Academic Emergency Medicine

Guidelines for reasonable and appropriate care in the
emergency department (GRACE): Recurrent, low- risk chest
pain in the emergency department

American Journal of Emergency Medicine

No articles this month

Annals of Emergency Medicine

Managing a Cutaneous Abscess in the Emergency
Department

Early Care of Adults With Suspected Sepsis in the Emergency Department and Out-of-Hospital Environment: A Consensus-Based Task Force Report

BMJ

Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial

• No difference in outcome at 16 weeks
• Population was all ankle fractures managed nonoperatively
• Duration on non-weightbearing, period of immobilization up to clinician and patient.

Circulation

AHA Scientific Statement. Mechanical Complications of Acute Myocardial Infarction: A Scientific Statement From the American Heart Association

EMCRIT

PulmCrit – Is piperacillin-tazobactam safe in patients with penicillin allergy?

Subarachnoid Hemorrhage (SAH)

Emergency Medicine Journal

Diagnostic yield of bacteriological tests and predictors of severe outcome in adult patients with COVID-19 presenting to the emergency department

• In this retrospective study of patients receiving blood cultures at a hospital in The Netherlands, we found that 6.3% of patients with SARS- CoV-2 had positive blood cultures and all were considered contaminated. Overall bacterial coinfection using other diagnostics was 1.4%. This suggests that in patients known to have SARS- CoV-2, blood cultures are unlikely to be of use.

• Procalcitonin and the Pneumonia Severity Index seem most promising to recognise patients at risk for severe outcome of COVID-19 when presenting to the ED.

EMRAP

Traumatic Arthrotomy

• A traumatic arthrotomy is a laceration that extends into the joint capsule exposing the intra-articular surface to the environment. It is important to identify, as operative washout, debridement and proper closure of the joint capsule is required.
• Instill saline into the joint and see if it leaks out through the laceration. Leakage of saline means you have an arthrotomy.
• For the knee, a load of 194 mL achieves 95% sensitivity.
• Keese GR, Boody AR, Wongworawat MD, Jobe CM. The Accuracy of the Saline Load Test in the Diagnosis of Traumatic Knee Arthrotomies. Journal of Orthopaedic Trauma. 2007;21(7):442-443. doi: 10.1097/BOT.0b013e31812e5186.

Frontiers in Medicine

The Risk of COVID-19 Related Hospitalsation, Intensive Care Unit
Admission and Mortality in People With Underlying Asthma or COPD: A
Systematic Review and Meta-Analysis

• Risk increased with COPD but not with asthma.

JAMA

Ways to Quit Smoking

Lancet

Acute respiratory distress syndrome

NEJM

Administration of Supplemental Oxygen

Cerebral Venous Thrombosis

Depression in Adolescents

Hematuria in Adults

Initial Management of Seizure in Adults

Substance Use among Men Who Have Sex with Men

PLOS ONE

Relative sensitivity of anterior nares and nasopharyngeal swabs for initial detection of
SARS-CoV-2 in ambulatory patients: Rapid review and meta-analysis

• Sensitivity of anterior nares is lower (82-88%) than nasopharyngeal (98%) but in a population with 10% positivity, the negative predictive value is still greater than 98%.

REBELEM

None