2024
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Jan 25 2024
Should Testing for THC in Altered Children Be Routine?
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Given a substantial increase in the number of children who have accidental ingestion of THC-based products, these authors advocate for consideration of early urine drug screen testing on children who present with altered mental status or neurological symptoms.Source
Urine Toxicology Test for Children With Altered Mental Status. Pediatrics. 2023. Nov 1;152(5):e2022060861Doi: 10.1542/peds. -
Jan 24 2024
Grandma MIGHT Have Hit Her Head…CT or Not?
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Overall rates of intracranial hemorrhage (ICH) in patients >65 years of age with either definite or uncertain head trauma were found to be 11.4% and 1.7%, respectively, leading these authors to recommend head CT imaging on all geriatric patients presenting with possible head trauma. -
Jan 23 2024
New Meta-Analysis – Steroids Lower CAP Mortality
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This meta-analysis found a reduction in all-cause mortality in patients hospitalized with severe CAP who received adjunctive corticosteroid therapy.Source
Efficacy and Safety of Corticosteroid Therapy for Community-Acquired Pneumonia: A Meta-Analysis and Meta-Regression of Randomized, Controlled Trials. Clin Infect Dis. 2023 Dec 15;77(12):1704-1713. doi: 10.1093/cid/ciad496. -
Jan 22 2024
Simplest Way to Boost Patient Satisfaction? You Might Want to Sit Down for This…
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Chair placement near the bedside is a simple intervention that increased the likelihood of physician sitting during patient encounters and yielded higher patient scores in satisfaction and communication.Source
Effect of chair placement on physicians' behavior and patients' satisfaction: randomized deception trial. BMJ. 2023;383:e076309. Published 2023 Dec 15. doi:10.1136/bmj-2023-076309. -
Jan 19 2024
A Bolus of Coca-Cola for Esophageal Food Impaction?
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Ever tried having your patient drink Coca-Cola to relieve an esophageal food bolus? This interesting and well-designed multicenter RCT suggests limited efficacy of this off-label approach.Source
Efficacy of cola ingestion for oesophageal food bolus impaction: open label, multicentre, randomised controlled trial. BMJ. 2023 Dec 11;383:e077294. doi: 10.1136/bmj-2023-077294. -
Jan 18 2024
High-Sensitivity vs Conventional Troponin HEART Pathway
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Use of a high-sensitivity troponin (hsTn) HEART pathway resulted in a small (but significant) increase in percentage of patients diagnosed with acute myocardial infarction (AMI) during index ED visit, and a small but significant decreased in diagnosis of AMI within 30 days after the visit when compared with conventional troponin assays (cTn). It also resulted in reduced hospital admission, stress testing, and coronary revascularization.Source
Emergency Department Cardiac Risk Stratification With High-Sensitivity vs Conventional Troponin HEART Pathway. JAMA Netw Open. 2023 Dec 1;6(12):e2348351. doi: 10.1001/jamanetworkopen.2023.48351. -
Jan 17 2024
Do Febrile Neonates with COVID-19 Need a Full Workup?
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This systematic review and meta-analysis of almost 4,000 febrile infants ≤ 90 days old diagnosed with COVID-19 indicated that these patients have a low prevalence of invasive bacterial infection (IBI), especially the subgroup >28 days old. -
Jan 16 2024
Oxy-PICU RCT – Oxygenation Targets in Ventilated Children
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A conservative (SpO2 88-92%) oxygenation target resulted in a small but significant greater probability of better outcome compared to a liberal (SpO2 >94%) target in children admitted to the PICU on invasive mechanical ventilation.Source
Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU): a UK multicentre, open, parallel-group, randomised clinical trial. Lancet. 2023 Dec 1:S0140-6736(23)01968-2. doi: 10.1016/S0140-6736(23)01968-2. Epub ahead of print. -
Jan 15 2024
Can We Seriously Consider Non-op Management of Appendicitis?
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This expert opinion piece recommends consideration of nonoperative antibiotic treatment for select cases of uncomplicated acute appendicitis.Source
Treatment of Acute Uncomplicated Appendicitis. Treatment of Acute Uncomplicated Appendicitis. N Engl J Med. 2021 Sep 16;385(12):1116-1123. doi: 10.1056/NEJMcp2107675. -
Jan 12 2024
REBOA or Thoracotomy – Which Is Better?
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Traumatic cardiac arrest patients receiving either resuscitative endovascular balloon occlusion of the aorta (REBOA) or resuscitative thoracotomy (RT) experienced similar outcomes, though time to successful occlusion of the aorta took significantly longer with REBOA. The limiter? Common femoral artery (CFA) access.Source
Resuscitative endovascular balloon occlusion of the aorta and resuscitative thoracotomy are associated with similar outcomes in traumatic cardiac arrest. J Trauma Acute Care Surg. 2023 Dec 1;95(6):912-917. doi: 10.1097/TA.0000000000004094. Epub 2023 Jun 29.