January 2023
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Jan 17 2023
BTW…Cold Baby – Does Incidental Infant Hypothermia Warrant Workup?
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Well-appearing neonates with incidentally noted hypothermia at a routine visit are at a low risk for serious infection and may not warrant a full sepsis evaluation.Source
Jain SB, Anderson T, Mikhail D, Banerjee R, Arnold DH. Serious infections are rare in well-appearing neonates with hypothermia identified incidentally at routine visits. Am J Emerg Med. 2022 Dec 13;65:1-4. doi: 10.1016/j.ajem.2022.12.008. Epub ahead of print. -
Jan 16 2023
Infant Hypothermia – What’s the Magic Number for a Sepsis Workup?
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There is no definitive low temperature threshold that predicts severe bacterial infections in hypothermic infants. Clinical judgment and adjunct diagnostics are important considerations.Source
Temperature threshold in the screening of bacterial infections in young infants with hypothermia. Emerg Med J. 2022 Nov 17;emermed-2022-212575. doi: 10.1136/emermed-2022-212575. Online ahead of print. -
Jan 13 2023
Does Intra-Articular Lidocaine Work for Shoulder Reduction?
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Intra-articular lidocaine (IAL) is a safe alternative for the reduction of anterior shoulder dislocations and may have similar efficacy to intravenous (IV) sedation, with fewer adverse events and shorter ED length of stay.Source
Intra-articular lidocaine versus intravenous sedation for closed reduction of acute anterior shoulder dislocation in the emergency department: a systematic review and meta-analysis. CJEM. 2022 Dec;24(8):809-819. doi: 10.1007/s43678-022-00368-z. Epub 2022 Oct 1. -
Jan 12 2023
Does Fidelity of Simulation Equipment Matter in Fiber-Optic Airway Training?
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Anesthesia residents with little experience in fiber-optic intubation achieved competency faster when trained with a high-fidelity versus low-fidelity model.Source
Achieving Competency in Fiber-Optic Intubation Among Resident Physicians After Higher- Versus Lower-Fidelity Task Training: A Randomized Controlled Study. Anesth Analg. 2022 Nov 29. doi: 10.1213/ANE.0000000000006283. Online ahead of print. -
Jan 11 2023
Shark Sighting on ECG – STEMI Pattern You Need to Know
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Massive ST segment elevation on ECG (so called 'shark fin' pattern, see below) is indicative of severe myocardial injury and is associated with increased risk of ventricular arrhythmia, cardiogenic shock, and death. -
Jan 10 2023
MIPS Crummy at Incentivizing Key Quality Metrics
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The Medicare Merit-based Incentive Payment System (MIPS) seems to be ineffective at measuring quality of care and incentivizing quality improvement.Source
Association Between Individual Primary Care Physician Merit-based Incentive Payment System Score and Measures of Process and Patient Outcomes. JAMA, 328(21), 2136–2146. https://doi.org/10.1001/jama.2022.20619 -
Jan 09 2023
High-Dose Nitroglycerin Infusion in Sympathetic Crashing Acute Pulmonary Edema (SCAPE)
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This study suggests that high-dose nitroglycerin infusion may be a safe alternative to intermittent bolus dosing for SCAPE, but prospective trials are needed to determine optimal initial rates and titration strategies, as well as the proper use of other adjunct therapies.Source
High-dose nitroglycerin infusion description of safety and efficacy in sympathetic crashing acute pulmonary edema: The HI-DOSE SCAPE study. Am J Emerg Med. 2022 Oct 18;63:74-78. doi: 10.1016/j.ajem.2022.10.018. Epub ahead of print. -
Jan 06 2023
Amiodarone vs Lidocaine for In-Hospital Cardiac Arrest
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For in-hospital ventricular fibrillation/ventricular tachycardia (VF/VT) arrest (IHCA), lidocaine may have more favorable outcomes compared to amiodarone.Source
Comparative Effectiveness of Amiodarone and Lidocaine for Treatment of In-Hospital Cardiac Arrest (IHCA). Chest. 2022 Nov 1;S0012-3692(22)04039-9. doi: 10.1016/j.chest.2022.10.024. Online ahead of print. -
Jan 05 2023
ILCOR – 2022 Resuscitation Science Evidence Review
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Here are the latest evidence updates on basic, advanced, and pediatric life support - and more - from this expert literature review.Source
2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation. 2022 Nov 3. doi: 10.1161/CIR.0000000000001095. Online ahead of print. -
Jan 04 2023
PILOT RCT – Do Oxygen Targets Matter in Critically Ill Patients?
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Among adult patients receiving mechanical ventilation, there was no significant difference in ventilator-free days or 28-day mortality between groups in which a lower (88-92%), intermediate (92-96%), or higher SpO2 target (96-100%) was used.