Retail and Urgent Care Articles
Interrater agreement on whether a child’s throat was red or not was “fair” (aka…pretty bad), although agreement was significantly better when grading tonsillar hypertrophy.
In this large cohort study of over 1.8 million pregnancies, first trimester ondansetron use was not associated with cardiac malformations or total congenital malformations. However, there was a small increased risk of oral clefts (3 additional cases per 10,000 women treated).
Penicillin allergy is a lot less common than patients report. A low-risk history could allow you to prescribe it in the ED or clinic.
”Tachypnea at triage, chronic ulcers, history of MRSA colonization or infection, and cellulitis within the past year,” were the risk factors associated with failure of oral antibiotic therapy for non-purulent cellulitis.
The overall sensitivity of the Wood’s lamp, compared to the gold standard slit lamp, to establish the diagnosis of common corneal and conjunctival abnormalities was found to be an abysmal 52%.
This is the IDSA influenza guideline, updated from the previous one in 2009. It covers testing, treatment, complications, and more.
Pelvic examination added little to clinical judgment when evaluating for sexually transmitted infections in young women.
These are the top articles from 2018.
Topical antibiotic use for bacterial conjunctivitis was associated with improved rate of clinical cure compared to placebo. For early and late clinical cure with topical antibiotics, the NNT was 9 and 11, respectively.
In premenopausal women with recurrent cystitis, drinking more water on a daily basis can reduce episodes of cystitis.
Probiotics decrease the risk of C. difficile infection in adults and children taking antibiotics and may reduce overall adverse events like cramping, nausea, or diarrhea.
There was no difference between a regular medical mask and N-95 mask worn by healthcare workers in preventing influenza or any other respiratory infection.
Adults with cough <3weeks or 3-8 weeks with post-tussive vomiting or whooping should be treated for pertussis; those with fever or without paroxysmal cough should be considered to have an alternate diagnosis. Children with <4 weeks of cough and post-tussive vomiting may have pertussis, but it was much less clear than in adults.
It took an extra 67 seconds when not prescribing an antibiotic to patients with acute respiratory infection compared to visits in which an antibiotic was prescribed.
Highly resistant, extended spectrum β-lactamase (ESBL) producing Enterobacteriaceae in the urine are becoming increasingly common in unexpected patients in the ED.
Specific emergency department variables are strongly predictive of infants with bronchiolitis requiring escalated care.
Use of fluoroquinolones was associated with a 2.5-fold increase in risk of hospitalization for aortic aneurysm or aortic dissection.
Taking care of children with mild traumatic brain injury is not easy. This guideline states clearly, based on compiled evidence, what you should and should not do. It’s helpful.
From 2008 to 2015, low acuity care in commercially insured patients has dropped 36% in EDs and increased 140% in non-ED settings, dominated by an increase in urgent care but also, less so, by increases in retail clinic and telemedicine utilization.
Malpractice suits against emergency physicians have some common themes. This post will help you understand them in brief.
Outpatient treatment failure for pyelonephritis occurred more often in patients treated with fluoroquinolones or trimethoprim-sulfamethoxazole (TMP-SMX) than in patient treated with cephalosporins.
Although opioids are not first-line treatment for ankle sprains, an opioid was prescribed for 25% of emergency department patients diagnosed with an isolated ankle sprain. Prescribing varied widely among states. Additionally, patients prescribe greater quantities of opioids were more likely to transition to continued use.
Adverse drug events related to antibiotics led to nearly 70,000 ED visits a year in children ≤19 years. One out of every 330 children ≤2 years given amoxicillin will end up in the ED with an ADE.
Use of pregabalin in addition to opioids vs opioids alone was associated with an increased risk of death by opioid overdose.
The incidence of suicide nearly doubled in patients who had traumatic brain injury (TBI) compared to baseline. Risk increased with severity of injury, number of visits, and was highest in the first 6 months post-injury.
Suturing of facial lacerations by novice physicians resulted in less cosmetically favorable repair in follow up than experienced physicians.
Self-referral for elevated blood pressure after using a home or pharmacy cuff had a very low admission rate at 3%.
Incidence of intracerebral hemorrhage (ICH) on CT following minor head trauma in anticoagulated patients was 9%, which means we have to CT all these people.
Patients with a penicillin allergy were 69% more likely to develop MRSA infection and 26% more likely to contract C. difficile.
Most doctors and clinicians think someone else is the problem when it comes to antibiotic resistance and stewardship. We are the problem. And we are the solution.