Is This Patient REALLY Penicillin-Allergic? Try the PEN-FAST Decision Tool
Spoon Feed
PEN-FAST is a clinical decision-making tool that effectively identifies patients with self-reported penicillin allergy who are at negligible risk of hypersensitivity reaction after exposure to these antibiotics.
LUS (Let’s Use Sonography) to Diagnose ARDS!
Spoon Feed
The LUS-ARDS score can make a diagnosis of acute respiratory distress syndrome (ARDS) easier, particularly in patients who can’t have CT scan. The LUS-ARDS score performs similarly to the standard of care (Berlin criteria plus CXR evaluation) in diagnosis of ARDS in ventilated patients.
Should We Rx Inhaled Steroids for Asthma?
Spoon Feed
In this study, only 6% of asthma patients discharged from the ED received a prescription for inhaled corticosteroids and only 14% had any outpatient follow-up within 30 days of their ED visit. Patients who were Hispanic, uninsured, and privately insured had the lowest odds of receiving an ICS prescription from the ED.
Source
Inhaled Corticosteroids Rarely Prescribed at Emergency Department Discharge Despite Low Rates of Follow-Up Care. J Emerg Med. 2023 May;64(5):555-563. doi: 10.1016/j.jemermed.2023.02.013. Epub 2023 Mar 21.
Primary Spontaneous Pneumothorax – Needle or Not?
Spoon Feed
Primary spontaneous pneumothorax (PSP) may be most cost-effectively managed by observation alone in the appropriate patient population.
Hydrocortisone for Severe Pneumonia – Can It Stop the Coffin? CAPE COD RCT
Spoon Feed
Hydrocortisone treatment for patients with severe community-acquired pneumonia was associated with reduced 28-day mortality and no increase in major adverse events.
Source
Hydrocortisone in Severe Community-Acquired Pneumonia. N Engl J Med. 2023 Mar 21. doi: 10.1056/NEJMoa2215145. Online ahead of print.
Not Just for Kids – RSV vs Flu Impact on Adults
Spoon Feed
Respiratory syncytial virus (RSV) is prevalent in hospitalized adults and is associated with higher odds of prolonged hospitalization and mechanical ventilation, particularly in patients with CHF and COPD.
Source
Prevalence and Clinical Outcomes of Respiratory Syncytial Virus versus Influenza in Adults Hospitalized with Acute Respiratory Illness from a Prospective Multicenter Study. Clin Infect Dis. 2023 Jan 24;ciad031. doi: 10.1093/cid/ciad031. Online ahead of print.
Does an Epinephrine MDI (Primatene Mist) Work for Croup?
Spoon Feed
Epinephrine administration via metered-dose inhaler (MDI) for the treatment of croup in children may be a safe and effective alternative to nebulization.
Source
Epinephrine metered-dose inhaler for pediatric croup. Acad Emerg Med. 2023 Feb;30(2):144-146. doi: 10.1111/acem.14616. Epub 2022 Dec 7.
PARIS-2 RCT – Does High Flow Oxygen Help Hypoxic Children?
Spoon Feed
As compared with standard oxygen therapy, high flow oxygen was associated with increased length of hospital stay in pediatric patients with hypoxemic respiratory failure.
Source
Effect of Early High-Flow Nasal Oxygen vs Standard Oxygen Therapy on Length of Hospital Stay in Hospitalized Children With Acute Hypoxemic Respiratory Failure: The PARIS-2 Randomized Clinical Trial. JAMA. 2023;329(3):224-234.
Angioedema – Who Needs Intubation?
Spoon Feed
In patients presenting with angioedema, history of hypertension, shortness of breath, drooling, and anterior tongue or pharyngeal swelling were risk factors predicting eventual need for intubation.
Source
Clinical predictors of endotracheal intubation in patients presenting to the emergency department with angioedema. Am J Emerg Med. 2023 Jan;63:44-49. doi: 10.1016/j.ajem.2022.10.017. Epub 2022 Oct 19.
Should We Use Steroids in Community Acquired Pneumonia Patients?
Spoon Feed
Corticosteroid use was associated with a prevention of progression to mechanical ventilation among inpatients with community acquired pneumonia (CAP), but it had no association with the primary outcome of mortality.
Source
Effect of corticosteroids on mortality and clinical cure in community-acquired pneumonia: A systematic review, meta-analysis, and meta-regression of randomized control trials. Chest. 2022 Sep 7;S0012-3692(22)03705-9. doi: 10.1016/j.chest.2022.08.2229. Online ahead of print.