November 2023
-
Nov 16 2023
Pop Quiz for Dr. Chatbot – How Did AI Do?
Spoon Feed
A popular artificial intelligence (AI) chatbot, ChatGPT, was fed hundreds of medical questions of varying difficulty. Responses generally demonstrated high accuracy and completeness, but inaccuracies were still noted. AI chatbot use in routine clinical practice simply isn’t ready for primetime.Source
Accuracy and Reliability of Chatbot Responses to Physician Questions. JAMA Netw Open. 2023 Oct 2;6(10):e2336483. doi: 10.1001/jamanetworkopen.2023.36483. -
Nov 15 2023
Is REBOA Dead? The UK-REBOA RCT
Spoon Feed
In the first ever randomized clinical trial (RCT) of resuscitative endovascular balloon occlusion of the aorta (REBOA), exsanguinating patients receiving REBOA and standard care suffered greater mortality than those receiving standard care alone. But don’t throw those balloons away just yet, this study had significant limitations. -
Nov 14 2023
How to Lower Your Mortality (And Your Patients) – One Step at a Time
Spoon Feed
There is a nonlinear inverse dose-response trend between daily step count and all-cause death and cardiovascular disease, with progressive risk reductions starting at as few as 2500 to 2700 steps/day, independent of sex. Walking faster provided additive health benefits.Source
Relationship of Daily Step Counts to All-Cause Mortality and Cardiovascular Events. J Am Coll Cardiol. 2023 Oct 10;82(15):1483-1494. doi: 10.1016/j.jacc.2023.07.029. Epub 2023 Sep 6. -
Nov 13 2023
Can We Simplify a HEART Score to a HET Score?
Spoon Feed
Both the HEART- and HET-score (using history, ECG changes, and high-sensitivity troponin) performed similarly when risk-stratifying ACS rule-out patients, but the HET-score had higher overall diagnostic accuracy.Source
HEART-score can be simplified without loss of discriminatory power in patients with chest pain - Introducing the HET-score. Am J Emerg Med. 2023 Oct 1;74:104-111. doi: 10.1016/j.ajem.2023.09.037. Epub ahead of print. -
Nov 10 2023
Transfusion Trigger – New AABB Guidelines for Adults and Children
Spoon Feed
For hemodynamically stable adults and children, 7g/dL is the best transfusion trigger, with a few exceptions.Source
Red Blood Cell Transfusion: 2023 AABB International Guidelines. JAMA. 2023 Oct 12. doi: 10.1001/jama.2023.12914. Online ahead of print. -
Nov 09 2023
Snarky Sign-outs – How to Avoid Bias During Handoff
Spoon Feed
Our words during handoff can bias our colleagues against our patients. Here's how it happens and what we can do to improve.Source
Patient Factors Associated With Biased Language in Nightly Resident Verbal Handoff. JAMA Pediatr. 2023 Oct 1;177(10):1098-1100. doi: 10.1001/jamapediatrics.2023.2581. -
Nov 08 2023
Does Contact Precaution for MRSA Really Matter?
Spoon Feed
Contact precaution (CP) for patients with MRSA infection or colonization is listed as an "essential practice" for all U.S. hospitals, but should it be? -
Nov 07 2023
Loperamide (Imodium) and Mitragynine (Kratom) and Risk of Ventricular Arrhythmia
Spoon Feed
Loperamide, an over-the-counter antidiarrheal opiate, and mitragynine (kratom) are both associated with ventricular arrhythmia and death.Source
Ventricular Arrhythmias Associated With Over-the-Counter and Recreational Opioids. J Am Coll Cardiol. 2023 Jun 13;81(23):2258-2268. doi: 10.1016/j.jacc.2023.04.009. -
Nov 06 2023
Alpha-gal and Anaphylaxis – What You Need to Know
Spoon Feed
Anaphylaxis secondary to alpha-gal syndrome is increasing in frequency, particularly in the Southeast United States. It is important for Emergency Physicians to be aware of the rising incidence so as to include it on their differential.Source
Alpha-Gal Syndrome: A Novel and Increasingly Common Cause of Anaphylaxis. Ann Emerg Med. 2023 Oct 11:S0196-0644(23)01187-3. doi: 10.1016/j.annemergmed.2023.08.491. Epub ahead of print. -
Nov 03 2023
ACORN RCT – Piperacillin-Tazobactam or Cefepime?
Spoon Feed
In this randomized control trial of patients receiving cefepime or piperacillin-tazobactam, there was no difference in risk of acute kidney injury between the two groups. However, those who received cefepime were more likely to have neurologic side effects.Source
Cefepime vs Piperacillin-Tazobactam in Adults Hospitalized With Acute Infection: The ACORN Randomized Clinical Trial. JAMA. 2023 Oct 14:e2320583. doi: 10.1001/jama.2023.20583. Online ahead of print.