August 2018

A door-to-tPA in under 20 minute protocol at this center with 1015 stroke alerts resulted in a misdiagnosis rate of 14.8% and 8 people being harmed.  The authors concluded this was safe.  I'm not so sure about that.

There is a normal drop in platelet count during pregnancy.  In the first trimester, the normal count is around 250,000 and decreases to about 225,000 at delivery.  Platelet counts <100,000 were rarely encountered in normal, uncomplicated pregnancies and should not generally be considered a physiologic change.

PRN dosing of antivenom (Crofab) for rattlesnake bite based on a clinical and laboratory-triggered strategy led to an overall decreased hospital length of stay (LOS) (27h vs 34h) and amount of antivenom used (8 vs 16 vials) compared to standard maintenance dosing.

Watch emDOCs demystify two common EM myths in these two excellent posts: epi in arrest and several myths on cerebral edema in pediatric DKA.

Tattoos or atypical body piercings did not seem to impact patient rating of physician competence, professionalism, caring, approachability, trustworthiness, or reliability in this single-center study.

Transfeminine patients had nearly doubled risk for venous thromboembolism (VTE).  The risk tripled for VTE and doubled for stroke if taking hormone supplementation.

Practicing to find the midpoint of the cricothyroid membrane with ultrasound is a much better way to learn than by using only external landmarks and no ultrasound.