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September 2018
Epi vs. Norepi for Cardiogenic Shock
Among patients with cardiogenic shock secondary to acute myocardial infarction (AMI), epinephrine led to a significantly increased rate of refractory shock compared to norepinephrine.
Outpatient Antibiotic for Pyelonephritis – Ciprofloxacin, TMP/SMX, or Cephalosporins?
Outpatient treatment failure for pyelonephritis occurred more often in patients treated with fluoroquinolones or trimethoprim-sulfamethoxazole (TMP-SMX) than in patient treated with cephalosporins.
Spinal Motion Restriction Guidelines
The American College of Surgeons Committee on Trauma, American College of Emergency Physicians, and the National Association of EMS Physicians have offered a joint consensus statement on spinal motion restriction in trauma patients.
RICO? Rest, Ice, Compression, Opiate for Ankle Sprain?
Although opioids are not first-line treatment for ankle sprains, an opioid was prescribed for 25% of emergency department patients diagnosed with an isolated ankle sprain. Prescribing varied widely among states. Additionally, patients prescribe greater quantities of opioids were more likely to transition to continued use.
MRI = CT for Appendicitis
CT and MRI had similar diagnostic accuracy for acute appendicitis and may be used interchangeably.
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Antibiotic Harms – 70,000 PED Visits a Year
Adverse drug events related to antibiotics led to nearly 70,000 ED visits a year in children ≤19 years. One out of every 330 children ≤2 years given amoxicillin will end up in the ED with an ADE.
Same Song, Different Lyrica – Pregabalin and Risk of Opiate Overdose
Use of pregabalin in addition to opioids vs opioids alone was associated with an increased risk of death by opioid overdose.
Nasal Spray Calcium Channel Blocker for SVT
Nasally administered etripamil was more effective than placebo at converting SVT to normal sinus rhythm and is now moving on to phase 3 trials. Stay tuned.