Month: September 2022

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

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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?

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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?

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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.

Do We Need Sterile Gloves for Laceration Repair?

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This trial suggests that there is unlikely to be a large difference in wound infection rates between non-sterile gloves and dressings and sterile gloves, dressings, and drapes for suturing of traumatic wounds in the ED.

Source
Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department: a non-inferiority multicentre randomised controlled trial. Emerg Med J. 2022 Jul 26;emermed-2021-211540. doi: 10.1136/emermed-2021-211540. Online ahead of print.

More Acute Kidney Injury With Vancomycin Plus… Pip/Tazo Or Ceftolozane/Tazo?

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Patients receiving vancomycin + piperacillin/tazobactam had greater adjusted odds of acute kidney injury than those receiving vancomycin + ceftolozane/tazobactam.

Source
Nephrotoxicity of Vancomycin in Combination with Beta-lactam Agents: Ceftolozane-tazobactam vs. Piperacillin-tazobactam. Clin Infect Dis. 2022 Aug 19;ciac670. doi: 10.1093/cid/ciac670. Online ahead of print.

Should We Use Plain Old Doxycycline for Pneumonia?

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Doxycycline is an accessible and effective option to treat both typical and atypical bacteria that may cause community acquired pneumonia (CAP).

Source
Efficacy of Doxycycline for Mild-to-moderate Community-acquired Pneumonia in Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Clin Infect Dis. 2022 Jul 29;ciac615. doi: 10.1093/cid/ciac615. Online ahead of print.

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