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Clinicians have an important role in advising families on the appropriate evidence-based treatments for upper respiratory tract infections (URTIs) in children.

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Treatments for cough and common cold in children. BMJ. 2024 Jan 25;384:e075306. doi: 10.1136/bmj-2023-075306.

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Using online telemedicine platforms, the authors found that it was appallingly easy to rapidly obtain inappropriate antibiotic prescriptions for symptoms of viral URIs by paying a nominal fee. This highlights the need for increased education and regulations around inappropriate prescribing of antibiotics to safeguard the public and uphold good medical practices.

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Antibiotics on Demand: Advances in Asynchronous Telemedicine Call for Increased Antibiotic Surveillance. Clin Infect Dis. 2024 Feb 17;78(2):308-311. doi: 10.1093/cid/ciad472.

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In this retrospective study of ED physicians in one state, researchers found statistically significant differences in admission rates among clinicians but little consistency in admission tendencies across multiple conditions. Clinicians with greater tolerance to risk (as a general attitude) had associated lower rates of admission when compared to projections.

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Clinician Risk Tolerance and Rates of Admission From the Emergency Department. JAMA Netw Open. 2024 Feb 5;7(2):e2356189. doi: 10.1001/jamanetworkopen.2023.56189.

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In the absence of a standardized approach, patients placed in hallway beds were more likely to be male, have Medicaid/self-pay payer status, and elope in this single health system study.

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Inequities among patient placement in emergency department hallway treatment spaces. Am J Emerg Med. 2024 Feb;76:70-74. doi: 10.1016/j.ajem.2023.11.013. Epub 2023 Nov 11.

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This article is a call to action for emergency medicine clinicians to encourage us to embrace the opportunity to leverage digital technologies and shape their implementation within our healthcare system. 

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This Bayesian network meta-analysis of RCTs indirectly compares hydrocortisone + fludrocortisone to hydrocortisone alone or placebo in septic shock and finds superiority with the combination regimen.

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Effectiveness of Fludrocortisone Plus Hydrocortisone Versus Hydrocortisone Alone in Septic Shock: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Am J Respir Crit Care Med. Published online January 25, 2024. doi:10.1164/rccm.202310-1785OC

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One third of eligible patients with high-risk pulmonary embolism (PE) receive systemic thrombolysis (ST) despite demonstrated mortality benefit. This review provides a comprehensive overview of current evidence on assessment and management of high-risk PE, with emphasis on reperfusion therapies.

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Rouleau SG, Casey SD, Kabrhel C, Vinson DR, Long B. Management of high-risk pulmonary embolism in the emergency department: A narrative review. Am J Emerg Med. Published online February 3, 2024. doi:10.1016/j.ajem.2024.01.039

Dr. Amal Mattu and friends have a new video course you don't want to miss. Take a look!

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A Bayesian meta-analysis found an 83.2% probability that ketamine lowers mortality compared to etomidate in critically ill patients undergoing intubation.

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Ketamine versus etomidate as an induction agent for tracheal intubation in critically ill adults: a Bayesian meta-analysis. Crit Care. 2024 Feb 17.

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This updated meta-analysis re-demonstrated a benefit for extracorporeal cardiopulmonary resuscitation (ECPR) in reducing overall in-hospital cardiac arrest (IHCA) mortality and improving neurological outcomes after cardiac arrest but also demonstrated a new significant reduction in out of hospital cardiac arrest (OHCA) mortality with ECPR.

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Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: an updated meta-analysis and trial sequential analysis. Crit Care. 2024 Feb 21;28(1):57. doi: 10.1186/s13054-024-04830-5.

Dr. Amal Mattu and friends have a new video course you don't want to miss. Take a look!

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Review of tracheal intubations (TIs) performed in pediatric ICUs found advanced practice registered nurses (APRNs) had a lower first attempt success compared to doctors and respiratory therapists.