April 2019
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Apr 16 2019
iCOMPARE RCT – Patient Safety and Resident Duty Hours
There was no difference in patient safety between standard resident duty hour restrictions and a more flexible schedule that allowed for longer shifts and no mandated time off between shifts.
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Apr 15 2019
Resident Schedule Perfection? Not Yet
A flexible duty hour schedule that kept total weekly hours under 80 but allowed for longer shift length and no fixed mandatory time off between shifts was not inferior to the current standard duty hour regulations when it came to sleep duration or morning alertness.
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Apr 12 2019
NEJM Brilliance – The Not My Problem Problem
This editorial helps us understand how to avoid the bystander effect in medicine and has direct applicability for the ED.
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Apr 11 2019
What Defines Pediatric Hypotension?
Critical Care, Emergency Medicine, EMS, Pediatric Emergency, Resuscitation, Retail/Urgent Care, TraumaThe Pediatric Advanced Life Support (PALS)/Advanced Trauma Life Support (ATLS) formula to define hypotension in children (i.e. 5th percentile SBP) seems to be a good compromise between German and U.S. population norms for children. The formula is: Low SBP = <70 + 2(age in years).
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Apr 10 2019
Do You LP Febrile Neonates with Bronchiolitis?
In this survey of physicians from Canada and UK/Ireland, the strongest predictors of performing a LP in neonates with a clinical diagnosis of bronchiolitis were: practice location in Canada, <10 years in practice, and less comfort diagnosing bronchiolitis.
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Apr 09 2019
Advanced Airway for Pediatric Cardiac Arrest – Should We Just Bag?
There may be a slight advantage for pediatric cardiac arrest patients in survival with good neurological outcome by using simple bag-valve mask ventilation over advanced airway management.
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Apr 08 2019
Advanced Airway For Non-Shockable OHCA?
Advanced airway management (AAM) was associated with increased overall survival in out-of-hospital cardiac arrest (OHCA) (though not survival with favorable neurological outcome) in patients with non-shockable initial rhythm. There was no difference in survival with use of AAM in patients with initial shockable rhythm.
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Apr 05 2019
Vitamin C – ICU Wonder Drug?
Use of vitamin C in a mixed ICU population did not appear to reduce mortality or improve other important outcomes, though there may be other benefits in a cohort of post-op cardiac surgery patients.
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Apr 04 2019
How Often Do We Miss Serious Causes of Headache and Back Pain?
In patients presenting to the ED with headache or back pain, very few return with serious, missed diagnoses after the initial evaluation. Patient who are elderly, immunocompromised, or have preexisting neurologic disease were at greater risk of missing serious conditions.
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Apr 03 2019
SWAP Score – Shockable, Witness, Age, pH for OHCA
Patients presenting to the ED with out-of-hospital cardiac arrest with a non-shockable rhythm, unwitnessed arrest, age >60, and pH≤7 have a 0% chance of good neurological outcome, specificity 100%.