August 2020

Spoon Feed No matter what you think about tPA (alteplase), this is a quick clinical practice summary to consider when you are taking care of your next stroke patient.

Spoon Feed Topical application of capsaicin cream reduced nausea and vomiting in patients with suspected cannabinoid hyperemesis syndrome in this small randomized placebo-controlled trial.

Spoon Feed Hypoxia (or inability to measure pulse oximetry), was the most powerful predictor of pediatric peri-intubation cardiac arrest (PICA). This plus age under 1 would have been moderately accurate for predicting PICA.

Spoon Feed The Infant Scalp Score refines TBI risk stratification recommendations for infants with isolated scalp hematoma after head injury to guide clinicians on which infants require CT imaging.

Spoon Feed We need to closely examine how best to utilize advanced practice providers (APPs) in our ED staffing models. In settings where APPs are treating lower complexity patients, APP coverage does not have a negative impact on clinical quality or patient experience. Authors noted higher APP coverage allowed physicians to see higher acuity cases but did not seem to lower staffing costs.

Spoon Feed In this multicenter, cluster-randomized, crossover trial conducted across six pediatric ICUs in the United States, an intervention schedule that eliminated extended work hour shifts resulted in an increased incidence of harmful medical errors by resident physicians.

Spoon Feed While we are learning more about COVID-19 each day, it would have been nice to know these clinical and logistical points of interest when it all started. There are many publications about COVID-19, but this paper sought to present 10 lessons learned that were relatively underrepresented in other publications.

Spoon Feed The use of dexamethasone was associated with lower mortality for patients hospitalized with COVID-19 receiving invasive mechanical ventilation or supplemental oxygen therapy. There was no benefit for patients who did not require initial respiratory support.

Spoon Feed The incidence of GI bleeding, sepsis, and heart failure was increased even with a short steroid burst, defined as oral corticosteroids for 14 days or fewer.

Spoon Feed Children suffering from severe blunt trauma underwent less CT imaging at level 1 pediatric trauma centers (PTCs) when compared to level 2 PTCs or adult level 1 or 2 trauma centers, with no significant difference in mortality.