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To Treat or Not to Treat

Sensible Medicine

For many doctors in academic medicine, publishing in peer reviewed journal is an important part of their careers. People can rise through the academic ranks as gifted clinicians, creative and effective educators, and talented administrators. [i] Patients were then randomly assigned to apixaban or 81 mg of ASA. to 0.88; P=0.007).

Stroke 99
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Intranasal Fentanyl for Sickle Cell Vaso-Occlusive Pain

ACEP Now

The National Heart, Lung, and Blood Institute released an expert panel report in 2014 with evidence-based guidelines for management of SCD recommending timely administration of parenteral opioids for VOE.2 Two interesting findings were time to parenteral opioid administration and total dose of opioid morphine equivalents. Am J Hematol.

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The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

RebelEM

They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine. However, peripherally dosed push dose pressors, (PDPs), are beginning to be administered more frequently for management of acute hypotension.

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Sepsis alerts work! Just not in the patients who fire the alerts

PulmCCM

With financial penalties coming for noncompliance with the new rule, hospital administrators rapidly deployed the alerts to fire on all eligible inpatients. Administratively, CMS could convert SEP-1 to a “process”-based or “intermediate outcome measure” or another type. And have they fired.

Sepsis 45
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Contrast Media Shortage of 2022 – Lessons Learned

EMDocs

Relative proportions of reported diagnostic indications versus clinical outcomes in a retrospective analysis of all CT imaging in 3 EDs over 1 year at an academic center. A 12% reduction in CECTs performed was recorded after EHR interventions in a large health system encompassing 12 hospitals including academic and community medical centers.

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Emergency Medicine Deserves to “Re-Brand” Itself as a Cost Saver

ACEP Now

Now, many PID patients are treated and released after ED administration of appropriate antibiotics to eradicate possible infection by Neisseria gonorrhea and Chlamydia trachomatis , often with added treatment for anaerobic microbes. Acute pyelonephritis has become a disease for which outpatient management is often feasible and appropriate.

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The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury

RebelEM

3, 6 Among patients with stroke or traumatic brain injury (TBI), the risk may be as high as 28%-76% and 23%-60%, respectively. Limited to academic hospitals in one country, which may call generalizability into question. Post-stroke infection: a systematic review and meta-analysis. 4, 8 Paper: Dahyot-Fizelier, C., Vermeij, J.

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