October 2023
-
Oct 17 2023
Help or Hurt? Efficacy of Short-Term Opioid Prescriptions Post-Discharge
Spoon Feed
Opioids, other than codeine, were found to be more effective when compared to non-opioids for treatment of acute musculoskeletal pain after ED discharge. However, they were also associated with a higher rate of adverse outcomes.Source
Efficacy of prescribed opioids for acute pain after being discharged from the emergency department: A systematic review and meta-analysis. Acad Emerg Med. 2023 Aug 22. doi: 10.1111/acem.14790. Online ahead of print. -
Oct 16 2023
NSAIDs + OCPs = More VTEs?
Spoon Feed
This Danish nationwide cohort study found that in reproductive-age women, NSAID use alone increased the risk of venous thromboembolism (VTE). The magnitude of risk was compounded by concomitant use of hormonal contraception.Source
Venous thromboembolism with use of hormonal contraception and non-steroidal anti-inflammatory drugs: nationwide cohort study. BMJ 2023; 382 :e074450 doi:10.1136/bmj-2022-074450. -
Oct 13 2023
Who Gets Sued in EM – NP, PA, Attending, or Resident?
Spoon Feed
In a retrospective analysis of 5,854 emergency department malpractice cases from over 550 US hospitals, 193 (3.3%) involved an NP, 513 (8.8%) involved a PA, 535 (9.1%) involved a trainee, and 4,568 (78.0%) were attending only.Source
Characterizing malpractice cases involving emergency department advanced practice providers, physicians in training, and attending physicians [published online ahead of print, 2023 Sep 8]. Acad Emerg Med. 2023;10.1111/acem.14800. -
Oct 12 2023
What’s the BEST Target SBP Post-Embolectomy for Stroke?
Spoon Feed
More aggressive systolic blood pressure (SBP) goals, beyond keeping it <180 mmHg, probably don’t make much of a difference in outcomes for patients who have undergone endovascular therapy for ischemic stroke.Source
Blood Pressure Management After Endovascular Therapy for Acute Ischemic Stroke: The BEST-II Randomized Clinical Trial. JAMA. 2023 Sep 5;330(9):821-831. doi: 10.1001/jama.2023.14330. -
Oct 11 2023
1-Plane, 2-Plane, X-plane? Ultrasound-Guided Central Lines
Spoon Feed
In a small, randomized trial, placing an ultrasound-guided central venous catheter (CVC) using 2 planes simultaneously was more likely to be successful on the first attempt and performed more quickly. Both groups had a 100% procedural success rate. -
Oct 10 2023
Does a Gun Safety Video Make Kids Safer Around Actual Guns?
Spoon Feed
Children who viewed a 1-minute firearm safety video exhibited safer behaviors around inert firearms staged in a playroom. With firearm-related deaths overtaking motor vehicles as the leading cause of US minor deaths, introducing children to firearm safety shows promise in addressing one dimension of this public health crisis.Source
Effect of a Gun Safety Video on Children's Behavior Around Real Guns: A Randomized Clinical Trial. JAMA Pediatr. 2023 Sep 1;177(9):903-910. doi: 10.1001/jamapediatrics.2023.2397. -
Oct 09 2023
How to Identify Errors – “Would You Have Done Something Differently?”
Spoon Feed
Asking EPs the question - “Would you have done something differently? (WYHDSD)” - was found to have high sensitivity (97.4%) and NPV (99.8%) in predicting medical error. Specificity was lower at 92.9%.Source
Can Asking Emergency Physicians Whether or Not They Would Have Done Something Differently (WYHDSD) be a Useful Screening Tool to Identify Emergency Department Error? J Emerg Med. 2023 Sep;65(3):e250-e255. doi: 10.1016/j.jemermed.2023.05.005. Epub 2023 Jun 10. -
Oct 06 2023
Cauda Equina Syndrome – Spoon-Feed Version
Spoon Feed
Cauda equina syndrome (CES) is a spinal emergency. This is a practical guide for diagnosis and management as well as review of recent literature published on the topic. -
Oct 05 2023
New DOAC Score Outperforms HAS-BLED for Major Bleeding
Spoon Feed
The new DOAC score had stronger predictive performance for major bleeding in patients on anticoagulation for atrial fibrillation (A-fib) compared to the HAS BLED score.Source
Development and Validation of the DOAC Score: A Novel Bleeding Risk Prediction Tool for Patients With Atrial Fibrillation on Direct-Acting Oral Anticoagulants. Circulation. 2023 Sep 19;148(12):936-946. doi: 10.1161/CIRCULATIONAHA.123.064556. Epub 2023 Aug 25. -
Oct 04 2023
Identifying Objective Performance Errors During Intubation
Spoon Feed
Using intubation videos, this group identified 13 key performance errors that occur during laryngoscopy. Read more to see what the proceduralists did wrong.