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May 24, 2013The risk/benefit of active ventilation during the onset phase of muscle relaxants must be carefully assessed in each patient. In patients at low risk for desaturation (>95% saturation), manual ventilation is not necessary. In patients at higher risk (91% to 95% saturation), a risk-benefit assessment should include an estimation of desaturation risk and the presence of pulmonary pathology. In hypoxemic patients, low-pressure, low-volume, low-rate ventilations will be required.
Ann Emerg Med. 2012;59:165-175
May 23, 2013
Differential Diagnosis For Children With Altered Mental Status : AEIOU Tips:
Pediatric Emergency Medicine Practice, 2011, ebmedicine.net
May 22, 2013
Clinical indicators of potential bladder injury:
Emerg Med Clin N Am 29 (2011) 501–518
May 21, 2013Intussusception is not a likely diagnosis in children over 3 years of age and is rare in children older than age 5. In 10% to 20% of children who do have intussusception, diarrhea will be present, and vomiting occurs 60% to 80% of the time.
Pediatric Emergency Medicine Practice, 2012, ebmedicine.net
May 20, 2013Results from retrospective study demonstrated a negative association between pre-hospital ETI attempts and survival from OOHCA. Individuals having no ETI were 5.46 (95% CI?= 3.36 to 8.90) times more likely to be discharged from the hospital alive compared to individuals with one successful ETI attempt. The individuals most likely to have pre-hospital ROSC and survival to hospital discharge were those who did not have a reported ETI attempt.
Acad Emerg Med. 2010 Sep;17(9):918-25
May 19, 2013
Changes to the 2010 AHA Guidelines for resuscitation and emergency care of children:
Emerg Med Clin N Am 30 (2012) 153–168
May 18, 2013Lorazepam is the drug of choice in alcoholic patients who have had a seizure or who are demonstrating signs of withdrawal. Alcoholic patients who have had a seizure should generally be observed for 4 to 6 hours and, if discharged, referred to a detoxificaton/rehabilitation program, if possible.
Emerg Med Clin N Am 29 (2011) 117–124
May 17, 2013Treatable causes of diaphragmatic dysfunction include myopathies related to metabolic disturbances such as hypokalemia, hypomagnesemia, hypocalcemia, and hypophosphatemia. Correction of electrolyte and hormonal imbalances and avoidance of neuropathic or neuromuscular blocking agents can restore diaphragmatic strength.
N Engl J Med 2012;366:932-942
May 16, 2013Headache or migraine is a presenting symptom in 57% to 92% of carotid artery dissections and 69% to 72% of vertebral artery dissections.
EBmedicine.net, April 2012
May 15, 2013
When compared to ultrasound for the diagnosis of acute cholecystitis, HIDA has better sensitivity (88% vs. 50%), specificity (93% vs. 88%), positive predictive value (85%vs 64%), negative predictive value (95% vs. 80%), and accuracy (92% vs. 77%).
American Journal of Emergency Medicine (2011) 29, 91–101
May 14, 2013
Characteristics of the Ketamine "Dissociative State":
Ann Emerg Med. 2011;57:449-461
May 13, 2013
A randomized, single-blind, crossover, prospective study of 70 critically ill adult patients demonstrated that nebulized albuterol and ipratropium do not cause significant tachycardia or tachyarrhythmias. Substitution of levalbuterol for albuterol to avoid tachycardia and tachyarrhythmias is unwarranted.
Chest, Volume 140, Issue 6 (December 2011)
May 12, 2013
In ED record review of 111 discharged patients receiving warfarin, 71% of patients had an international normalized ratio measured, with 49% of values non-therapeutic and 46% with any record of recognition or action. Physicians administered or prescribed potentially interacting drugs for 17% and 13% of patients, respectively.
Ann Emerg Med. 2011;58:192-199
May 11, 2013
In hemodynamically unstable patients (systolic blood pressure <90 mm Hg) with blunt abdominal trauma, bedside ultrasound, when available, should be the initial diagnostic modality performed to identify the need for emergent laparotomy.
Ann Emerg Med. 2011;57: 387-404
May 10, 2013Topical nonsteroidal anti-inflammatory drugs effectively reduce pain associated with musculoskeletal conditions compared with placebo, with fewer adverse events compared with oral nonsteroidal anti-inflammatory drugs.
Annals of Emergency Medicine, 2012;59 (4)
May 09, 2013Discordant diagnoses in a retrospective cohort study between emergency physicians and neurologists were observed in 36% of patients. The presence of headache, involuntary movement, and dizziness predicted discordant diagnoses, whereas the presence of tingling and an increased ABCD2 score predicted concordant transient ischemic attack diagnosis.
Ann Emerg Med. 2012;59:19-26
May 08, 2013
Common ED Uses For Ketamine:
|In the ED||Other Indications|
EBMedicine.net, January 2011
May 07, 2013The clinical diagnosis of delirium hinges on the presence of two cardinal features: disruption of attention and disruption of the sleep–wake cycle, which leads to fluctuation in symptoms over the course of a day.
N Engl J Med 2012;366:648-657
May 06, 2013In acute methanol overdose, ophthalmologic symptoms can range from blurry vision, decreased visual acuity, and photophobia to blindness or the classic “snowstorm” vision.
EBMedicine.net, 2010, Volume 12, Number 11
May 05, 2013The combination of these 3 examination findings (head impulse test, skew deviation, and spontaneous nystagmus direction) appears to be more sensitive than MRI in acute vertigo.
Mayo Clin Proc 2012;87(3):280-5
May 04, 2013Pyuria in a urine specimen, in the absence of symptoms, is not an indication for antimicrobial therapy.
EBMedicine.net, January 2012
May 03, 2013
Advantages and Disadvantages of VKAs (Vit K Antagonists):
Proven high effectiveness
Monitoring of INR
Therapeutic window established
Long action: low thrombosis risk
with poor compliance
Slow onset of action
High bleeding risk
Emedhome.com, February 1, 2012
May 02, 2013After out-of-hospital cardiac arrest, therapeutic hypothermia was associated with an increased risk of early-onset pneumonia. This complication was associated with prolonged respiratory support and ICU stay, but did not significantly influence ICU mortality.
Am J Respir Crit Care Med 2011 Nov 1; 184:1048