August 2018

Patients over age 65 did not have superior pain control with hydromorphone 0.5mg IV + acetaminophen (APAP) 1000mg IV vs. hydromorphone + placebo.

For adults with severe pain in the ED, IV hydromorphone provided significantly better pain control than IV acetaminophen but resulted in more nausea and vomiting.

Sepsis bundles like the CMS SEP-1 guidelines are too restrictive, requiring an all-or-nothing approach to achieve compliance. These bundles fail to prioritize the most important bundle components while penalizing providers for meaningless omissions that have no impact on mortality.

With ED boarding, the burden of sign-out patients is greater than ever. This study shows just what I expected.  All of these sign-out patients negatively affects how many new cases each resident is able to see on each shift.

Patients with a penicillin allergy were 69% more likely to develop MRSA infection and 26% more likely to contract C. difficile.

It's easy to read the JournalFeed emails and forget what you learned by lunchtime.  Did you know you retain more if you take a test on it? Take the Spoon Feed quiz!

​​​​​​​Low dose ketamine is non-inferior to IV opioids for acute pain control in adult patients in the emergency department.

Patient preference for a specific analgesic should raise concern that the individual is at greater risk for overdose.

A low daily dose of aspirin (75-100mg) prevents cardiovascular events only in patients weighing < 70 kg. Higher doses are required in patients weighing more.

Most doctors and clinicians think someone else is the problem when it comes to antibiotic resistance and stewardship.  We are the problem.  And we are the solution.