Spoon Feed
A 1g dose of IV acetaminophen had no additional effect on pain control or reduction in overall morphine dosage.
Source
Intravenous acetaminophen does not reduce morphine use for pain relief in emergency department patients: A multicenter, randomized, double-blind, placebo-controlled trial. Acad Emerg Med. 2022 May 2. doi: 10.1111/acem.14517. Epub ahead of print.
Spoon Feed
There was no significant difference in first-attempt success rate for ramped and upright position intubations in the Emergency Department when comparing hyperangulated and standard geometry video laryngoscopes.
Source
Impact of video laryngoscope shape on first-attempt success during non-supine emergency department intubations. Am J Emerg Med. 2022 Apr 27;57:47-53. doi: 10.1016/j.ajem.2022.04.024. Online ahead of print.
Spoon Feed
Race was strongly associated with UTI risk, with non-Black children having 2-4 times greater odds of infection. However, replacement of race with 2 other variable resulted in similar diagnostic accuracy for the UTICalc tool.
Source
Reassessment of the Role of Race in Calculating the Risk for Urinary Tract Infection: A Systematic Review and Meta-analysis. JAMA Pediatr. 2022 Apr 18. doi: 10.1001/jamapediatrics.2022.0700. Online ahead of print.
Spoon Feed
Serious bacterial infection was rare in well appearing, afebrile infants with omphalitis, suggesting that routinely obtaining cultures may not be needed.
Source
Omphalitis and Concurrent Serious Bacterial Infection. Pediatrics. 2022 Apr 20;e2021054189. doi: 10.1542/peds.2021-054189. Online ahead of print.
Spoon Feed
Risk for venous thromboembolism (VTE) was highest during hospitalization, but the risk remained elevated 3-fold at 3 months post-discharge.
Source
Venous Thrombosis Risk during and after Medical and Surgical Hospitalizations: The Medical Inpatient Thrombosis and Hemostasis (MITH) Study. J Thromb Haemost. 2022 Apr 15. doi: 10.1111/jth.15729. Online ahead of print.
Spoon Feed
Nonoperative management (NOM) for uncomplicated appendicitis has become more common over the past 10 years in the pediatric population. Although many children do well, those who have recurrences have higher rates of surgical complications and hospitalizations.
Source
Nonoperative Management of Uncomplicated Appendicitis. Pediatrics. 2022 Apr 18;e2021054693. doi: 10.1542/peds.2021-054693. Online ahead of print.
Spoon Feed
Adenosine is not just a therapy for regular narrow complex tachycardia. It can also be an important diagnostic tool to determine the etiology of the arrhythmia.
Source
Narrow Complex Tachycardias-Therapeutic and Diagnostic Role of Adenosine. JAMA Intern Med. 2022 Apr 1;182(4):436-437. doi: 10.1001/jamainternmed.2021.7764.
Spoon Feed
There is undeniable corporate influence in the practice of emergency medicine, and this could cause problems for patients or for those of us who care for them. We need to thoughtfully consider this.
Source
Corporate Control of Emergency Departments: Dangers from the Growing Monster. J Emerg Med. 2022 Apr 7;S0736-4679(22)00074-9. doi: 10.1016/j.jemermed.2022.01.026. Online ahead of print.
Spoon Feed
One in 180 out-of-hospital pediatric encounters require bag-mask ventilation (BMV) or advanced airway management (AAM). Of these, 49% involve tracheal intubation (TI) despite a lack of evidence showing superiority to BMV.
Source
Epidemiology of out-of-hospital pediatric airway management in the 2019 national emergency medical services information system data set. Resuscitation. 2022 Apr;173:124-133. doi: 10.1016/j.resuscitation.2022.01.008. Epub 2022 Jan 19.
Spoon Feed
Cancer-associated hypercalcemia requires prompt recognition and treatment in the ED, starting with aggressive rehydration +/- loop diuretics as well as coordination of initiation of bone resorption inhibition, which can take up to 48 or longer hours to have a full effect.
Source
Cancer-Associated Hypercalemia. N Engl J Med 2022; 386: 1443-51. DOI 10.1056/NEJMcp2113128.
