2022

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Inconsistency and incongruence are two keys to diagnosing a functional neurological disorder. The video demonstration really helps sort this out.

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Inconsistency and incongruence: the two diagnostic pillars of functional movement disorder. Lancet. 2022 Jul 23;400(10348):328. doi: 10.1016/S0140-6736(22)01184-9.

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In the spectrum of heat related illness, heat stroke is a can’t miss diagnosis. Aggressive management, with rapid cooling to 38-39°C within 30 minutes of presentation at a rate of 0.20-0.35°C per minute has been shown to not only be safe but improve outcomes.

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Treatment and Prevention of Heat-Related Illness. N Engl J Med. 2022 Oct 13;387(15):1404-1413. doi: 10.1056/NEJMcp2210623. Epub 2022 Sep 28.

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Not all pediatric bruising needs workup for a bleeding disorder. This report details not only how but when to do it.

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Biphasic or deep precordial T waves on ECG can occur with spontaneous reperfusion of an occluded left anterior descending artery and should not be ignored in the patient with chest pain.

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Wellens' Syndrome. N Engl J Med. 2022 Sep 22;387(12):e25. doi: 10.1056/NEJMicm2201699.

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Esophageal bougienage is an underutilized bedside technique for managing retained esophageal coins.

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Esophageal Bougienage for Management of Lodged Esophageal Coins: Safe, Effective, Efficient, and Underused. Pediatr Emerg Care. 2022 Sep 30. doi: 10.1097/PEC.0000000000002849. Online ahead of print.

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Previously, first-attempt success rates for pediatric intubations hovered around 50%. Video-assisted laryngoscopy significantly increased first-attempt success rates and also had fewer adverse outcomes.

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Video-Assisted Laryngoscopy for Pediatric Tracheal Intubation in the Emergency Department: A Multicenter Study of Clinical Outcomes. Ann Emerg Med. 2022 Oct 15:S0196-0644(22)00604-7. doi: 10.1016/j.annemergmed.2022.08.021. Epub ahead of print.

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In patients presenting with ‘wake-up’ strokes, endovascular therapy improves functional outcomes, while intravenous alteplase may also provide a small beneficial impact.

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What is the Efficacy and Safety of Intravenous Thrombolysis and Thrombectomy Among Patients With a Wake-Up Stroke?. Ann Emerg Med. 2022;80(2):165-167. doi:10.1016/j.annemergmed.2022.02.013

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Relative thoracic distention pattern seen on capnography during cardiac arrest may have a negative impact on blood pressure and cerebral perfusion. Here's how to recognize and fix it.

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With ventilation rate standardized, chest compression depth explains variations in ETCO2 better than chest compression rate.

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Contribution of chest compressions to end-tidal carbon dioxide levels generated during out-of-hospital cardiopulmonary resuscitation. Resuscitation. 2022 Oct;179:225-232. doi: 10.1016/j.resuscitation.2022.07.009. Epub 2022 Jul 11.

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Drowning is a common cause of death worldwide. The duration of submersion is the best predictor of outcome, with immediate on-scene CPR and ventilation improving outcomes. Prevention is the best medicine, with public health intervention and policy being the most effective way to prevent drowning.

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Prevention of and Emergency Response to Drowning. NEJM 2022 Oct 6. Doi:10.1056/NEJMra2202392