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For sickle cell patients (particularly Hgb SS) with a vaso-occlusive episode (VOE), large volume resuscitation (>2L) with lactated ringers (LR) has been shown to have improved outcome measures compared to normal saline (NS).

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Lactated Ringer vs Normal Saline Solution During Sickle Cell Vaso-Occlusive Episodes. JAMA Intern Med. 2024 Sep 9:e244428. doi: 10.1001/jamainternmed.2024.4428. Epub ahead of print. PMID: 39250114; PMCID: PMC11385329.

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Cavernous sinus thrombosis (CST) is a rare but serious thrombophlebitic disease that can be easy to miss in the emergency department setting. This article provides an overview of CST as well as some pearls for clinching this diagnosis for emergency medicine physicians.

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High risk and low prevalence diseases: Cavernous sinus thrombosis. Am J Emerg Med. 2024;83:47-53. doi:10.1016/j.ajem.2024.06.024.
PMID: 38959601.

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This retrospective observational analysis showed an association with more favorable neurologic outcomes, survival to hospital discharge, and ROSC upon ED arrival, in an IV-first approach compared to humeral IO in out-of-hospital cardiac arrests.

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The association of intravenous vs. humeral-intraosseous vascular access with patient outcomes in adult out-of-hospital cardiac arrests. Resuscitation. 2024 Sep;202:110360. doi: 10.1016/j.resuscitation.2024.110360. Epub 2024 Aug 16. PMID: 39154890.

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ACEP released a clinical policy that addresses the choice of a second-line agent for adults with refractory seizures after adequate dosing of benzodiazepines.

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Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Seizures: Approved by the ACEP Board of Directors, April 17, 2024. Ann Emerg Med. 2024 Jul;84(1):e1-e12. doi: 10.1016/j.annemergmed.2024.02.018. PMID: 38906639.

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This systematic review snapshot found that when the HINTS exam is used by properly trained clinicians, it shows high sensitivity and moderate specificity to identify central causes of acute vestibular syndrome (AVS).

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Are the HINTS and HINTS Plus Examinations Accurate for Identifying a Central Cause of Acute Vestibular Syndrome? Ann Emerg Med. 2024 Jul;84(1):60-62. doi: 10.1016/j.annemergmed.2024.01.027. Epub 2024 Feb 22. PMID: 38385911.

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Mental practice, a cognitive rehearsal technique from sports psychology, can enhance skill retention and competency in emergency medicine, particularly for high-acuity, low-frequency procedures.

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Mental Practice: Applying Successful Strategies in Sports to the Practice of Emergency Medicine. Ann Emerg Med. 2024 Aug;84(2):159-166. doi: 10.1016/j.annemergmed.2023.12.011. Epub 2024 Jan 18. PMID: 38244027.

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Pediatric volvulus is associated with a high morbidity and mortality rate but remains a challenging diagnosis. This review highlights pearls and pitfalls of diagnosis and management.

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High risk and low incidence diseases: Pediatric digestive volvulus. Am J Emerg Med. 2024 Aug;82:153-160. doi: 10.1016/j.ajem.2024.06.012. Epub 2024 Jun 14. PMID: 38908340.

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In the complex world of modern medicine, it often requires purposeful thought and action to place our patients at the center of the care process. This study serves to remind us how to employ evidence-based patient-centered care during the course of emergency medicine (EM) practice. 

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Recommendations for patient-centered emergency care. CJEM. 2024 Aug;26(8):513-519. doi: 10.1007/s43678-024-00706-3. Epub 2024 Jun 21. PMID: 38904747.

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This retrospective study found increased first pass success (FPS) when EM post-graduate year (PGY) PGY2s, 3s, or 4s intubated patients with Cormack-Lehane grade 3 or 4 airways compared to EM PGY1s. There was no difference in obtained views by PGY after PGY1.

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Emergency Medicine Postgraduate Year, Laryngoscopic View, and Endotracheal Tube Placement Success. Ann Emerg Med. 2024 Jul;84(1):11-19. doi: 10.1016/j.annemergmed.2024.03.004. Epub 2024 Apr 19. PMID: 38639674.

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In adult patients with sepsis, empiric use of vancomycin and piperacillin/tazobactam compared to vancomycin and cefepime, when anti-anaerobic coverage was not clinically indicated, was associated with a 5% increase in mortality.

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Mortality of Patients With Sepsis Administered Piperacillin-Tazobactam vs Cefepime. JAMA Intern Med. 2024 Jul 1;184(7):769-777. doi: 10.1001/jamainternmed.2024.0581. PMID: 38739397.