Blog

Getting an MRI for back pain does not reduce recurrent patient visits within a week.  The only time we should get an MRI for back pain in the ED is if there is a clinical concern that the findings may prompt emergent surgery, such as for cauda equina, epidural abscess, or impinging mass (may need radiation), etc.

Using loss of wave capnography rather than gestalt assessment of relaxation after paralytic administration for RSI in the ED led to shorter time to intubation and increased first-pass success.

Morphine was associated with worse short-term mortality all other known variables being equal: 20% vs. 12.7%.

In this systematic review, the D-Dimer was 100% sensitive in low risk Geneva (0-3), intermediate-risk Geneva (4-10), and Wells non-high risk (≤4) for detecting PE. Specificity dropped (more false-positives) as age increased in the Wells non-high risk patients.

Female surgeons had small but significantly improved 30-day mortality and other surgical outcomes over male surgeons, all other factors being equal.

Tranexamic acid (TXA) decreased mortality from bleeding in trauma patients.  But there are a few caveats to note.

We can't draw firm conclusions from this paper, since it was not designed or powered to detect differences in subgroups with skin abscesses.  But it was notable that patients who received TMP/SMX did better than those who received placebo across all subgroups, including those with larger abscesses; especially those with fever, history of MRSA, or MRSA positive culture.

Applying an ice cube (inside a sterile glove) to the skin over a laceration for 2 minutes significantly reduced pain from local anesthetic injection.

Ibutilide worked to chemically cardiovert rapid atrial fibrillation in just over half of cases but was associated with the feared complication, ventricular tachycardia, in 2 patients (0.6%).

In this RCT, patients suspected of acute myocardial infarction (AMI) with O2 saturations >/=90% were randomized to receive supplemental oxygen vs ambient air.  There was no statistically significant difference between patients in death from any cause at 1 year.