ANDROMEDA-SHOCK - Capillary Refill vs. Lactate

ANDROMEDA-SHOCK - Capillary Refill vs. Lactate

Peripheral perfusion guided resuscitation was better than lactate clearance in patients with septic shock in regard to improving organ dysfunction at 72 hours (SOFA score) and barely missed statistical significance in reducing 28-day mortality.

PRIME RCT - Ketamine or Fentanyl Intranasal For Pediatric Injuries?

PRIME RCT - Ketamine or Fentanyl Intranasal For Pediatric Injuries?

Intranasal ketamine is noninferior to intranasal fentanyl for pain associated with pediatric extremity injuries. However, there is a higher risk of minor adverse events.

Can We Use Ondansetron In Pregnancy?

Can We Use Ondansetron In Pregnancy?

In this large cohort study of over 1.8 million pregnancies, first trimester ondansetron use was not associated with cardiac malformations or total congenital malformations. However, there was a small increased risk of oral clefts (3 additional cases per 10,000 women treated).

Is This Patient Really Penicillin Allergic?

Is This Patient Really Penicillin Allergic?

Penicillin allergy is a lot less common than patients report. A low-risk history could allow you to prescribe it in the ED or clinic.

I&D Only or Add Antibiotics?

I&D Only or Add Antibiotics?

Treating skin and soft tissue abscesses with antibiotics in addition to incision and drainage (I&D) resulted in significantly increased clinical cure rate (NNT = 14) and decreased incidence of new lesions (NNT = 10) compared to I&D alone.

When Will Oral Antibiotics for Cellulitis Fail?

When Will Oral Antibiotics for Cellulitis Fail?

”Tachypnea at triage, chronic ulcers, history of MRSA colonization or infection, and cellulitis within the past year,” were the risk factors associated with failure of oral antibiotic therapy for non-purulent cellulitis.

Succinylcholine or Rocuronium - Which Is Better?

Succinylcholine or Rocuronium - Which Is Better?

A large observational series with over 4,000 intubations compared succinylcholine vs. rocuronium in rapid sequence intubation and found no association between these two paralytics and first-pass intubation success or peri-intubation adverse effects.

Nerve Agent Incidents and Public Health Preparedness

Nerve Agent Incidents and Public Health Preparedness

Management of nerve agent (NA) poisoning requires recognition of the syndrome and availability of the antidote. It is important to remember that besides the classic “SLUDGE” and “Killer B’s,” there is also the nicotinic syndrome which can cloud the clinical presentation. Add the “weekdays” mnemonic for nicotinic effects to your list of symptoms in NA toxicity.

HOUR - Early Discharge After Opioid OD

HOUR - Early Discharge After Opioid OD

The HOUR clinical decision rule can help determine which patients with opioid overdose who have received prehospital naloxone are safe for discharge after one hour of observation. But clinician judgment was just as good, which begs the question of why we need a decision rule.

Antiarrhythmics In Arrest - New ILCOR Update

Antiarrhythmics In Arrest - New ILCOR Update

The European Resuscitation Council International Liaison Committee on Resuscitation 2018 guideline has made one minor change regarding antiarrhythmic drugs in arrest: lidocaine, in place of amiodarone, is now a viable, equally effective option in patients with VF/pVT refractory to defibrillation.

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