Primary Spontaneous Pneumothorax – Needle or Not?
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Primary spontaneous pneumothorax (PSP) may be most cost-effectively managed by observation alone in the appropriate patient population.
And the Best Shoulder Reduction Award Goes to…
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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.
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.2022.10.020
Opioids for Abdominal Pain – Are We Influencing Rate of Return?
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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.
Propofol Dose (per kg) Drops From Infant to Teen
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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.
Does Ketamine Raise ICP in Children with TBI?
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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
Captain Morgan or Crane? Can We Use a Hydraulic Lift for Hip Reduction?
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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.
What is the Optimal Position for Successful Lumbar Puncture?
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This randomized controlled trial demonstrated that lateral decubitus position was statistically the same as the upright position for lumbar puncture success.
Source
Is Lateral Decubitus or Upright Positioning Optimal for Lumbar Puncture Success in a Teaching Hospital? J Emerg Med. 2023 Jan 11;S0736-4679(22)00527-3. doi: 10.1016/j.jemermed.2022.09.002. Online ahead of print.
New RCT – Remifentanil vs. Neuromuscular Blockers for RSI First-Pass Success
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This randomized, non-inferiority trial found that remifentanil plus hypnotics were inferior to neuromuscular blocking agents plus hypnotics for rapid sequence intubation of patients at risk of aspiration in the operating room setting.
Source
Effect of Remifentanil vs Neuromuscular Blockers During Rapid Sequence Intubation on Successful Intubation Without Major Complications Among Patients at Risk of Aspiration: A Randomized Clinical Trial. JAMA. 2023 Jan 3;329(1):28-38. doi: 10.1001/jama.2022.23550.
Point-Counterpoint | IV Haloperidol Should be Avoided in the Emergency Department
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Here are the counterpoints for why these authors think intravenous (IV) haloperidol (Haldol) should be avoided in the emergency department setting.
Point-Counterpoint | IV Haloperidol is Safe for Emergency Department Use
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The next couple of reviews will look at different authors making their case for why intravenous (IV) haloperidol (Haldol) should or should not be used in the emergency department setting.
Source
Haloperidol May Be Safely Administered Intravenously in the Emergency Department. Annals of Emergency Medicine. 2023;81:95-96. doi: 10.1016/j.annemergmed.2022.07.004