PulmCCM

NOVEMBER 6, 2023

open label) at 17 sites in Belgium in 2020-2022, 35% of those receiving plasma died at 28 days, vs. 45% of the usual care patients — a number needed to treat of 10 to save one life. Among 475 patients with ARDS due to Covid-19, randomized within 5 days of ventilation to receive convalescent plasma or usual care (i.e.,

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Taming the SRU

JUNE 12, 2023

Finally, a randomized-control trial found that prophylactic antibiotics for dog bite wounds did not statistically change infection outcomes and was not cost-effective, recommending that prophylactic antibiotics only be used in high-risk wounds [12]. Clinical Infectious Diseases. Published June 24, 2022. 2010;59(02):1-9.

Infectious Diseases 102

Infectious Diseases Emergency Department Administration Academics 102

The Skeptics' Guide to EM

MARCH 18, 2023

Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. Guest Skeptic: Dr. Marisu Rueda-Altez is a pediatric infectious disease fellow at Children’s National Hospital in Washington, DC. JAMA Pediatr. JAMA Pediatr. JAMA Pediatr.

Pediatrics 40

Pediatrics Infectious Diseases Administration Outcomes 40

Sensible Medicine

JUNE 6, 2023

Two nearly identical trials of the monoclonal drug aducanumab, ENGAGE and EMERGE, had disparate outcomes: ENGAGE showed no benefit and EMERGE showed that the drug slowed decline. In late 2022 we learned that a large RCT found that the monoclonal lecanemab appeared to slow progression in AD. This makes the results hard to interpret.

Outcomes 98

Outcomes Infectious Diseases Research Academics 98

Don't Forget the Bubbles

FEBRUARY 28, 2024

Outcomes were: (1) crusting of the lesions; then (2) complete healing of lesions -the end goal of treatment. Was the exposure and outcome accurately measured to minimise bias? There were no objective tests to confirm disease clearance. It was not clear if there was any vested interest in ensuring a certain outcome.

Pediatrics 59

Pediatrics Infectious Diseases Outcomes Research 59

PulmCCM

JUNE 19, 2023

No drug or combination improved the primary outcome (a composite outcome of hypoxemia, visit to the emergency department, hospitalization, or death). That was in NEJM Aug 18 2022. Metformin also has positive immune-modulatory effects (on cytokine profiles and T-cell immunity).

Infectious Diseases 52

Infectious Diseases Hyperthermia / Hypothermia Outcomes Sepsis 52

Pediatric Education

OCTOBER 1, 2023

Learning Point As of 2022 only two countries still have endemic WPV ; those are Afghanistan and Pakistan which in 2019 had a total of 163 recorded cases. Despite this tremendously positive outcome, there still are continued threats against polio eradication. The last cVDPV isolates were noted in November 2022. link] Polio.

Infectious Diseases 40

Infectious Diseases Pediatrics Outcomes Wellness 40

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

ALiEM

AUGUST 21, 2023

Risk factors for poor outcomes include immunocompromise (HIV, diabetes, immunosuppression), intravenous drug use, peripheral vascular disease, and polymicrobial infection. Accessed November 30, 2022. Antibiotics should target gram-positive organisms (Staphylococcus, including MRSA, and Streptococcus). Tenosynovitis.

Academics 52

Academics Outcomes Hospitals Wellness 52

EMDocs

DECEMBER 1, 2024

The disease is generally mild, but in untreated cases, it can lead to more severe outcomes, especially in patients with underlying conditions such as glucose-6-phosphate dehydrogenase deficiency. Even though the disease often resolves spontaneously, prompt antibiotic therapy is essential for optimal outcomes. and Sarah L.

EMS 94

EMS Infectious Diseases Shock Airway Management 94

Taming the SRU

AUGUST 30, 2023

Spinal Infection: According to the Infectious Disease Society of America’s (IDSA) 2015 guidelines for native vertebral osteomyelitis, CRP and ESR in the setting of protracted back pain have sensitivities ranging from 94 to 100% for ruling out infection and malignancy in these patients.

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

RebelEM

AUGUST 3, 2023

What They Did: Parallel, 2-arm, noninferiority, open-label, multicenter, international randomized clinical trial Occurred in 6 specialized centers (3 in North America – US & Canada and 3 Outside of North America – Australia) Trial took place from June 2021 to December 2022 Used PEN-FAST to risk stratify patients.

Anaphylaxis 52

Anaphylaxis Allergic Reactions Outcomes Infectious Diseases 52

EMDocs

DECEMBER 18, 2023

Multiple studies published in 2022 have indicated that, despite disagreement surrounding prognostic accuracy, no such screening tool so far exists. The Infectious Diseases Society of America (IDSA) guidelines provide the most up-to-date guidance on appropriate agent choice. 2020;4(5):537-541. 2020;157(2):286-292.

Sepsis 75

Sepsis Fluid Resuscitation Resuscitation Shock 75

ALiEM

DECEMBER 9, 2024

Antibiotic treatment duration and long-term outcomes of patients with early lyme disease from a lyme disease- hyperendemic area. Lyme Disease. Centers for Disease Control and Prevention. 2022, Jan 19. Lyme disease. References Kowalski TJ, Tata S, Berth W, Mathiason MA, Agger WA. Clin Infect Dis.

Emergency Department 60

Emergency Department CDC EMS Academics 60

EMDocs

NOVEMBER 16, 2024

13 Management: Dislocation As with all dislocation, early reduction improves outcomes. Infections For stable patients, obtain microbiologic samples prior to antibiotics (per the American Academy of Orthopedic surgery and The Infectious Diseases Society of America). 2022 Jul;3(7):543-548. BJO-2022-0026.R1.

EMS 88

EMS Dislocations Fractures Operations 88

Don't Forget the Bubbles

MARCH 4, 2024

This was a secondary outcome embedded in the Travel Fever study – a multi-centre, retrospective diagnostic accuracy study for imported malaria. Safety and efficacy of a nitrous oxide procedural sedation programme in a paediatric emergency department: a decade of outcomes. doi: 10.1136/emermed-2022-212931. Emerg Med J.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

EMDocs

JANUARY 6, 2024

It is difficult to distinguish this from ACS secondary to acute plaque rupture in the ED, and management would be similar with antiplatelet agents, anticoagulation until coronary angiography can be performed to assess for the underlying disease process. Published 2022 Jun 4. 13 Cefepime 2 g or Piperacillin-Tazobactam 4.5 doi:10.1034/j.1399-0012.1999.130307.x

EMS 73

EMS Infectious Diseases Shock Emergency Department 73

Don't Forget the Bubbles

SEPTEMBER 23, 2024

Consider CMV, EBV and BK-polyoma virus infections: Patients are often on prophylaxis for a variable length of time, with differing outcomes. CMV can present as a nonspecific viral illness or tissue-invasive CMV disease. Obesity: Obesity, whether before or after transplant, is linked to worse outcomes. Aydin, A.M., Dogan, H.S.,

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

PulmCCM

NOVEMBER 25, 2024

Surveyed infectious disease experts advise about 14 days of antibiotic treatment for most patients with bloodstream infections, especially the critically ill. days of treatment), or clunky composite outcomes (e.g., 2022 Apr;28(4):550-557. Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections.

Infectious Diseases 40

Infectious Diseases Research Hospitals Outcomes 40

EMDocs

NOVEMBER 25, 2024

Vision loss carries a high degree of morbidity and is associated with higher all-cause mortality, 4 and it is our role as emergency providers to recognize potentially reversible causes of such adverse outcomes. million infected people suffer from skin disease and 1.15 7 Approximately 14.6 million from partial or complete blindness.

Infectious Diseases 63

Infectious Diseases Emergency Department EMS Administration 63

Don't Forget the Bubbles

NOVEMBER 5, 2023

In the Pediatric Infectious Disease Journal, Guo and colleagues assessed the difference in clinical characteristics between viral pneumonia and Mycoplasma pneumoniae in a large Chinese cohort. Reviews and opinion articles An update on the role of fluid overload in the prediction of outcome in acute kidney injury. 2023 Oct 20.

Pediatrics 105

Pediatrics Hospitals Infectious Diseases Outcomes 105

Taming the SRU

JANUARY 31, 2025

Moderate evidence it helps in a Cochrane review in 2022 NSAIDs Cochrane review 2020 Acute pain: effective but small change Sciatica: no effect Tylenol BMJ Meta-analysis 2015 Tylenol NOT effective Muscle relaxers 2017 Meta Analysis Effective for acute LBP, unclear for chronic No evidence for benzodiazepines qikt: Acute limb ischemia WITH Drs.

Documentation/Coding 54

Documentation/Coding Infectious Diseases Resuscitation Administration 54

EMDocs

DECEMBER 9, 2024

In July 2022, mpox was declared a Public Health Emergency of International Concern (PHEIC) after a clade 2 strain began spreading rapidly across 110 countries. During the 2022 clade 2 mpox outbreak, the majority of cases occurred among men who have sex with men (MSM), including individuals with multiple sexual partners and sex workers.

CDC 68

CDC Documentation/Coding Infectious Diseases Dehydration 68