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There continues to be a lack of evidence to strongly recommend one treponemal assay over another in the diagnosis of syphilis, particularly given the varying accuracy of each test depending on the stage of the disease. For now, this review suggests the diagnostic algorithm recommended by the CDC (see below!) seems to be a reasonable approach, but more trials are needed to refine this.

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Operating Characteristics of Diagnostic Tests for Syphilis. Acad Emerg Med. 2024 Sep 6; 00:1-3. doi: 10.1111/acem.15008. PMID: 39239836.

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This prospective study of a new proprietary rapid host-protein test, MeMed BV (MMBV), shows promising results for differentiating viral vs bacterial causes of fever. However, the gold standard for comparison was similar to current common practice, making it difficult to measure the added value of MMBV over usual care.

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A rapid host-protein test for differentiating bacterial from viral infection: Apollo diagnostic accuracy study. J Am Coll Emerg Physicians Open. 2024 May 8;5(3):e13167. doi: 10.1002/emp2.13167. PMID: 38721037; PMCID: PMC11077430.

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Dequalinium chloride was noninferior to metronidazole for treatment of bacterial vaginosis (BV), with fewer side effects.

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Efficacy of Dequalinium Chloride vs Metronidazole for the Treatment of Bacterial Vaginosis: A Randomized Clinical Trial. JAMA Netw Open. 2024 May 1;7(5):e248661. doi: 10.1001/jamanetworkopen.2024.8661. PMID: 38696172; PMCID: PMC11066704.

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Anterior-posterior (AP) - compared to standard anterolateral (AL) defibrillator pad placement - was associated with higher rates of ROSC among patients with out-of-hospital-cardiac-arrest (OHCA), but no difference in survival to discharge or functional survival at discharge was observed.

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Initial Defibrillator Pad Position and Outcomes for Shockable Out-of-Hospital Cardiac Arrest. JAMA Netw Open. 2024 Sep 3;7(9):e2431673. doi: 10.1001/jamanetworkopen.2024.31673. PMID: 39250154; PMCID: PMC11385052.

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For sickle cell patients (particularly Hgb SS) with a vaso-occlusive episode (VOE), large volume resuscitation (>2L) with lactated ringers (LR) has been shown to have improved outcome measures compared to normal saline (NS).

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Lactated Ringer vs Normal Saline Solution During Sickle Cell Vaso-Occlusive Episodes. JAMA Intern Med. 2024 Sep 9:e244428. doi: 10.1001/jamainternmed.2024.4428. Epub ahead of print. PMID: 39250114; PMCID: PMC11385329.

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Cavernous sinus thrombosis (CST) is a rare but serious thrombophlebitic disease that can be easy to miss in the emergency department setting. This article provides an overview of CST as well as some pearls for clinching this diagnosis for emergency medicine physicians.

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High risk and low prevalence diseases: Cavernous sinus thrombosis. Am J Emerg Med. 2024;83:47-53. doi:10.1016/j.ajem.2024.06.024.
PMID: 38959601.

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This retrospective observational analysis showed an association with more favorable neurologic outcomes, survival to hospital discharge, and ROSC upon ED arrival, in an IV-first approach compared to humeral IO in out-of-hospital cardiac arrests.

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The association of intravenous vs. humeral-intraosseous vascular access with patient outcomes in adult out-of-hospital cardiac arrests. Resuscitation. 2024 Sep;202:110360. doi: 10.1016/j.resuscitation.2024.110360. Epub 2024 Aug 16. PMID: 39154890.

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ACEP released a clinical policy that addresses the choice of a second-line agent for adults with refractory seizures after adequate dosing of benzodiazepines.

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Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Seizures: Approved by the ACEP Board of Directors, April 17, 2024. Ann Emerg Med. 2024 Jul;84(1):e1-e12. doi: 10.1016/j.annemergmed.2024.02.018. PMID: 38906639.

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This systematic review snapshot found that when the HINTS exam is used by properly trained clinicians, it shows high sensitivity and moderate specificity to identify central causes of acute vestibular syndrome (AVS).

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Are the HINTS and HINTS Plus Examinations Accurate for Identifying a Central Cause of Acute Vestibular Syndrome? Ann Emerg Med. 2024 Jul;84(1):60-62. doi: 10.1016/j.annemergmed.2024.01.027. Epub 2024 Feb 22. PMID: 38385911.

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Mental practice, a cognitive rehearsal technique from sports psychology, can enhance skill retention and competency in emergency medicine, particularly for high-acuity, low-frequency procedures.

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Mental Practice: Applying Successful Strategies in Sports to the Practice of Emergency Medicine. Ann Emerg Med. 2024 Aug;84(2):159-166. doi: 10.1016/j.annemergmed.2023.12.011. Epub 2024 Jan 18. PMID: 38244027.