Top Articles of 2017

Best of the Best

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It was a great refresher to go back over the articles we covered in 2017.  We have hand-picked some of our favorites.  Take just a few minutes to skim through the titles and excerpts to lock in some of the most important highlights from 2017.

Happy New Year!

Thomas and Clay

Airway | Procedure

Ramped Position Doesn't Work? Let's Do a Check-UP On This Study

Ear-Sternal Notch - How Should You Ramp?

  • We’ve all been taught to use the “sniffing position” when intubating patients in a supine position. However, when adding ramped positioning for pre-oxygenation and intubation, fidelity to the “sniffing position” degrades. A couple Australian anesthesiologists have written a letter to clarify the proper technique.
  • The "Ear-Sternal Notch" Line-How Should You Lie?  Anesth Analg. 2017 Sep 14. doi: 10.1213/ANE.0000000000002493. [Epub ahead of print]

A Simple Trick For Easier Subclavian Access

Cricoid Pressure Is Mechanically Impossible

Cool! Ice Therapy to Reduce Pain from Laceration Repair

Cardiology

Bolus Nitroglycerin for CHF

HEART Score in Practice - Randomized Trial

Critical Care | Pulmonary

Update of Surviving Sepsis

PEITHO - Long-term Follow Up

D-dimer Cutoffs Are So 2016

Weird Sepsis Cocktail - Vitamin C, Thiamine, Hydrocortisone

ENT | Ophthalmology

Tetracaine for Corneal Abrasion

Mounting Evidence for Dexamethasone in Pharyngitis

TXA for Epistaxis

General Medicine

IV Contrast and AKI - No Association

Why 10,000 Die Within a Week of ER Discharge

  • When in doubt, err on the side of admission - even if you get push back.  When people feel bad enough to come to the ED, it often means something is really wrong, even if it's not apparent on a surface level.  Also, err on the side of ordering a few more tests when you're not sure, especially in patients who are altered, dyspneic, or have generalized malaise.
  • Early death after discharge from emergency departments: analysis of national US insurance claims data. BMJ. 2017 Feb 1;356:j239. doi: 10.1136/bmj.j239.

Short-Course Glucocorticoids May Not Be Harmless

Urticaria- Hold the Prednisone

GI

Haloperidol Works for Gastroparesis Symptoms

Infectious Disease

Do We Need Cephalexin Plus TMP-SMX?

Small Abscesses Do Better With Antibiotics

Neurology

CVA, TIA, SAH - Imaging Misses Nine Percent

Stroke Oxygen Study

IV Prochlorperazine + Diphenhydramine vs Hydromorphone for Migraines

Orthopedics | Sports

Velcro Wrist Splint vs. Cast for Torus Fracture

Concussion Paradigm Change - Rest Is Bad

Diazepam Doesn't Help Back Pain

Pain | Sedation

Ketorolac - A Little Dab'll Do Ya

ED Opiate Rx Risks Long-Term Use

How A 5-Sentence NEJM Letter Caused the Opioid Epidemic

  • A 5-sentence letter to the NEJM editor in 1980 was cited over 600 times to support opiate prescribing, which was not the point of the original letter.  We bought the line that opiates for legitimate pain were not addictive but didn't consider the source.
  • A 1980 Letter on the Risk of Opioid Addiction.  N Engl J Med. 2017 Jun 1;376(22):2194-2195. doi: 10.1056/NEJMc1700150.

Ketamine Effective as Add-on to Opiates

Infusion vs IV Push Ketamine for Pain

Pediatrics

No Shortcut for Acute Otitis Media

Rudeness Impacts Team Performance

  • Sometimes caregivers or patients are rude.  The best thing we can do is anticipate it and mentally prepare before the encounter so we can still perform well as a team.
  • Rudeness and Medical Team Performance. Pediatrics. 2017 Jan 10. pii: e20162305. doi: 10.1542/peds.2016-2305. [Epub ahead of print]

Ketamine and Long-term Behavioral Change in Children

  • After using ketamine for pediatric procedural sedation, 22% of children experienced negative behavioral symptoms measured 1-2 weeks after ED discharge. The most common symptoms were apathy/withdrawal and separation anxiety.  You may want to warn families of these possible side effects.
  • Behavioral Changes in Children after Emergency Department Procedural Sedation. Acad Emerg Med. 2017 Oct 9. doi: 10.1111/acem.13332. [Epub ahead of print]

Resuscitation

Early ETT in Adult Arrest Worse

ETT During Pediatric Arrest May Harm

When to Expect Zero Survival in Arrest

Trauma | Surgery

Etomidate or Ketamine Safe for Trauma Airway

MRI Low Yield If Negative CT C-Spine

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