February 2019

In patients admitted to the hospital with concern for ACS and discharged without a specific diagnosis, the higher the troponin elevation above the 99th percentile, the greater their risk for major adverse events.

Intranasal ketamine is noninferior to intranasal fentanyl for pain associated with pediatric extremity injuries. However, there is a higher risk of minor adverse events.

In this large cohort study of over 1.8 million pregnancies, first trimester ondansetron use was not associated with cardiac malformations or total congenital malformations. However, there was a small increased risk of oral clefts (3 additional cases per 10,000 women treated).

Propofol may rarely cause greenish discoloration of the hair. It is benign and self-limited.

Penicillin allergy is a lot less common than patients report. A low-risk history could allow you to prescribe it in the ED or clinic.

A standard 5cm 14-16 gauge needle for chest decompression was more than twice as long as needed for children < 13 years old based on CT chest wall thickness (CWT).

The prevalence of traumatic brain injury (TBI) on CT in children with head injury presenting > 24 hours post-injury was 3.8%. Predictors on TBI on CT were suspicion of depressed skull fracture and non-frontal scalp hematoma.

This review of open source data since 1981 strongly suggests that the period of an assault weapons ban from 1994-2004 was associated a reduction in fatality from mass shootings.

Trauma patients with blunt (and maybe penetrating) chest injury, who had a pneumothorax ≤35mm on CT did well without a thoracostomy tube, with only 9% failing observation only.

Treating skin and soft tissue abscesses with antibiotics in addition to incision and drainage (I&D) resulted in significantly increased clinical cure rate (NNT = 14) and decreased incidence of new lesions (NNT = 10) compared to I&D alone.