September 2022

Is It Just Me or Are We Seeing More Cannabis Hyperemesis?

GI, Toxicology

Spoon Feed
Legalization of cannabis in Ontario was not associated with an increase in ED visits for cannabis hyperemesis syndrome (CHS); however, after legislation passed allowing commercialization of cannabis, there was a large increase in visits for CHS.

Source
Changes in Emergency Department Visits for Cannabis Hyperemesis Syndrome Following Recreational Cannabis Legalization and Subsequent Commercialization in Ontario, Canada. JAMA Netw Open. 2022 Sep 16. Doi:10.1001/jamanetworkopen.2022.31937

Should Sodium Bicarbonate Be Used In Pediatric Arrest?

Pediatrics, Resuscitation

Spoon Feed
Administration of sodium bicarbonate during in-hospital pediatric cardiac arrest was associated with lower rates of survival to hospital discharge, return of spontaneous circulation, and survival with favorable neurologic outcomes and functional status.

Source
Sodium Bicarbonate Use During Pediatric Cardiopulmonary Resuscitation: A Secondary Analysis of the ICU-RESUScitation Project Trial. Pediatr Crit Care Med. 2022 Jul 26. doi: 10.1097/PCC.0000000000003045. Online ahead of print.

Raising the Bar on Neonatal Hyperbilirubinemia Care

Pediatrics

Spoon Feed
The American Academy of Pediatrics (AAP) updated clinical guidelines for management of term infants presenting with hyperbilirubinemia. Relevant sections for ED providers include slightly raising phototherapy treatment thresholds, removing race as a consideration, and giving courses of action for infants requiring higher levels of care.

Source
Technical Report: Diagnosis and Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics. 2022 Aug 5;e2022058865. doi: 10.1542/peds.2022-058865. Online ahead of print.

Does Prepatellar Bursitis Need Aspiration?

Infectious Disease, Orthopedics

Spoon Feed
Empiric antibiotic therapy – without aspiration – is a reasonable approach for the management of suspected prepatellar septic bursitis in non-toxic patients with close outpatient follow up.

Source
Efficacy of empiric antibiotic therapy without aspiration for septic prepatellar bursitis in emergency department patients. Acad Emerg Med. 2022 Aug;29(8):1027-1032. doi: 10.1111/acem.14499. Epub 2022 Apr 25.

What is The Added Value of Hemoptysis in our Decision Rules for PE?

Venous Thromboembolism

Spoon Feed
Removing the “hemoptysis” item from PERC, YEARS, and PEGeD clinical decision tools (CDTs) did not significantly increase diagnostic failure in a cohort of patients at low risk for acute pulmonary embolism (PE).

Source
Evaluation of the “hemoptysis” item in clinical decision rules for the diagnosis of pulmonary embolism in the emergency department. Acad Emerg Med. 2022 Jul 30. doi: 10.1111/acem.14574.

Imaging Decisions Vary On Shift – Are We Feeling More Confident, Fatiguing, or Somewhere In Between?

Imaging, Practice of EM

Spoon Feed
Emergency physicians have dynamic changes to their work-ups (particularly in the selection of imaging) related to how busy, not how long, a shift is.

Source
How are Patient Order and Shift Timing Associated With Imaging Choices in the Emergency Department? Evidence From Niagara Health Administrative Data. Ann Emerg Med. 2022 Aug 8;S0196-0644(22)00412-7. doi: 10.1016/j.annemergmed.2022.06.002. Online ahead of print.

Should Benadryl Be in Your Migraine Cocktail?

Neurology, Pharmacy/Pharmacology

Spoon Feed
There is still no strong evidence to suggest that an anticholinergic agent should be administered prophylactically to prevent extrapyramidal symptoms when treating migraine.

Source
Adjuvant anticholinergic therapy for the prevention of akathisia in patients with primary headache in the emergency department: a systematic review. Acad Emerg Med. 2022 Aug 13. doi: 10.1111/acem.14581. Online ahead of print.

Scroll to Top