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. Nasopharyngeal PCR testing is positive for Influenza A.

Pediatrics 40

Pediatrics Infectious Diseases Administration Outcomes 40

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

PEMBlog

JANUARY 17, 2024

Camargo, Clinical Trial: Comparative Effectiveness of Cephalexin Plus Trimethoprim-Sulfamethoxazole Versus Cephalexin Alone for Treatment of Uncomplicated Cellulitis: A Randomized Controlled Trial, Clinical Infectious Diseases, Volume 56, Issue 12, 15 June 2013, Pages 1754–1762, [link] Liu C, Bayer A, Cosgrove SE, et al.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

Don't Forget the Bubbles

JANUARY 10, 2024

Let’s take the humble blood transfusion – used in emergency departments across the globe and playing a key role in critical care. Some wonder if giving blood to children with a haemoglobin <6g/dl will improve outcomes. Outcomes Primary outcome Mortality at 28 days after randomisation. Was blinding achieved?

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

ACEP Now

MARCH 6, 2024

The PATCH-Trauma trial took a critical look at TXA in major trauma in the advanced trauma systems of Australia and found a mixed result: a slightly greater number of patients were still alive six months following TXA administration, but there was no difference in survival with a good functional outcome. percent to 38.3

Research 52

Research Airway Management Stroke Outcomes 52

Pediatric EM Morsels

SEPTEMBER 20, 2024

Diarrhea is one of the most common complaints in the pediatric emergency department, especially in the summer and early fall. It is critical to detect HUS early in its disease course to ensure the best outcomes. Predicting Adverse Outcomes for Shiga Toxin-Producing Escherichia coli Infections in Emergency Departments.

Pediatrics 161

Pediatrics Ultrasounds Dehydration Emergency Department 161

EMDocs

OCTOBER 5, 2024

A 62-year-old female patient with a history of recurrent urinary tract infections (UTIs) presents to the emergency department with fever, chills, and dysuria. 12 Complications Inadequate empiric therapy can lead to treatment delays and worse outcomes. Consider Infectious Disease consultation prior to any potential discharges.

EMS 86

EMS Infectious Diseases Sepsis Hospitals 86

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. In 7 studies with 4164 patients, PCT with a cut-off > 0.1

Infectious Diseases 88

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

EMDocs

DECEMBER 18, 2023

8 Based on multiple randomized controlled trials (RCTs), SSC 2021 guidelines suggest against using procalcitonin as a screening method to guide initiation of antibiotic therapy, as no difference in clinical outcomes was appreciated. 36 However, the literature has failed to prove that the double coverage has any effect on clinical outcomes.

Sepsis 75

Sepsis Fluid Resuscitation Resuscitation Shock 75

ALiEM

DECEMBER 9, 2024

A 25-year-old female with no pertinent past medical history presented to an emergency department in Massachusetts with four days of generalized malaise, myalgias, congestion, low-grade fever, and a rash behind her left knee. Lyme Disease. Centers for Disease Control and Prevention. Clin Infect Dis. doi: 10.1086/649920.

Emergency Department 60

Emergency Department CDC EMS Academics 60

EMDocs

APRIL 27, 2024

A 67-year-old man with a history of hypertension and diabetes presents to the emergency department with right ear pain for 2 weeks. However, the bioavailability of antipseudomonal antibiotics has improved outcomes, limiting surgery as a confirmatory diagnostic procedure and as needed for granulation tissue removal. The Lancet.

EMS 96

EMS Infectious Diseases Radiology Radiology 96

RebelEM

AUGUST 3, 2023

Authors determined they would need to enroll 380 patients (190/group) to achieve a statistical power of 80%, assuming an event rate in the control group of 4% of which neither was achieved however if the control group had a lower prevalence of the outcome (i.e. randomization) as per protocol (i.e.

Anaphylaxis 52

Anaphylaxis Allergic Reactions Outcomes Infectious Diseases 52

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). The American Journal of Emergency Medicine. Zalikha, A.K.

EMS 88

EMS Dislocations Fractures Operations 88

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Emerg Med J. Paediatr Int Child Health. 2024 Jan 11:1-7.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

RebelEM

MAY 15, 2024

Read More: Infectious Disease Society of America 2010 Clinical Practice Guidelines Life in the Fast Lane: Febrile Neutropaenia Uptodate: overview of neutropenic fever syndromes EMRAP: Risk stratification of neutropenic fever MDCalc: MASCC Score MDCalc: CISNE Score References: Ahn S, Rice TW, Yeung SJ, Cooksley T. Ann Emerg Med.

Infectious Diseases 86

Infectious Diseases Administration Sepsis Anaphylaxis 86

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. A 63-year-old man presents to the emergency department for dyspnea on exertion.

EMS 73

EMS Infectious Diseases Shock Emergency Department 73

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. These centres have a close relationship with their patients, but this does not mean they may not turn up at your emergency department! CMV can present as a nonspecific viral illness or tissue-invasive CMV disease.

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

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

Infectious Diseases 63

Infectious Diseases Emergency Department EMS Administration 63

PEMBlog

SEPTEMBER 27, 2023

Reasons to not order a comprehensive respiratory viral panel (i.e.,

Pediatrics 52

Pediatrics Hospitals Emergency Department Outcomes 52

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

ACEP Now

NOVEMBER 7, 2024

If you work in the emergency department, you’re out there in the trenches “suspecting sepsis” on a daily basis. These are among the questions at the forefront in the exciting world of infectious disease. Grossly speaking, the results were a wash. percent absolute advantage to cefepime.

Sepsis 64

Sepsis Infectious Diseases Outcomes Emergency Department 64

EMDocs

DECEMBER 9, 2024

Authors: Noah Kronk, MS-4 (University of Missouri-Columbia); Jessica Pelletier, DO, MHPE (APD, EM Attending Physician, University of Missouri-Columbia, USA) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 30-year-old female presents to the emergency department (ED) with fever, fatigue, and an extensive rash.

CDC 68

CDC Documentation/Coding Infectious Diseases Dehydration 68