February 2019

”Tachypnea at triage, chronic ulcers, history of MRSA colonization or infection, and cellulitis within the past year,” were the risk factors associated with failure of oral antibiotic therapy for non-purulent cellulitis.

The overall sensitivity of the Wood’s lamp, compared to the gold standard slit lamp, to establish the diagnosis of common corneal and conjunctival abnormalities was found to be an abysmal 52%.

A large observational series with over 4,000 intubations compared succinylcholine vs. rocuronium in rapid sequence intubation and found no association between these two paralytics and first-pass intubation success or peri-intubation adverse effects.

This expert panel came up with a comprehensive algorithm to clear the c-spine in children with trauma.

A low-risk Canadian Syncope Risk Score plus 2 hours of ECG monitoring in the ED was able to identify 99.8% of patients at low risk for 30-day serious arrhythmic outcome.

High-flow nasal cannula (HFNC) compared to bag-valve mask (BVM) ventilation for preoxygenation of critically ill patients did not improve lowest SpO2 but significantly reduced severe complications (SpO2 < 80%, severe hypotension, and cardiac arrest); 6% HFNC vs. 16% BVM, NNT = 10.

Apneic oxygenation works in children, with half as many becoming hypoxemic during endotracheal intubation.

Management of nerve agent (NA) poisoning requires recognition of the syndrome and availability of the antidote. It is important to remember that besides the classic “SLUDGE” and “Killer B’s,” there is also the nicotinic syndrome which can cloud the clinical presentation. Add the “weekdays” mnemonic for nicotinic effects to your list of symptoms in NA toxicity.

Pretreatment with either midazolam or haloperidol prior to ketamine sedation markedly reduced the risk of recovery agitation but delayed recovery time by about 20-30 minutes.

Only 1.1% of patients with a HEART score of 5 had an acute MI or died within 30 days of ED presentation. Using this revised threshold would have allowed 89% of patients to be discharged from the emergency department. Consider the limitations of this study before you implement this higher cutoff.