July 2018

JournalFeed week in review - was it a POCUS hate train this week? Maybe not…

At 12-month follow up, no patients who were low risk on the HEART Pathway (score plus 0 and 3-hour troponin) had major adverse coronary events.  Those for whom the HEART pathway was used did not have reduction in objective testing or ED visits over the next year.

Tachypnea, chronic ulcers, prior MRSA colonization, and prior cellulitis in the past 12 months were all associated with an increased risk of oral antibiotic failure for treatment of non-purulent cellulitis.

Point-of-care ultrasound (POCUS) in addition to usual care did not improve 30-day mortality in ED patients with undifferentiated hypotension, SBP <100mmHg.

Point-of-care ultrasound in patients with renal colic had tepid diagnostic accuracy for nephrolithiasis.  If hydronephrosis was present, specificity was 94% and often indicated a stone >5mm.

In less experienced sonographers, ocular ultrasound for retinal detachment was specific but not sensitive.  It's useful to rule it in, but don't use it as the sole means to rule it out.