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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.
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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.
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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.
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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.
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Primary spontaneous pneumothorax (PSP) may be most cost-effectively managed by observation alone in the appropriate patient population.
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This meta-analysis found Boss-Holzach-Matter/Davos and FARES had the most favorable value for success rates, while both FARES and modified external rotation were more favorable in reduction times. FARES also had the most favorable score for pain during reduction.Â
Source
A Systematic Review With Pairwise and Network Meta-analysis of Closed Reduction Methods for Anterior Shoulder Dislocation. Annals of emergency medicine vol. 81,4 (2023): 453-465. doi:10.1016/j.annemergmed.2022.10.020Â
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Patients who are discharged from the emergency department after presenting with abdominal pain and receiving opioids have 57% greater odds of return within 30 days. This population is also at higher risk for adverse effects from these medications.
Source
Return Rates for Opioid versus Nonopioid Management of Patients with Abdominal Pain in the Emergency Department. J Emerg Med. 2023 Apr;64(4):471-475. doi: 10.1016/j.jemermed.2023.01.008. Epub 2023 Mar 28.
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The dose of propofol to achieve a desired level of sedation decreased linearly with increasing age in this extensive retrospective review of pediatric procedural sedations.
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This retrospective study of thirty-three pediatric patients with severe traumatic brain injury (sTBI) demonstrated no increase in intracranial pressure (ICP) after administration of ketamine.
Source
Acute Effects of Ketamine on Intracranial Pressure in Children with Severe Traumatic Brain Injury. Crit Care Med. 2023 Feb 24; e005806 DOI: 10.1097
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The authors describe a novel reduction method for posterior hip dislocations using a hydraulic lift to apply longitudinal traction on the upper leg.
