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.

Migraine - A Better Steroid than Dexamethasone?

Migraine - A Better Steroid than Dexamethasone?

Methylprednisolone acetate 160mg IM was not better than dexamethasone 10mg IM (both given with metoclopramide 10mg IM) for reducing headache days in the week following the ED visit in migraine patients.

New AHA Bradycardia Guidelines

New AHA Bradycardia Guidelines

The newest AHA guidelines address the evaluation and management of bradycardia and conduction disorders. This includes sinus node dysfunction, AV blocks, and bundle branch blocks.  Here’s what you need to know as an emergency physician.

Ketamine RCT - Multiple Rib Fractures

Ketamine RCT - Multiple Rib Fractures

Low dose ketamine did not reduce overall pain or opioid use in this study of patients with rib fractures. However, for severely injured patients with ISS>15, ketamine allowed patients to achieve the same level of pain control with significantly less opioid medication.

Immune Checkpoint Inhibitor Toxicity

Immune Checkpoint Inhibitor Toxicity

Immune checkpoint inhibitors are monoclonal antibodies that block inhibitors of T-cell activation and function. They are increasingly used in different malignancies by removing inhibition of T-cell function and have an array of toxic side effects you need to know.

Do Topical Antibiotics Help Conjunctivitis?

Do Topical Antibiotics Help Conjunctivitis?

Topical antibiotic use for bacterial conjunctivitis was associated with improved rate of clinical cure compared to placebo. For early and late clinical cure with topical antibiotics, the NNT was 9 and 11, respectively.

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