September 2022
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Sep 30 2022
Is It Just Me or Are We Seeing More Cannabis Hyperemesis?
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 -
Sep 29 2022
Should Sodium Bicarbonate Be Used In Pediatric Arrest?
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. -
Sep 28 2022
How to Provide Targeted Sedation for Intubated Emergency Department Patients
Spoon Feed
This pilot trial showed that an educational initiative focused on reducing deep post-intubation sedation in the Emergency Department was feasible and associated with lower mortality, more ventilator-free and ICU-free days, and no increase in adverse events. -
Sep 27 2022
Raising the Bar on Neonatal Hyperbilirubinemia Care
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. -
Sep 26 2022
Does Prepatellar Bursitis Need Aspiration?
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. -
Sep 23 2022
What is The Added Value of Hemoptysis in our Decision Rules for PE?
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. -
Sep 22 2022
Imaging Decisions Vary On Shift – Are We Feeling More Confident, Fatiguing, or Somewhere In Between?
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. -
Sep 21 2022
Accuracy of Neuroimaging for Dizziness – It’s Not Pretty
Spoon Feed
We cannot rely on neuroimaging (CT, CTA, MRI or MRA) alone to effectively rule out stroke in patients presenting to the ED with acute dizziness or vertigo. -
Sep 20 2022
Are We Missing the Target on Febrile Infants 60 Days to 6 Months?
Spoon Feed
The lack of evidence-based guidelines in the management of the febrile infants 2 to 6 months old results in variable practices amongst providers.Source
Prevalence and Management of Invasive Bacterial Infections in Febrile Infants Ages 2 to 6 Months. Ann Emerg Med. 2022 Aug 5:S0196-0644(22)00441-3. doi: 10.1016/j.annemergmed.2022.06.014. Epub ahead of print. -
Sep 19 2022
Should Benadryl Be in Your Migraine Cocktail?
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.