May 2023
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May 17 2023
Mystery ECG – Would You Send This to the Cath Lab?
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Presented is a discussion of ECG and clinical findings in the setting of a ventricular paced rhythm (and other wide QRS complex rhythms) that could signal the presence of occlusion myocardial infarction (OMI). -
May 16 2023
Fever, Leg Pain, Pediatrics – Blood Culture or Not?
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Bacteremia is common in pediatric patients who present to the ED with fever and acute lower extremity pain. Obtain a blood cultures in these patients, as it is likely to assist in diagnosis or change management, particularly if they also have a higher fever, focal bony tenderness, or an elevated CRP.Source
Bacteremia in Children With Fever and Acute Lower Extremity Pain. Pediatrics. 2023 Apr 4;e2022059504. doi: 10.1542/peds.2022-059504. Online ahead of print. -
May 15 2023
Mistriaged – How Good Is ESI?
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The Emergency Severity Index (ESI) mistriaged roughly 1 of every 3 patients who presented to 21 EDs in the Kaiser Permanente health system.Source
Evaluation of the Emergency Severity Index in US Emergency Departments for the Rate of Mistriage. JAMA network open vol. 6,3 e233404. 1 Mar. 2023, doi:10.1001/jamanetworkopen.2023.3404 -
May 12 2023
Resident Physician Work Hours – Association with Harm and Occupational Injury
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Working extended duration shifts (≥ 24 hours) and > 48 hours/week were associated with an increased risk of medical errors, adverse events, MVAs, occupational exposures, percutaneous injuries, and attentional failures regardless of experience level in a large nationwide prospective cohort study.Source
Impact of work schedules of senior resident physicians on patient and resident physician safety: nationwide, prospective cohort study. BMJ Medicine 2023;2:e000320. doi: 10.1136/bmjmed-2022-000320 -
May 11 2023
Is Having Results at Your Fingertips a Good Thing? How Patients Perceive 21st Century Cures Act
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In general, patients prefer to review and see their testing results (even if abnormal) via a patient portal even before discussing them with a healthcare provider.Source
Perspectives of Patients About Immediate Access to Test Results Through an Online Patient Portal. JAMA Netw Open. 2023 Mar 1;6(3):e233572. doi: 10.1001/jamanetworkopen.2023.3572. -
May 10 2023
CT C-Spine Negative? Clear The Kid’s Collar
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In this large, single-institution retrospective review of pediatric blunt trauma patients, no clinically significant injuries (requiring operative intervention) were missed when using multi-detector CT scan as the imaging modality of choice. -
May 09 2023
Thionamide Smackdown – PTU vs MMI for Thyroid Storm
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This comparative effectiveness study showed no significant difference in clinical outcomes or adverse effects when comparing use of propylthiouracil (PTU) and methimazole (MMI) for thyroid storm. This suggests both medications may be reasonable first-line treatment options for patients with thyroid storm.Source
Comparison of Propylthiouracil vs Methimazole for Thyroid Storm in Critically Ill Patients. JAMA Netw Open. 2023 Apr 3;6(4):e238655. doi: 10.1001/jamanetworkopen.2023.8655. -
May 08 2023
VL vs. DL – Better View and More First-Pass Success?
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A post hoc analysis of two RCTs found greater adjusted odds of a favorable glottic view and first-attempt success (with suboptimal view) when using video laryngoscopy (VL) vs. direct laryngoscopy (DL).Source
Laryngoscopy and Tracheal Intubation: Does Use of a Video Laryngoscope Facilitate Both Steps of the Procedure? Ann Emerg Med. 2023 Apr 5;S0196-0644(23)00126-9. doi: 10.1016/j.annemergmed.2023.02.016. Online ahead of print. -
May 05 2023
Is Delayed Sequence Intubation (DSI) Safe in Trauma?
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When compared to rapid sequence intubation (RSI), this RCT showed decreased peri-intubation hypoxic events and increased first attempt success in agitated and delirious ED patients with major trauma who underwent delayed sequence intubation (DSI).Source
Peri-Intubation Hypoxia After Delayed Versus Rapid Sequence Intubation in Critically Injured Patients on Arrival to Trauma Triage: A Randomized Controlled Trial. Anesth Analg. 2023 May 1;136(5):913-919. doi: 10.1213/ANE.0000000000006171. Epub 2023 Apr 14. -
May 04 2023
Is Your Favorite Blog Any Good? New Digital Impact Factor Can Help
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The Digital Impact Factor is a way to objectively determine the impact, quality, reach, and consistency of free emergency medicine and critical care blogs and podcasts.Source
Digital Impact Factor: A Quality Index for Educational Blogs and Podcasts in Emergency Medicine and Critical Care. Ann Emerg Med. 2023 Mar 24;S0196-0644(23)00119-1. doi: 10.1016/j.annemergmed.2023.02.011. Online ahead of print.