Short Attention Span Summary Coronary CTA use has increased in frequency and is associated with increased subsequent “PCI, CABG, repeat non-invasive testing, hospitalization, and return ED visits.” This test for CAD seems to beget more testing and invasive procedures without improving the outcome, which begs the question – is CCTA the wisest non-invasive way to …
Short Attention Span Summary Neither amiodarone nor lidocaine made an impact on survival or neurological outcome for out-of-hospital arrest due to shock-refractory v-fib or pulseless v-tach. In witnessed arrest, patients who received active drug had improved survival. My take is that I don’t plan to stop using antiarrhythmic agents for patients with v-fib or v-tach …
Short Attention Span Summary Using a trauma registry, REBOA was comparable (trending toward more favorable) to open aortic occlusion. We have not started using REBOA at our facility yet. I’m curious how many are using it at their institutions. Take the poll, immediately see the results, and find out what your colleagues are doing. FOAM Report Heft …
Short Attention Span Summary Is this adolescent/young adult’s sore throat mono? This rational clinical exam feature found that, “posterior cervical, inguinal or axillary adenopathy, palatine petechiae, splenomegaly, or atypical lymphocytosis is associated with an increased likelihood of mononucleosis.” Why does it matter if it’s mono? Because when we inadvertently treat mono with ampicillin or amoxicillin, …
Short Attention Span Summary A new shoulder reduction technique was highly successful, allowed patients to sit up, and required no sedation. It is called the Sool’s method. See the video on You Tube. FOAM Report YouTube Abstract Am J Emerg Med. 2016 Apr 9. pii: S0735-6757(16)30036-5. doi: 10.1016/j.ajem.2016.04.012. [Epub ahead of print] The effectiveness of …
Short Attention Span Summary You may lay your child in a manger (but only on his or her back), but do not wrap them in swaddling clothes. Swaddling babies is associated with increased risk of SIDS, according to this meta-analysis. This is especially true as they become better able to roll into a prone position. Why …
Short Attention Span Summary Ingredients and dose matter in oral contraceptives. Lower dose estrogen – 20 vs. 30-40 micrograms – was safer, with lower risk for PE, stroke, and MI. Regarding the progestogen, desogestrel and gestodene, compared to levonorgestrel, were associated with ~2x the risk of PE but not stroke or MI. Why does this matter? The …
Estrogen dose and progestogen type change PE risk Read More »
Short Attention Span Summary Is it ever beneficial to do CPR longer than 10 minutes, as survival theoretically drops 10% per minute? In this Danish study, an amazing 14% with CPR > 25 minutes survived at 30 days (18/19 able to live at home vs. nursing home). FOAM Report So it turns out we are …
Survival with prolonged CPR better than expected Read More »
Short Attention Span Summary Tourniquets can save lives but could cause injury if not used appropriately. In this retrospective review of civilian use of tourniquets, 56% were placed but no vascular injury ultimately identified. Of tourniquets ultimately found to be unnecessary, authors concluded that no complications arose from tourniquet use. FOAM Report Twitter Abstract Prehosp …
Short Attention Span Summary Detergent packets are dangerous when kids munch them. And the number of exposures is increasing. I would like to advocate for making the pods less eye appealing to kids. If it was packed to look like a piece of broccoli, exposures would stop overnight. In all seriousness, they look like candy …
