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In a retrospective study of 331 low risk acute pulmonary embolism patients, concerning CTPA findings were not associated with adverse clinical outcomes.
Source
Adverse Clinical Outcomes Among Patients With Acute Low-risk Pulmonary Embolism and Concerning Computed Tomography Imaging Findings. JAMA Netw Open. 2023 May 1;6(5):e2311455. doi: 10.1001/jamanetworkopen.2023.11455.
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A recalibrated HEART score ≤ 3 utilizing hs-cTnT ruled out MACE (adjudicated type 1 MI, unplanned coronary revascularization, and all cause death) at 30 days at a sensitivity of 98.5% and NPV of 99.7% with the ability to discharge 46.5% of patients in this cohort.
Source
HEART Score Recalibration Using Higher Sensitivity Troponin T. Annals of emergency medicine, S0196-0644(23)00313-X. 10 Jun. 2023, doi:10.1016/j.annemergmed.2023.04.024
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Clinically relevant bleeding events were more common after central venous catheter placement in patients with platelet counts of 10,000 to 50,000/mm3 who did not receive prophylactic platelet transfusion than those who did.
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Verified physician answers to patient questions on a public social media forum were compared to Chatbot answers to the same questions by rating the quality and empathy of responses. Guess who won?
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In patients resuscitated after out-of-hospital cardiac arrest (OHCA), targeted mild hypercapnia was not associated with better neurologic outcomes at 6 months compared to normocapnia.
Source
Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest. N Engl J Med. 2023 Jun 15. doi: 10.1056/NEJMoa2214552. Epub ahead of print.
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Prehospital administration of tranexamic acid (TXA) did not result in greater functional survival in patients with major trauma and suspected trauma-induced coagulopathy.
Source
Prehospital Tranexamic Acid for Severe Trauma. N Engl J Med. 2023 Jun 14. doi: 10.1056/NEJMoa2215457. Epub ahead of print.
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In this small, retrospective review of 22 patients with antimuscarinic delirium who received antidotal therapy with transdermal +/- oral rivastigmine, there were no major adverse effects observed, and symptom resolution generally occurred within a matter of hours.
Source
Greene SC. Rivastigmine Use in the Treatment of Antimuscarinic Delirium. J Med Toxicol. 2023 Jul;19(3):284-287. doi: 10.1007/s13181-023-00947-1. Epub 2023 May 19.
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Empiric macrolide therapy was associated with improved six and twelve-month survival among ICU patients with community-acquired pneumonia (CAP).
Source
Impact of macrolide treatment on long-term mortality in patients admitted to the ICU due to CAP: a targeted maximum likelihood estimation and survival analysis. Crit Care. 2023 May 31;27(1):212. doi: 10.1186/s13054-023-04466-x.
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PEN-FAST is a clinical decision-making tool that effectively identifies patients with self-reported penicillin allergy who are at negligible risk of hypersensitivity reaction after exposure to these antibiotics.
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On average, female EM physicians leave clinical practice 12 years younger than their male counterparts, after fewer years of practice, and the amount of time spent in the workforce is decreasing over time. We need to identify and implement systemic fixes to stop this.
Source
Emergency medicine physician workforce attrition differences by age and gender. Acad Emerg Med. 2023 Jun 14. doi: 10.1111/acem.14764. Online ahead of print.
