Ketamine for the Win? Induction Agents Compared
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A Bayesian meta-analysis found an 83.2% probability that ketamine lowers mortality compared to etomidate in critically ill patients undergoing intubation.
Source
Ketamine versus etomidate as an induction agent for tracheal intubation in critically ill adults: a Bayesian meta-analysis. Crit Care. 2024 Feb 17.
New ACEP Guideline – Topical Anesthetics for Corneal Abrasion
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The ACEP consensus seems to indicate that it may be safe for patients with a simple corneal abrasion to go home with 24 hour usage of topical anesthetics for pain relief, but the ophthalmologists are not on board.
Ketamine vs Morphine for Acute Pain
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A meta-analysis of 15 randomized trials found that ketamine had a quicker analgesic effect than morphine, but morphine exhibited sustained reduction in pain at 120 minutes.
Source
Low-dose ketamine versus morphine in the treatment of acute pain in the emergency department: A meta-analysis of 15 randomized controlled trials. Am J Emerg Med. 2024;76:140-149. doi:10.1016/j.ajem.2023.11.056
Can Topical Lidocaine Help Solve Chronic Neck Pain?
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In this randomized trial of patients with chronic neck pain, patients who received lidocaine patch treatments had an equivalent pain response to patients who received placebo patches.
Source
Multicenter, Randomized, Placebo-Controlled Crossover Trial Evaluating Topical Lidocaine for Mechanical Cervical Pain. Anesthesiology. Published online December 11, 2023. doi:10.1097/ALN.0000000000004857.
Hot Topics in RSI – Guidelines from The Society of Critical Care Medicine
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Positioning, preoxygenation, medication selection, and other questions surrounding emergent rapid sequence intubation (RSI) are addressed by an expert panel.
Help or Hurt? Efficacy of Short-Term Opioid Prescriptions Post-Discharge
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Opioids, other than codeine, were found to be more effective when compared to non-opioids for treatment of acute musculoskeletal pain after ED discharge. However, they were also associated with a higher rate of adverse outcomes.
Source
Efficacy of prescribed opioids for acute pain after being discharged from the emergency department: A systematic review and meta-analysis. Acad Emerg Med. 2023 Aug 22. doi: 10.1111/acem.14790. Online ahead of print.
OPAL RCT – No More Opioids for Back Pain
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Opioid pain medications offer no benefit compared to placebo for patients with acute back or neck pain.
Source
Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial. Lancet. 2023 Jun 27:S0140-6736(23)00404-X. doi: 10.1016/S0140-6736(23)00404-X. Epub ahead of print.
Is Platelet Transfusion Over 50k Needed for Central Line Placement?
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Clinically relevant bleeding events were more common after central venous catheter placement in patients with platelet counts of 10,000 to 50,000/mm3 who did not receive prophylactic platelet transfusion than those who did.
A Band-Aid for a Bullet Hole? – Maybe with microMend
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In this very limited study, the microMend* device was found to be comparable to classic repair techniques in terms of wound closure and cosmetic outcome, with high satisfaction among both providers as well as patients, but note the caveats below.
Can Emergency Physicians Do Lateral Canthotomy?
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This retrospective study showed that EM providers are equipped to perform lateral canthotomy and cantholysis (C&C) in cases of orbital compartment syndrome (OCS) with success rates comparable to ophthalmologists.
Source
Success rates of lateral canthotomy and cantholysis for treatment of orbital compartment syndrome. Am J Emerg Med. 2023 Jun 1;70:140-143. doi: 10.1016/j.ajem.2023.05.037. Epub ahead of print.