Clay Smith
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Jun 22 2016
Take an aspirin after TIA to reduce stroke
Short Attention Span Summary In this meta-analysis focusing on time since TIA, early use of aspirin after TIA reduced the incidence of recurrent stroke at 6 weeks by 60%, NNT = 72. The hazard ratio for those receiving aspirin vs control from 0-2 weeks was 0.07, NNT = 269. This is a dramatically reduced risk. […]Read More -
Jun 21 2016
PATCH trial – no platelet transfusion for ICH
Short Attention Span Summary It makes sense that patients on antiplatelet agents with spontaneous ICH would benefit from transfusion of new, sticky platelets. But this multicenter study found that it increased the odds of death or dependence at 3 months by 105% (Odds ratio 2.05). And more in the transfusion group died while still in […]Read More -
Jun 20 2016
C. difficile reactive arthritis in kids
Short Attention Span Summary Have you ever heard of C. difficile associated reactive arthritis in pediatric patients? Me neither! So I thought we could learn something with this article. After C. difficile infection, a reactive arthritis may occur that can mimic septic arthritis. Make sure to ask about preceding antibiotics and diarrhea in your next pediatric patient with […]Read More -
Jun 17 2016
Dexamethasone equals prednisolone in pediatric asthma
Emergency Medicine, Pediatric Emergency, Pharmacy/Pharmacology, Pulmonary/Allergy, Retail/Urgent CareShort Attention Span Summary Single dose dexamethasone 0.3mg/kg, up to 12mg, was not inferior to multiple dose prednisolone in pediatric asthma exacerbation. Fewer dex kids vomited, and more dex kids had additional steroids prescribed. I covered this article last year. FOAM Report Emergency Medicine Cases First10EM PEM Playbook emeddoc Abstract Ann Emerg Med. 2016 May;67(5):593-601.e3. doi: […]Read More -
Jun 16 2016
Low dose tPA for stroke
Short Attention Span Summary Low dose (0.6mg/kg) tPA was found to be (barely) inferior to standard dose (0.9mg/kg) tPA in regard to the primary outcome of death or severe disability at 90 days, but there were fewer bleeds (1% vs 2.1%) in the low-dose group. This was predominantly an Asian population, which limits generalizability. FOAM […]Read More -
Jun 15 2016
Legislating mortality – firearm law impact
Short Attention Span Summary I know this is a hot button issue, but in light of the recent mass shooting in Orlando this article from March in the Lancet is timely. Authors concluded that universal background checks for firearm purchases would decrease firearm related mortality from the current 10.35 deaths/100,000 to 4.46 deaths/100,000. Before we […]Read More -
Jun 14 2016
ALTE changes to BRUE
Short Attention Span Summary Apparent Life Threatening Event (ALTE) has undergone a name change and redefinition. The new name for this is BRUE – Brief Resolved Unexplained Events. A BRUE consists of: “sudden, brief, and now resolved episode of ≥1 of the following: (1) cyanosis or pallor; (2) absent, decreased, or irregular breathing; (3) marked […]Read More -
Jun 13 2016
Ultrasound guided IV blows more in CT
Short Attention Span Summary Do you have the anecdotal sense that ultrasound guided IVs blow more often with IV contrast in CT? Your hunch is now proven with this study. Unadjusted RR for contrast extravasation compared with standard IV was 14. FOAM Report EM Topics No other FOAM lovin’ Abstract Acad Emerg Med. 2016 May […]Read More -
Jun 11 2016