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The Modified Valsalva Maneuver: Practical Treatment or Pointless Trick?

RebelEM

The primary outcomes are patient-centered and objectively measured, potentially ensuring relevance and reliability. The unblinded nature of the study could influence outcomes due to observer bias. Employing P-values to compare demographics between groups could mislead interpretations of the data’s relevance to the primary outcomes.

Outcomes 137
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Perichondritis of the Ear in Children

Pediatric EM Morsels

Infections there become complicated very quickly and the outcomes can be very poor. 2006 Dec;22(12):804-6. Inpatient Vs Outpatient Therapy No standard approach… but… here is what I say: “ Always Fear Infections in the Hands, Feet, or Face.” ” Those areas have very important and delicate structures.

Burns 130
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Rebaked Morsel: Pediatric Buckle and Greenstick Forearm Fractures

Pediatric EM Morsels

Plint, 2006. No formal follow up was scheduled Outcomes were: effectiveness, parental satisfaction, and economic benefits The majority of children wore their braces as directed (94%)There was no re-fractureAll parents were happy with the treatment (100%) and felt comfortable removing the brace (100%). West, 2005.

Fractures 286
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Intensive blood glucose control in the ICU is not helpful (TGC-FAST trial)

PulmCCM

Hyperglycemia is associated with worse outcomes in the ICU (and in medical patients generally), so correcting it must improve outcomes … right?

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Glasgow Coma Scale in Children

Pediatric EM Morsels

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. 2006 May;34(5):379-87.

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The US FDA's cancer drug approval process is broken and needs audit

Sensible Medicine

In the latest project from our team , led by medical student Josh Elbaz, we examine how many FDA approvals from 2006 to 2023 improve survival. COVID19 vaccines have never shown benefit with respect to clinical outcomes among people who already had COVID. Note the time from safety alert to withdrawal, and when the data was generated.

Poisoning 131
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SAEM Clinical Images Series: Wolf in Sheep’s Clothing

ALiEM

Outcome and use of antiarrhythmic drugs during follow-up. 2006 Oct;11(4):340-53. Radiofrequency catheter ablation of accessory pathways. European heart journal. 1999 Dec 1;20(24):1826-32. Wolff L, Parkinson J, White PD. Bundle-branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia. doi: 10.1111/j.1542-474X.2006.00127.x.

EKG/ECG 78