June 2021
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Jun 30 2021
How Do Patients See Me? Impact of Age and Gender
Spoon Feed Younger patients may perceive older anesthesiologists as more confident and intelligent. Female anesthesiologists may be perceived as more confident and more likely to be recommended to patients’ family members than males, but only in a subgroup of white patients.Read More -
Jun 29 2021
How to Manage Postpartum Hemorrhage
Spoon Feed Postpartum hemorrhage is defined as ≥1000mL of blood loss irrespective of the delivery route, with associated shock. Remember the four “T’s”: tone (uterine atony), trauma (lacerations, uterine rupture), tissue (retained placenta, clots) and thrombin (coagulopathies). Manage the ABCs (especially two large bore IV’s for massive transfusion) and tailor treatment to the specific cause. Recommendations for balanced transfusion are derived from the trauma literature, but it is important to administer cryoprecipitate earlier to maintain a higher fibrinogen level (at term the normal level is >350mg/dL).Read More -
Jun 28 2021
Acute Diverticulitis – Expanding Utility of Abdominal Ultrasound
Spoon Feed In patients with suspected uncomplicated acute diverticulitis, consider ultrasound as a first approach.Read More -
Jun 25 2021
Shot Through the HEART – Problems with the HEART Score
Spoon FeedRead MoreEmergency departments should reconsider using the HEART score and its variants due to significant concerns regarding the rule’s creation and performance.
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Jun 24 2021
How to Treat ESBL, CRE, and DTR-Pseudomonas
Spoon Feed For ESBL, non-β-lactam antibiotics - like TMP/SMX or nitrofurantoin - usually work well for cystitis. For CRE or DTR-P. aeruginosa, look it up, call ID, and know this may mean alternative (and often expensive) antibiotics.Read More -
Jun 23 2021
How to Prevent Post-LP Headaches
Spoon Feed Risk for post-LP headache can be lessened by using atraumatic non-cutting needles, which, contrary to popular belief, are not more difficult to use than traditional cutting needles. Utilizing the lateral decubitus position, a higher intervertebral space, and orienting the needle bevel parallel to the spinal axis may also decrease risk. Other common recommendations, including IV fluids, caffeine, and bed rest are unlikely to help.Read More -
Jun 22 2021
Dunking on Overuse of Alternative Antibiotics in Patient-Reported β-lactam Allergies
Spoon Feed A standardized process for investigating patient-reported β-lactam allergies together with a side-chain cross-reactivity chart led to significantly increased use of structurally dissimilar β-lactams for surgical prophylaxis instead of alternate antibiotic classes.Read More -
Jun 21 2021
Scribes – Do the Facts Live Up to the Hype?
Spoon Feed In-person ED scribes may improve financial productivity (RVUs) and clinical efficiency, though effects are probably small and good data are lacking. Insufficient data exist to determine impact on patient or clinician satisfaction, scribe documentation quality, or differences in scribe training.Read More -
Jun 18 2021
BASICS RCT – Endovascular Therapy for Basilar Artery Occlusion
Spoon Feed There was no statistical difference in endovascular therapy compared with usual medical therapy for patients with basilar artery occlusion.Read More -
Jun 17 2021
CARPE DIEM – PEM Prediction of Pneumonia Complications
Spoon Feed Clinician gestalt leaves much to be desired in determining which children with community acquired pneumonia will develop subsequent complications.Read More