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Epinephrine administration via metered-dose inhaler (MDI) for the treatment of croup in children may be a safe and effective alternative to nebulization.
Source
Epinephrine metered-dose inhaler for pediatric croup. Acad Emerg Med. 2023 Feb;30(2):144-146. doi: 10.1111/acem.14616. Epub 2022 Dec 7.
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A negative D-dimer performed similarly in predicting a 30-day risk of pulmonary embolism (PE) regardless of a patient’s COVID-19 status.
Source
Prognostic association between d-dimer thresholds and 30-day pulmonary embolism diagnosis among emergency department patients with suspected SARS-CoV-2 infection: a Canadian COVID-19 Emergency Department Rapid Response Network study. CJEM. 2023 Feb;25(2):134-142. doi: 10.1007/s43678-022-00440-8. Epub 2023 Jan 10.
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Diagnostic errors in the ED occur at rates similar to those in other clinical settings. Not all errors have human causes, and not all are inevitable – this article suggests systems-level opportunities for improvement.
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When delivering bad news, authenticity is the name of the game.
Source
Delivering Bad News Badly. JAMA. 2023 Feb 14;329(6):463-464. doi: 10.1001/jama.2022.24765.
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Violence directed at healthcare workers (HCWs) is common in the ED setting. Studies have demonstrated workplace violence is underreported and can have long term effects on HCWs.
Source
Exploring verbal and physical workplace violence in a large, urban emergency department. Am J Emerg Med. 2023 Jan 27;67:1-4. doi: 10.1016/j.ajem.2023.01.036. Epub ahead of print.
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This unblinded superiority trial found no significant difference in mortality among patients who were randomized to a restrictive fluid strategy with earlier use of vasopressors or liberal fluid administration for treatment of sepsis-induced hypotension.
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This is a scientific statement from the American Heart Association emphasizing the need for more research on surgical embolectomy and mechanical circulatory support in the treatment of high-risk pulmonary embolism.
Source
Surgical Management and Mechanical Circulatory Support in High-Risk Pulmonary Embolisms: Historical Context, Current Status, and Future Directions: A Scientific Statement From the American Heart Association. Circulation. 2023;10.1161/CIR.0000000000001117. doi:10.1161/CIR.0000000000001117
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Conducting energy devices (CEDs, i.e., TASER) are used to bridge the gap between interpersonal (punching, batons, spray) and firearm techniques when deescalating violent or serious situations by law enforcement. This article covers general considerations of CEDs and specific need to know info on the newest TASER model to hit the streets.
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This study supports the notion that an early return to school (RTS), results in faster recovery from concussion symptoms versus prolonged absences.
Source
Association Between Early Return to School Following Acute Concussion and Symptom Burden at 2 Weeks Postinjury. JAMA Netw Open. 2023 Jan 3;6(1):e2251839. doi: 10.1001/jamanetworkopen.2022.51839.
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There is rarely any need to repeat potassium testing when the laboratory reports hyperkalemia on a hemolyzed sample in a child with a normal blood urea nitrogen (BUN) and creatinine (Cr).
Source
Hyperkalemia in a Hemolyzed Sample in Pediatric Patients: Repeat or Do Not Repeat? Pediatr Emerg Care. 2023 Jan 1;39(1):e1-e5. doi: 10.1097/PEC.0000000000002857. Epub 2022 Sep 29.
