Acute Ischemic Stroke – Spoon-Feed Version
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.
August 2020
Capsaicin for Cannabis Hyperemesis – A Randomized Trial
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.
Preventing Death by Intubation in Kids
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.
Infant Scalp Hematoma Score – Maybe Some Don’t Need CT
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.
Advanced Practice Clinicians and Emergency Department Flow
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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.
ICU Resident Shift Length and Effect on Patient Safety
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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.
COVID-19 – Ten Things I Wish We Had Known
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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.
RECOVERY – Dexamethasone for COVID-19
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.
Are Steroid Bursts Harmful?
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.
More CT in Pediatric Trauma – Same Mortality, More Radiation
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.