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Diagnostics: Inflammatory Markers

Taming the SRU

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. A 2011 meta-analysis in the journal of Academic Emergency Medicine found ESR, CRP, and PCT were not acutely useful in the diagnosis of septic arthritis due to wildly varying sensitivities and specificities between studies. J Arthroplasty.

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

RebelEM

Patient data anonymized when presented to adjudication committee to avoid detection bias Well-balanced patient characteristics between groups. Limited to academic hospitals in one country, which may call generalizability into question. coli Need for broad-spectrum antibiotics after randomization was not different between groups.

CDC 119
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Skeptics

Sensible Medicine

Both the amyloid believers and non-believers would do well to think about whether they are interpreting evidence objectively or are trying make trial results they don’t believe go away. If a trial shows something very different from what you would have expected, it is worth searching for flaws that might explain the unexpected results.

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SAEM Clinical Images Series: Fever with Rash

ALiEM

The patient also complained of shortness of breath for one week associated with a dry cough, as well as an altered sensorium for one day. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved.

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SAEM Clinical Images Series: A Serious Pain in the Neck

ALiEM

Additional Images Physical Exam Vitals : BP 115/80; HR 120; T 101°F; RR 16; O2 sat 97% General : Well appearing in no acute distress HEENT : Poor dentition, mild trismus. Treatment should include both an extended course of antibiotic therapy as well as surgical source control of abscesses. The floor of the mouth is unremarkable.

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SAEM Clinical Images Series: The Color Purple

ALiEM

Treatment is appropriate antibiotics and improved foley hygiene, foley exchange as well as improved bowel regimen to increase stool transit time. It is predominantly found in women, chronically catheterized, institutionalized, and constipated patients. References Meekins Pauline, Ramsay Amy, Ramsay Michael. Purple Urine Bag Syndrome.

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SAEM Clinical Images Series: A Painful Swollen Digit

ALiEM

History of trauma or penetrating injury and immunocompromised status should raise suspicion for infectious flexor tenosynovitis; common pathogens include Staphylococcus and Streptococcus species. Treatment includes emergent consultation with orthopedics or hand surgery as well as early initiation of IV antibiotics. Tenosynovitis.