Practicing to find the midpoint of the cricothyroid membrane with ultrasound is a much better way to learn than by using only external landmarks and no ultrasound.

Prehospital administration of 2 units of thawed plasma in adult trauma patients at risk for hemorrhagic shock reduced mortality compared to standard care, NNT = 10.

After almost twenty years as a doctor, constantly reading, it never ceases to amaze me how much I still don't know.  One of the highlights of my job is working with great residents who also teach me.  This week was no exception.  Here are two things I learned from our residents this week.

This meta-analysis of 4 RCTs found anti-MRSA antibiotics in addition to I&D led to a far better cure rate than I&D alone.

This single-center series found button batteries (BB) lodged in the esophagus all caused mucosal injury, but those in the stomach also caused mucosal injury in 6 out of 12.  We may need to rethink the urgency of retrieving gastric BB.

Allowing penetrating or blunt trauma patients to remain temporarily hypotensive in the field vs giving volume resuscitation prior to definitive surgical repair improves mortality and seems to decrease blood loss and need for transfusion of blood products.

Hold ACE-inhibitors (ACEi) or angiotensin receptor blockers (ARBs) in patients you know will need surgery. These drugs are not associated with mortality but are associated with, at times, profound, sustained hypotension after induction.

Nine percent of patients with negative CT for anterior abdominal stab wound (AASW) subsequently required surgery.  Negative CT for AASW was inadequate to consider patients safe for immediate discharge.

Total duration of opioid use was the strongest predictor of misuse. Each refill and additional week of opioid use increased the hazard of misuse by 44% and 19.9% respectively. Shorter prescriptions (<2 weeks) of high vs low dosage prescriptions had a lower hazard.

In opioid naïve patients 13-21 years of age, persistent opioid use was found in 4.8% of the post-surgical group vs 0.1% of those in the non-surgical group. Procedures associated with the highest risk of persistent opioid use were cholecystectomy and colectomy. Independent risk factors included older age, female sex, diagnoses of substance use disorder and chronic pain.