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Basing IV fluid administration on stroke volume increase with passive leg raise vs usual care resulted in a lower 72-hour fluid balance and improvement in other important outcomes as well.
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COVID-19 has suddenly forced entire organizations into remote e-work. A list of applications of remote e-work for academic physicians, including a consensus-based list of advantages and disadvantages are summarized to get the most of your new digital organization.
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N-terminal pro-B-type natriuretic peptide (NT-proBNP) did not improve upon the Canadian Syncope Risk Score (CSRS) in risk stratifying adults in the ED with syncope.
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Epinephrine is the key drug for anaphylaxis. Give it early in suspected cases. Antihistamines and glucocorticoids are permissible but not very helpful and certainly should not supersede epinephrine.
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An increased incidence of severe Kawasaki disease has been recognized in association with COVID-19 infection in children. It is now called multisystem inflammatory syndrome in children, MIS-C.
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While some overlap exists, ST elevation in lead III>II and convex upward or horizontal ST segment suggests STEMI, while PR depression and Spodick’s signs (downsloping T-P segment) are suggestive of pericarditis.
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The Canadian Syncope Risk Score (CSRS) was successfully validated as a tool to risk stratify ED patients presenting with acute syncope. Patients at low risk for serious outcomes at 30 days can be safely discharged.
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ED physicians were found to be accurate, based on clinical gestalt alone, in predicting pediatric appendicitis, especially in patients they considered low risk.
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A 2-inch shoulder roll lowered the line of sight for direct laryngoscopy in infants but had no effect on view of the glottic opening.
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For out-of-hospital cardiac arrest, bag-valve-mask ventilation and BVM ventilation as a rescue after failed advanced airway placement were associated with improved survival to discharge and neurologically intact survival compared to advanced airway management (i.e. supraglottic airway or endotracheal intubation). However, given multiple possible confounders, these results should be viewed with caution.
