FOCUS for Unstable PE
Focused cardiac ultrasound (FOCUS) is sensitive for detecting the presence of PE in those with a HR > 100bpm or systolic blood pressure <90 and highly sensitive for detection of PE in patients with a HR > 110bpm.
October 2019
Adrenal Crisis
Adrenal crisis is increasing in frequency and can masquerade as something as seemingly benign as gastroenteritis. Read this summary to update your knowledge on the diagnosis and management of acute adrenal insufficiency.
How to Reduce Strep Tests for Kids Under 3
Rapid streptococcal testing among children under age 3 was reduced by 52% following a quality improvement initiative.
Blood Culture First – Then Antibiotics
Obtaining blood cultures after administration of antibiotics in severe sepsis decreases sensitivity of blood cultures.
CRASH 3 – TXA for TBI
TXA appears to have a slight 28-day mortality benefit in traumatic brain injury (TBI) patients with a GCS ≥9, especially when given early.
N95 vs Plain Mask for Flu Prevention
This study found no difference in effectiveness between an N95 respiratory and common medical mask in preventing transmission of influenza or other viral respiratory illnesses in a healthcare workplace.
Be SMART – Balanced Fluid for Sepsis
The use of balanced crystalloids for ICU patients with sepsis was associated with a lower 30-day in-hospital mortality (26.3% vs 31.2%, P=0.01) and a lower incidence of major adverse kidney events within 30 days (35.4% vs 40.1%, aOR 0.78) compared to normal saline.
Are Antipsychotics Effective for Delirium Treatment?
Neither haloperidol nor second generation antipsychotics were effective in improving patient-centered outcomes in hospitalized adults with delirium.
Does Urgent Care Decrease Low-Acuity Emergency Department Visits?
Opening urgent care locations may have a small impact on reducing low-acuity ED volume for patients living near the UC.
Lessons from Schrödinger’s Cat – Get Cozy with Uncertainty
Statistical methods were developed and applied to clinical trials to quantify uncertainty, not as a decision tool to be used in the face of uncertainty. We should become comfortable with uncertainty, as it is present irrespective of the arbitrary thresholds used for interpretation of data.