How to Prescribe Paxlovid for COVID-19
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Paxlovid offers an oral option for treating COVID-19 infection. Here is what you need to know before prescribing.
CASH-75 – Atypical Pneumonia Predictor Score
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Using the CASH-75 score can help predict the absence of atypical pathogens (L. pneumophila or M. pneumoniae) as the causative agents of community acquired pneumonia (CAP) in hospitalized patients.
Source
Accuracy of a score predicting the presence of an atypical pathogen in hospitalized patients with moderately severe community-acquired pneumonia. BMC Infect Dis. 2022 May 3;22(1):424. doi: 10.1186/s12879-022-07423-1.
Pediatric Asthma – One or Two-Dose Dexamethasone?
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A single dose of dexamethasone was as effective as two in treatment of mild to moderate pediatric asthma exacerbations in the emergency department.
Source
Single-Dose Dexamethasone Is Not Inferior to 2 Doses in Mild to Moderate Pediatric Asthma Exacerbations in the Emergency Department. Pediatr Emerg Care. 2022 May 3. doi: 10.1097/PEC.0000000000002727. Online ahead of print.
50 Years Since Tuskegee Syphilis Study – What Lessons Have We Learned?
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We need to understand our recent history. The syphilis study is a story we must tell, internalize, and learn from so we won’t make the same mistakes again.
Source
Fiftieth Anniversary of Uncovering the Tuskegee Syphilis Study: The Story and Timeless Lessons. Am J Respir Crit Care Med. 2022 May 15;205(10):1145-1158. doi: 10.1164/rccm.202201-0136SO.
Should We Use Ultrasound-Guided IV in Kids?
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Ultrasound guided peripheral intravenous cannulation (PIVC) has been shown to be effective in some pediatric populations.
Source
Ultrasound for Pediatric Peripheral Intravenous Catheter Insertion: A Systematic Review. Pediatrics. 2022 May 1;149(5):e2021055523. doi: 10.1542/peds.2021-055523.
Can I Discharge a Pediatric Patient with Abnormal Vital Signs?
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18% of children in this cohort were discharged from a pediatric ED with at least one abnormal vital sign. In all-comers, there was no significant difference in return rate between those discharged with or without abnormal vital signs. Those who, at time of discharge, had two or more abnormal vital signs or were less than 3 years of age were more likely to return.
Source
Outcomes of patients discharged from the pediatric emergency department with abnormal vital signs. Am J Emerg Med. 2022 Apr 26;57:76-80. Doi: 10.1016/j.ajem.2022.04.021.
New AHA Heart Failure Guidelines for Emergency Medicine – Spoon-Feed Version
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These are the take home points for emergency medicine from the AHA heart failure guidelines. There are some novel therapies for heart failure you need to know.
Source
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 May 3;145(18):e895-e1032. doi: 10.1161/CIR.0000000000001063. Epub 2022 Apr 1. Erratum in: Circulation. 2022 May 3;145(18):e1033.
Do Macrolides Reduce Mortality in Community Acquired Pneumonia?
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Among adults with culture-confirmed bacteremic pneumococcal pneumonia, empiric macrolide therapy was associated with 45% reduction in the odds for mortality, regardless of macrolide treatment duration, an effect was not seen with quinolones.
Source
The Effect of Macrolides on Mortality In Bacteremic Pneumococcal Pneumonia: A Retrospective Nationwide Cohort Study, Israel, 2009-2017. Clin Infect Dis. 2022 Apr20;ciac317. Doi: 10.1093/cid/ciac317.
Mystery ECG – Can You Spot What’s Wrong?
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Presented is a process to interpret an ECG with negative P waves and pathologic Q waves in leads I and aVL.
Source
An Unusual Wide Complex Rhythm-What Is the Diagnosis? JAMA Intern Med. 2022 Jan 1;182(1):72-73. doi: 10.1001/jamainternmed.2021.6778.
Does Vapocoolant Spray Work When Used Before Digital Block?
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Vapocoolant spray improved pain from digital blocks for repair of finger injuries.
Source
Evaluation of vapocoolant spray effect on pain reduction during digital nerve block: A randomized clinical trial. Am J Emerg Med. 2021 Dec;50:260-263. doi: 10.1016/j.ajem.2021.08.001. Epub 2021 Aug 6.