21 years of age, persistent opioid use was found in 4.8% of the post-surgical group vs 0.1% of those in the non-surgical group. Procedures associated with the highest risk of persistent opioid use were cholecystectomy and colectomy. Independent risk factors included older age, female sex, diagnoses of substance use disorder and chronic pain.
No Spine Immobilization in Penetrating Trauma per EAST
EAST concluded spine immobilization in penetrating trauma is unnecessary and associated with an increase in mortality.
2000 Flu Viruses Shed Each Hour By Breathing
Influenza particles are released simply by breathing. That means, a person does not have to cough or sneeze to spread the flu – just breathing will do it. This has infection control implications.
Dear CMS – Saying No Doesn’t Make Me a Bad Doctor
This may come as a shock, but when you tell patients no, it negatively impacts patient satisfaction. But that doesn’t make you a bad doctor, regardless of what CMS says.
Rhinovirus on RVP – What Does It Mean?
Don’t be falsely reassured if rhinovirus on a PCR viral panel is positive. The incidence of UTI was unchanged if </= 90 days, and the incidence of invasive bacterial infection (IBI) was no different </= 28 days. However, it may prove useful for risk stratifying infants for IBI in the 29 to 90-day age group.