May 2022
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May 17 2022
Does Monoclonal Antibody Work Against the BA.2 Variant?
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This brief report found that certain monoclonal antibodies: imdevimab-casirivimab (also known as REGEN-COV), tixagevimab-cilgavimab (also known as EVUSHELD), and sotrovimab precursor had lower neutralizing ability against the omicron BA.2 variant of COVID-19 than against earlier variants.Source
Efficacy of Antiviral Agents against the SARS-CoV-2 Omicron Subvariant BA.2. N Engl J Med. 2022 Apr 14;386(15):1475-1477. doi: 10.1056/NEJMc2201933. Epub 2022 Mar 9. -
May 16 2022
New Outbreak of Acute Hepatitis in Children – Why?
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A new, rare form of acute hepatitis has been seen in children, mostly under age 5 years, that presents with vomiting, diarrhea, and abdominal pain, followed by acute hepatitis with jaundice. If you see a child with a "stomach virus" who has jaundice - check labs!Source
Acute hepatitis is identified in more children, but cause remains elusive. BMJ. 2022 May 6;377:o1156. doi: 10.1136/bmj.o1156. -
May 13 2022
Does Ramped Position Increase First-Pass Success During Intubation?
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This systematic review and meta-analysis does not show any statistical difference in first-pass success rate or adverse intubation-related events between patients intubated in a inclined versus supine position.Source
Effect of inclined positioning on first-pass success during endotracheal intubation: a systematic review and meta-analysis. Emerg Med J. 2022;0:1-7. Doi:10.1136/emermed-2021-212968 -
May 12 2022
The Achilles’ Heals…Without Surgery? Non-op vs Operative Management RCT
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Patients with Achilles’ tendon rupture undergoing surgical repair, either open or minimally-invasive, did not have better outcomes at 12 months compared to non-operative treatment. However, those managed nonoperatively had a higher rate of tendon rerupture.Source
Nonoperative or Surgical Treatment of Acute Achilles' Tendon Rupture. N Engl J Med. 2022 Apr 14;386(15):1409-1420. doi: 10.1056/NEJMoa2108447. -
May 11 2022
POCUS – We Can…But Should We?
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POCUS in the ED can lead to clinically useful information, although research has not yet demonstrated patient-centered improvements in care. While this modality shouldn’t be used for routine screening in the ED, it performs well with a focused clinical question.Sources
- PoCUS: Just because we can doesn't mean we should. Acad Emerg Med. 2022 Apr;29(4):515-517. doi: 10.1111/acem.14474. Epub 2022 Mar 22.
- Risk-Benefit Analysis of PoCUS for Suspected, Ruptured Abdominal Aortic Aneurysm. Acad Emerg Med. 2022 Apr 14. doi: 10.1111/acem.14506. Online ahead of print. -
May 10 2022
Does Home Pulse Ox Keep COVID-19 Patients Out of Trouble?
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For patients with COVID-19 enrolled in an at-home monitoring program, utilization of home pulse oximetry did not result in mortality benefit and days out of the hospital in comparison to subjective assessments of dyspnea.Source
Pulse Oximetry for Monitoring Patients with Covid-19 at Home - A Pragmatic, Randomized Trial. 2022 Apr 6. N Engl J Med. 2022;NEJMc2201541. doi:10.1056/NEJMc2201541. Online ahead of print. -
May 09 2022
Decompression Sickness | Arterial Gas Embolism – Spoon-Feed Version
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Decompression sickness and arterial gas embolism can present similarly and have similar treatment protocols. Decompression illness is a term that can encompass both disease processes. Recompression and hyperbaric oxygen are definitive treatments for both conditions. If you need additional help, you should contact a 24-hour expert on the topic.Source
Decompression Sickness and Arterial Gas Embolism. NEJM. 2022;386:1254-1264. DOI: 10.1046/NEJMra2116554 -
May 06 2022
STEMI or Pericarditis? How to Tell the Difference
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Here are the clues from ECG, echo, and biomarkers that can help distinguish STEMI from pericarditis.Source
Diagnostic Dilemma of Pericarditis Concurrent With ST Elevation Myocardial Infarction. JAMA Intern Med. 2022 Mar 21. doi: 10.1001/jamainternmed.2022.0318. Online ahead of print. -
May 05 2022
Does Mechanism of Injury Matter for Trauma Triage by EMS?
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Mechanism of injury and special consideration criteria are important in predicting trauma severity, but some criteria need to be dropped and others added to current field triage guidelines.Source
Mechanism of Injury and Special Considerations as Predictive of Serious Injury: A Systematic Review. Acad Emerg Med. 2022 Mar 23. doi: 10.1111/acem.14489. Online ahead of print. -
May 04 2022
Is Early ECPR Better than ACLS for OHCA?
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Early extracorporeal cardiopulmonary resuscitation was not superior to standard advanced cardiac life support for 180-day survival with good neurological outcome, but there may be a silver lining.Source
Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2022 Feb 22;327(8):737-747. doi: 10.1001/jama.2022.1025.