Anchoring – Does Information from Triage Bias Our Workup?

Education, Practice of EM, Venous Thromboembolism

We’re trying something new! Watch quick videos, with my personal take on the articles we cover each week and more! Here’s the JournalFeed YouTube channel link. ~Clay

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Veterans Affairs (VA) patients with known congestive heart failure (CHF) presenting for shortness of breath as a chief complaint were less likely to receive testing for venous thromboembolism (VTE) when triage reported CHF.

Source
Evidence for Anchoring Bias During Physician Decision-Making. JAMA Intern Med. 2023 Aug 1;183(8):818-823. doi: 10.1001/jamainternmed.2023.2366.

New App for Pediatric Cardiac Arrest

Pediatrics, Resuscitation, Technology

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This RCT found residents using a pediatric cardiac arrest app better adhered to the pediatric cardiac arrest algorithm when compared to those using a PALS visual aid or no aid at all.

Source
Effectiveness of a Novel Tablet Application in Reducing Guideline Deviations During Pediatric Cardiac Arrest: A Randomized Clinical Trial. JAMA Netw Open. 2023 Aug 1;6(8):e2327272. doi: 10.1001/jamanetworkopen.2023.27272.

Is Nirmaltrevir-Ritonavir (Paxlovid) Safe for CKD or Dialysis Patients?

Infectious Disease, Pharmacy/Pharmacology, Renal

We’re trying something new! Watch quick videos, with my personal take on the articles we cover each week and more! Here’s the JournalFeed YouTube channel link. ~Clay

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Modified dose nirmaltrevir-ritonavir is well-tolerated in patients with CKD as therapy for mild COVID-19 and effectively suppresses viral load.

Source
Safety Profile and Clinical and Virological Outcomes of Nirmatrelvir-Ritonavir Treatment in Patients With Advanced Chronic Kidney Disease and Coronavirus Disease 2019 (COVID-19). Clin Infect Dis. 2023 Aug 2:ciad371. doi: 10.1093/cid/ciad371. Epub ahead of print.

Regret, Strain, Infertility – Building Families as Physicians and Medical Students

Wellness

First, a quick poll – How do you determine ETT depth in kids?

What’s your method? Take the poll!

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Growing a family while also navigating medical training is associated with delayed childbearing, and many physicians on this path experience regret, infertility, relational strain, and specific stresses associated with the use of assisted reproductive technology (ART).

Source
Psychosocial Burdens Associated With Family Building Among Physicians and Medical Students. JAMA Intern Med. 2023 Jul 24:e232570. doi: 10.1001/jamainternmed.2023.2570. Epub ahead of print. PMID: 37486671.

Rethinking Appropriate ETT Insertion Depth in Children

Airway, Pediatrics

First, a quick poll – How do you determine ETT depth in kids?

What’s your method? Take the poll!

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Formula-based calculations for ETT depth in pediatric patients are based on a linear curve, despite children’s growth not being linear or uniform. Looking at age, height, and weight, these authors provide ETT depth recommendations based on calculated best-fit curves.

Source
Recommendations for endotracheal tube insertion depths in children. Emerg Med J. 2023. Aug;40(8):583-587. Doi: 10.1136/emermed-2022-212494.

Should We Do Brain Imaging on Suspected Infective Endocarditis Patients?

Imaging, Infectious Disease

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Among patients with infective endocarditis (IE), 39% of neurologically “asymptomatic” patients had a cerebral embolic event (CEE) on neuroimaging, and a new surgical indication was established in 19% of these cases. CEEs were seen in 73% of neurologically symptomatic patients. But there were some issues with this study…

Source
Role of Cerebral Imaging on Diagnosis and Management in Patients With Suspected Infective Endocarditis. Clin Infect Dis. 2023 Aug 14;77(3):371-379. doi: 10.1093/cid/ciad192.

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