New PE Guidelines From ACEP
ACEP has taken a stand on some of the most contemporary issues within the diagnosis and management of venous thromboembolic disease in the emergency department.
May 2018
Influenza Kills – A Sobering Reminder
Influenza killed 675 children from the 2010-11 flu season to the 2015-16 season. Infants under 6 months had the highest incidence of mortality. Encourage everyone to get vaccinated. Antiviral treatment is encouraged in all children under 2, all patients with severe illness, and all hospitalized patients regardless of whether or not the duration of illness exceeds 48 hours.
You’re Not Crazy – Psychiatric Care Needs Are Up
Volume of children and teens needing psychiatric care in the PED has doubled, and length of stay has gone from 5 to 17 hours.
New Drones Actually Save Drowning Victims
Drones carrying a rescue buoy were able to find and rescue simulated (and three real) drowning victims in half the time of a traditional lifeguard or one on a Jet Ski.
Surviving Sepsis Update – Insane or Just Crazy?
The Surviving Sepsis Campaign has issued a new 1-hour bundle beginning at the time of triage in the emergency department. This replaces the current 3- and 6-hour bundles.
Does Pan-Scan Benefit Pediatric Trauma Patients?
Whole body CT vs selective CT in children with trauma did not result in mortality benefit. This large, retrospective study with propensity matching suggested that any additional injuries found on pan-CT may have been either not life-threatening or did not change management to produce mortality benefit.
Isolated Costal Margin Tenderness in Kids – CT or Not?
Pediatric patients with isolated costal margin tenderness (CMT) on exam are very unlikely to have underlying intra-abdominal injury and also unlikely to benefit from CT. But make sure there are no other signs of abdominal injury.
Don’t Forget the Fastest Vascular Access for Trauma
For trauma (or any) patients arriving in extremis, the IO route was fast and had a very high success rate compared to peripheral IV or central line.
ECG Predictors of Arrhythmia in Syncope
In the evaluation of older patients with syncope, certain ECG abnormalities increase the risk of 30-day serious cardiac arrhythmias. These ECG abnormalities include non-sinus rhythm; multiple premature ventricular conductions; short PR interval; first degree atrioventricular block; complete left bundle branch block; and ST, T, and Q-wave abnormalities consistent with acute or chronic ischemia.
Going Global? How to Do Global Health Ethically
For those participating in short-term global health experiences, the American College of Physicians has issued a position paper to guide ethical decision making.