March 2019

In patients with predicted difficult airway, use of a Glidescope plus fiberoptic scope (aScope, Ambu) as a dynamic, controllable stylet vs Glidescope with usual stylet resulted in much higher first-pass success, 91% vs 67%, NNT = 4.

An abnormal upper lip bite test, in which the patient’s lower incisors cannot extend to reach the upper lip, increases the probability of a difficult intubation from 10% to greater than 60%.

The characteristic findings of pericardial tamponade on bedside ultrasound are covered in this quick, high yield summary.

The application of the Ottawa SAH rule in this relatively small sample of patients had a 100% sensitivity for identifying SAH in the ED but a lower 95% confidence interval of 78.2. The 100% negative predictive value, with a promising 95% CI of 98.6-100%, may have been driven by the lower prevalence of SAH in this study population compared to a previous validation study.

The original Sgarbossa criteria have a high specificity (96%) but low sensitivity (36%), meaning it is useful when positive, but a negative result does not rule out MI. The modified Sgarbossa criteria by Smith et al., have a much better sensitivity (91%) with a slight decrease in specificity (90%). You should apply the modified Sgarbossa criteria to evaluate for MI in LBBB and paced rhythms.

Pan-scan (whole body CT) vs selective CT did not impact in-hospital mortality in traumatized children ≤16 years old.

This QI protocol to reduce LP, antibiotic use, and hospitalization in febrile infants 29-60 days was very effective and did not miss any serious bacterial infections post-implementation.

Infants ≤60 days are low risk for serious bacterial infection (SBI) if they have a negative urinalysis, ANC ≤4090/µL, and procalcitonin ≤1.71 ng/mL. NPV was 99.6%; negative likelihood ratio (NLR) 0.04. Keep in mind, this hasn’t yet been externally validated.

When UTI was defined as a positive urine culture plus abnormal UA, the prevalence of concomitant UTI in febrile infants with bronchiolitis was 0.8% - below the usual testing threshold.

Light aerobic activity that doesn’t evoke concussion symptoms speeds recovery vs rest.