Clay Smith
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Jul 06 2016
REBOA comparable to open occlusion
Short Attention Span Summary Using a trauma registry, REBOA was comparable (trending toward more favorable) to open aortic occlusion. We have not started using REBOA at our facility yet. I’m curious how many are using it at their institutions. Take the poll, immediately see the results, and find out what your colleagues are doing. FOAM Report Heft […]Read More -
Jul 05 2016
Does this teen have mono?
Short Attention Span Summary Is this adolescent/young adult’s sore throat mono? This rational clinical exam feature found that, “posterior cervical, inguinal or axillary adenopathy, palatine petechiae, splenomegaly, or atypical lymphocytosis is associated with an increased likelihood of mononucleosis.” Why does it matter if it’s mono? Because when we inadvertently treat mono with ampicillin or amoxicillin, […]Read More -
Jul 04 2016
New shoulder reduction technique
Short Attention Span Summary A new shoulder reduction technique was highly successful, allowed patients to sit up, and required no sedation. It is called the Sool’s method. See the video on You Tube. FOAM Report YouTube Abstract Am J Emerg Med. 2016 Apr 9. pii: S0735-6757(16)30036-5. doi: 10.1016/j.ajem.2016.04.012. [Epub ahead of print] The effectiveness of […]Read More -
Jul 01 2016
Manger? Yes – Swaddling Clothes? No
Short Attention Span Summary You may lay your child in a manger (but only on his or her back), but do not wrap them in swaddling clothes. Swaddling babies is associated with increased risk of SIDS, according to this meta-analysis. This is especially true as they become better able to roll into a prone position. Why […]Read More -
Jun 30 2016
Estrogen dose and progestogen type change PE risk
Short Attention Span Summary Ingredients and dose matter in oral contraceptives. Lower dose estrogen – 20 vs. 30-40 micrograms – was safer, with lower risk for PE, stroke, and MI. Regarding the progestogen, desogestrel and gestodene, compared to levonorgestrel, were associated with ~2x the risk of PE but not stroke or MI. Why does this matter? The […]Read More -
Jun 29 2016
Survival with prolonged CPR better than expected
Short Attention Span Summary Is it ever beneficial to do CPR longer than 10 minutes, as survival theoretically drops 10% per minute? In this Danish study, an amazing 14% with CPR > 25 minutes survived at 30 days (18/19 able to live at home vs. nursing home). FOAM Report So it turns out we are […]Read More -
Jun 28 2016
Tourniquets safe in civilian use
Short Attention Span Summary Tourniquets can save lives but could cause injury if not used appropriately. In this retrospective review of civilian use of tourniquets, 56% were placed but no vascular injury ultimately identified. Of tourniquets ultimately found to be unnecessary, authors concluded that no complications arose from tourniquet use. FOAM Report Twitter Abstract Prehosp […]Read More -
Jun 27 2016
Detergent packets should look like broccoli
Short Attention Span Summary Detergent packets are dangerous when kids munch them. And the number of exposures is increasing. I would like to advocate for making the pods less eye appealing to kids. If it was packed to look like a piece of broccoli, exposures would stop overnight. In all seriousness, they look like candy […]Read More -
Jun 24 2016
RSV+ neonates have same SBI rates
Short Attention Span Summary In neonates 28 days and under, rates of serious bacterial infection (SBI) were the same (11-15%) regardless of whether the patient was RSV + or not. Don’t be reassured by a febrile neonate with a positive RSV test. FOAM Report LITFL MD Linx Abstract Pediatr Emerg Care. 2016 May;32(5):286-9. doi: 10.1097/PEC.0000000000000799. […]Read More -
Jun 23 2016
Somatization pre-concussion predicts long recovery
Short Attention Span Summary If you are a little cray-cray before your concussion, you complain of symptoms longer than if you’re not. Pre-injury somatization symptom score was the best predictor of post-concussive symptom duration. FOAM Report Twitter Facebook Med Page Today Abstract Neurology. 2016 May 17;86(20):1856-63. doi: 10.1212/WNL.0000000000002679. Epub 2016 Apr 20. Preinjury somatization symptoms […]Read More