June 2022
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Jun 16 2022
Should We Use Ultrasound-Guided IV in Kids?
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Ultrasound guided peripheral intravenous cannulation (PIVC) has been shown to be effective in some pediatric populations.Source
Ultrasound for Pediatric Peripheral Intravenous Catheter Insertion: A Systematic Review. Pediatrics. 2022 May 1;149(5):e2021055523. doi: 10.1542/peds.2021-055523. -
Jun 15 2022
Can I Discharge a Pediatric Patient with Abnormal Vital Signs?
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18% of children in this cohort were discharged from a pediatric ED with at least one abnormal vital sign. In all-comers, there was no significant difference in return rate between those discharged with or without abnormal vital signs. Those who, at time of discharge, had two or more abnormal vital signs or were less than 3 years of age were more likely to return.Source
Outcomes of patients discharged from the pediatric emergency department with abnormal vital signs. Am J Emerg Med. 2022 Apr 26;57:76-80. Doi: 10.1016/j.ajem.2022.04.021. -
Jun 14 2022
New AHA Heart Failure Guidelines for Emergency Medicine – Spoon-Feed Version
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These are the take home points for emergency medicine from the AHA heart failure guidelines. There are some novel therapies for heart failure you need to know.Source
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 May 3;145(18):e895-e1032. doi: 10.1161/CIR.0000000000001063. Epub 2022 Apr 1. Erratum in: Circulation. 2022 May 3;145(18):e1033. -
Jun 13 2022
Do Macrolides Reduce Mortality in Community Acquired Pneumonia?
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Among adults with culture-confirmed bacteremic pneumococcal pneumonia, empiric macrolide therapy was associated with 45% reduction in the odds for mortality, regardless of macrolide treatment duration, an effect was not seen with quinolones.Source
The Effect of Macrolides on Mortality In Bacteremic Pneumococcal Pneumonia: A Retrospective Nationwide Cohort Study, Israel, 2009-2017. Clin Infect Dis. 2022 Apr20;ciac317. Doi: 10.1093/cid/ciac317. -
Jun 10 2022
Mystery ECG – Can You Spot What’s Wrong?
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Presented is a process to interpret an ECG with negative P waves and pathologic Q waves in leads I and aVL.Source
An Unusual Wide Complex Rhythm-What Is the Diagnosis? JAMA Intern Med. 2022 Jan 1;182(1):72-73. doi: 10.1001/jamainternmed.2021.6778. -
Jun 09 2022
Does Vapocoolant Spray Work When Used Before Digital Block?
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Vapocoolant spray improved pain from digital blocks for repair of finger injuries.Source
Evaluation of vapocoolant spray effect on pain reduction during digital nerve block: A randomized clinical trial. Am J Emerg Med. 2021 Dec;50:260-263. doi: 10.1016/j.ajem.2021.08.001. Epub 2021 Aug 6. -
Jun 08 2022
How to Manage Spinal Stenosis | Spoon-Feed Version
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Lumbar spinal stenosis affects more than 1 in 10 U.S. citizens and over 100 million patients worldwide. This painful condition is diagnosed clinically with confirmatory imaging. Firstline treatment is activity modification, analgesia, and physical therapy, and careful selection of surgical candidates should be done only if conservative management fails.Source
Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022 May 3;327(17):1688-1699. doi: 10.1001/jama.2022.5921. -
Jun 07 2022
Does Prehospital Intranasal Glucagon for Hypoglycemia Work?
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In this small study of hypoglycemic patients who received prehospital intranasal glucagon, 32% had substantial improvement, 30% had slight improvement, and 38% had no improvement. There was no clear patient characteristic that predicted response.Source
Prehospital Intranasal Glucagon for Hypoglycemia. Prehosp Emerg Care. 2022 Mar 2;1-4. doi: 10.1080/10903127.2022.2045406. Online ahead of print. -
Jun 06 2022
Should We Mention Race or Ethnicity at the Beginning of Case Presentations?
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These authors think race is best unmentioned early in case presentations. However, some clinicians come down on the opposite side of this debate. Let's take a look at both sides.Source
First Impressions - Should We Include Race or Ethnicity at the Beginning of Clinical Case Presentations? N Engl J Med. 2021 Dec 30;385(27):2497-2499. doi: 10.1056/NEJMp2112312. Epub 2021 Dec 25. -
Jun 03 2022
Should We Reconsider How We Treat Acute Otitis Media?
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We are writing too many prescriptions for antibiotics for acute otitis media. Here is how we can improve.Source
Rethinking Our Approach to Management of Acute Otitis Media. JAMA Pediatr. 2022 May 1;176(5):439-440. doi: 10.1001/jamapediatrics.2021.6575.