July 2024
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Jul 17 2024
Which Physician Specialists Are Behaving Badly?
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Unprofessional behaviors were reported most often among surgeons when comparing physician specialty subgroups.Source
Physician Specialty Differences in Unprofessional Behaviors Observed and Reported by Coworkers. JAMA Netw Open. 2024;7(6):e2415331. doi:10.1001/jamanetworkopen.2024.15331 -
Jul 16 2024
Optimal Time to Antibiotics in Pediatric Sepsis?
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In a cohort of septic children, delays in antibiotic administration 330 minutes or longer from arrival to the emergency department led to an increase in mortality.Source
Delays to Antibiotics in the Emergency Department and Risk of Mortality in Children With Sepsis. JAMA Netw Open. 2024 Jun 3;7(6):e2413955. doi: 10.1001/jamanetworkopen.2024.13955. PMID: 38837160; PMCID: PMC11154154. -
Jul 15 2024
Hematuria after Trauma…Urine Trouble?
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In a cohort of children with blunt trauma, the presence of hematuria does not predict clinically important intraabdominal injury.Source
Presence of Microscopic Hematuria Does Not Predict Clinically Important Intra-Abdominal Injury in Children. Pediatr Emerg Care. 2024 Jun 7. doi: 10.1097/PEC.0000000000003210. Epub ahead of print. PMID: 38849150. -
Jul 12 2024
No PERC, Wells, Geneva – Just D-Dimers for Everyone?
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A “D-dimer only” pathway in patients with suspected pulmonary embolism (PE) was safely used to determine need for imaging without clinical decision rules, but there are some concerns with this approach.Source
Implementation, Clinical Benefit and Safety of a D-Dimer-Focused Pulmonary Embolism Testing Pathway in the Emergency Department. Ann Emerg Med. 2024 Apr 23:S0196-0644(24)00156-2. doi: 10.1016/j.annemergmed.2024.03.010. Epub ahead of print. PMID: 38661619. -
Jul 11 2024
Does Stress Ulcer Prophylaxis with a PPI Work?
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An international, multi-center RCT found that administering pantoprazole to intubated ICU patients lowered the rate of upper GI bleeding compared to placebo.Source
Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation. N Engl J Med. Published online June 14, 2024. doi:10.1056/NEJMoa2404245 -
Jul 10 2024
UA Parameters and UTI – One Size Fits All?
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In a multi-hospital retrospective review of over 3,000 patient encounters, common urinalysis (UA) parameters had poor positive predictive value (PPV) in diagnosing urinary tract infection (UTI). Absence of certain parameters (i.e. pyuria and leukocyte esterase) had a high negative predictive value (NPV) for ruling out UTI, but were less reliable in older female patients.Source
Performance of Urinalysis Parameters in Predicting Urinary Tract Infection: Does One Size Fit all? Clin Infect Dis. 2024 Apr 26:ciae230. doi: 10.1093/cid/ciae230. Epub ahead of print. PMID: 38666412. -
Jul 09 2024
GRACE-4 – New Guidelines for Alcohol Withdrawal, Alcohol Use Disorder, and Cannabis Hyperemesis
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GRACE-4 is packed with practice-changing recommendations for patients with alcohol withdrawal syndrome (AWS), alcohol use disorder (AUD), and cannabinoid hyperemesis syndrome (CHS).Source
Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. Acad Emerg Med. 2024 May;31(5):425-455. doi: 10.1111/acem.14911. PMID: 38747203. -
Jul 08 2024
Mesenteric Ischemia – What You Need to Know
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This is a concise review on the diagnosis and management of mesenteric ischemia.Source
Just the facts: Evaluation and management of mesenteric ischemia. CJEM. 2024 May;26(5):316-318. doi: 10.1007/s43678-024-00696-2. Epub 2024 May 7. PMID: 38714638. -
Jul 05 2024
ETA…When?? – How Accurate is EMS ETA Estimate?
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Prehospital providers tend to underestimate the time to ED arrival for EMS ground transports.Source
Accuracy of Prehospital Services' Estimated Time to Arrival for Ground Transport to the Emergency Department. J Emerg Med. 2024 May;66(5):e581-e588. doi: 10.1016/j.jemermed.2023.12.010. Epub 2023 Dec 14. PMID: 38553364. -
Jul 04 2024
Should We Diagnose and Start Hypertension Treatment in the Emergency Department?
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This was an analysis of the 2016-2019 National Hospital Ambulatory Medical Care Survey (NHAMCS) of patients presenting to the ED with asymptomatic hypertension. ED physicians infrequently diagnosed hypertension in this cohort and rarely initiated outpatient antihypertensive prescriptions.Source
Missed Opportunities to Diagnose and Treat Asymptomatic Hypertension in Emergency Departments in the United States, 2016-2019. The Journal of emergency medicine vol. 66,5 (2024): e562-e570.