November 2022
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Nov 16 2022
How Massive PE Kills – A Review of Right Heart Failure
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Decompensated right heart failure (RHF) increases morbidity and mortality, but it can be challenging to diagnose and treat. This review summarizes the unique physiology of RHF and treatment implications. -
Nov 15 2022
Showing Vulnerability When We Miss the Diagnosis
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This op-ed piece highlights the emotional toll missed diagnoses may take on physicians. The author eloquently reflects on how this experience taught her vulnerability and ultimately strengthened her relationship with this patient.Source
Elizabeth A Fleming Notes on Healing After a Missed Diagnosis. JAMA. 2022 Oct 4;328(13):1297-1298. doi: 10.1001/jama.2022.15724. -
Nov 14 2022
Would You Hold Still for 2 Seconds? – New Fast CT Means Less Pediatric Sedation
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Newer CT scanners led to faster head CT by about 10 seconds, and this decreased the number of pediatric patients who required sedation.Source
Impact of a Faster Computed Tomography Scanner on Sedation for Pediatric Head Computed Tomography Scans in 2 Large Emergency Departments-A Retrospective Study. Pediatr Emerg Care. 2022 Aug 5. doi: 10.1097/PEC.0000000000002816. Online ahead of print. -
Nov 11 2022
Is Ketamine the New Go-To Drug for Status Epilepticus?
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In children with refractory status epilepticus, around 3/4 of patients who were started on a ketamine infusion had seizure termination or improvement.Source
Ketamine for Management of Neonatal and Pediatric Refractory Status Epilepticus. Neurology. 2022 Sep 20. Doi:10.1212/WNL.0000000000200889 -
Nov 10 2022
SGLT-2 Inhibitors – New Drugs for Heart Failure You Need to Know
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Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are known to have cardioprotective effects and are now recommended for all heart failure patients no matter their baseline ejection fraction (EF) or starting medication regimens.Source
SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. Lancet. 2022 Sep 3;400(10354):757-767. doi: 10.1016/S0140-6736(22)01429-5. Epub 2022 Aug 27. -
Nov 09 2022
EZ-IO for Epidural Hematoma? Drill This into Your Brain!
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The EZ-IO may be considered as a temporizing measure for trepanation of an epidural hematoma (EDH) in rural ED settings. This should be considered only under the guidance of a skilled neurosurgeon when immediate transportation to a higher level of care is not possible. -
Nov 08 2022
New RCT – Teamwork Makes the… Hospital Work
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Resident and nurse teams that worked together exclusively performed better on advanced medical simulations, were more likely to have nurses present on patient rounds, and had improved teamwork earlier in the year than rotating resident/nurse teams.Source
Effect of Increased Interprofessional Familiarity on Team Performance, Communication, and Psychological Safety on Inpatient Medical Teams: A Randomized Clinical Trial. JAMA Intern Med. 2022 Oct 10. doi: 10.1001/jamainternmed.2022.4373. Online ahead of print. -
Nov 07 2022
Let’s Get Digital! How to Do Three Digital Blocks
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Having an array of techniques for digital nerve blocks in your back pocket can only serve to improve your patient care. Let’s review some approaches.Source
Digital Nerve Blocks: A Comprehensive Review of Techniques. J Emerg Med. 2022 Oct 10;S0736-4679(22)00428-0. doi: 10.1016/j.jemermed.2022.07.002. Online ahead of print. -
Nov 04 2022
Guess the Radiation Risk – Portable X-Rays in the Emergency Department
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Despite a high number of portable radiographs obtained in the ED, exposure to this ionizing radiation does not appear to be a significant occupational hazard, and existing precautions appear to be adequate.Source
Risk of Radiation Exposure to Emergency Department Personnel From Portable Radiographs. J Emerg Med. 2022 Oct 12;S0736-4679(22)00449-8. doi: 10.1016/j.jemermed.2022.08.002. Online ahead of print. -
Nov 03 2022
REFACED RCT – Is Fluid Restriction in Sepsis Feasible?
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IV crystalloid fluid restriction in the first 24-hours for ED sepsis patients without associated shock significantly reduced volumes when compared to standard of care. A larger trial investigating patient-centered outcomes is likely imminent.Source
Restrictive fluids versus standard care in adults with sepsis in the emergency department (REFACED): A multicenter, randomized feasibility trial. Acad Emerg Med. 2022 Oct;29(10):1172-1184. doi: 10.1111/acem.14546. Epub 2022 Aug 5.