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This study supports the notion that an early return to school (RTS), results in faster recovery from concussion symptoms versus prolonged absences.
Source
Association Between Early Return to School Following Acute Concussion and Symptom Burden at 2 Weeks Postinjury. JAMA Netw Open. 2023 Jan 3;6(1):e2251839. doi: 10.1001/jamanetworkopen.2022.51839.
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There is rarely any need to repeat potassium testing when the laboratory reports hyperkalemia on a hemolyzed sample in a child with a normal blood urea nitrogen (BUN) and creatinine (Cr).
Source
Hyperkalemia in a Hemolyzed Sample in Pediatric Patients: Repeat or Do Not Repeat? Pediatr Emerg Care. 2023 Jan 1;39(1):e1-e5. doi: 10.1097/PEC.0000000000002857. Epub 2022 Sep 29.
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This randomized controlled trial demonstrated that lateral decubitus position was statistically the same as the upright position for lumbar puncture success.
Source
Is Lateral Decubitus or Upright Positioning Optimal for Lumbar Puncture Success in a Teaching Hospital? J Emerg Med. 2023 Jan 11;S0736-4679(22)00527-3. doi: 10.1016/j.jemermed.2022.09.002. Online ahead of print.
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This randomized, non-inferiority trial found that remifentanil plus hypnotics were inferior to neuromuscular blocking agents plus hypnotics for rapid sequence intubation of patients at risk of aspiration in the operating room setting.
Source
Effect of Remifentanil vs Neuromuscular Blockers During Rapid Sequence Intubation on Successful Intubation Without Major Complications Among Patients at Risk of Aspiration: A Randomized Clinical Trial. JAMA. 2023 Jan 3;329(1):28-38. doi: 10.1001/jama.2022.23550.
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High sensitivity cardiac troponins (hs-cTn) can be more complex to interpret than our usual diagnostics and are worth a deep dive to understand. This article does an incredible job summarizing existing guidelines and data about how to utilize hs-cTn clinically.
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Candida auris is an emerging, serious, multi-drug resistant fungal pathogen that can quickly spread in hospitals and long-term care facilities. Consider this in recently hospitalized patients or nursing home residents with a history of C. auris infection or colonization, as they may require appropriate infection control measures, testing, and treatment.
Source
On the Rise, Candida auris Outwits Treatments and Travels Incognito in Health Care Settings. JAMA. 2023 Jan 17;329(3):197-199. doi: 10.1001/jama.2022.17760.
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We have witnessed a seasonally uncharacteristic increase in invasive infections and scarlet fever due to group A strep (GAS). Early recognition and low threshold for antibiotics should be used to prevent severe disease.
Source
Resurgence of group A streptococcal disease in children. BMJ. 2023 Jan 10;380:p43. doi: 10.1136/bmj.p43.
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After a training session, both interns and senior emergency providers (EPs) could accurately distinguish between central and peripheral vertigo using the 4-step STANDING algorithm.
Source
Effectiveness and reliability of the 4-step STANDING algorithm performed by emergency interns and seniors for predicting central causes of vertigo. Acad Emerg Med. 2023 Jan 11. doi: 10.1111/acem.14659. Online ahead of print.
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As compared with standard oxygen therapy, high flow oxygen was associated with increased length of hospital stay in pediatric patients with hypoxemic respiratory failure.
Source
Effect of Early High-Flow Nasal Oxygen vs Standard Oxygen Therapy on Length of Hospital Stay in Hospitalized Children With Acute Hypoxemic Respiratory Failure: The PARIS-2 Randomized Clinical Trial. JAMA. 2023;329(3):224-234.
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Here are the counterpoints for why these authors think intravenous (IV) haloperidol (Haldol) should be avoided in the emergency department setting.
