Academic Emergency Medicine

Intravenous acetaminophen does not reduce morphine use for pain relief in emergency department patients: A multicenter, randomized, double-blind, placebo-controlled trial

Ultrasound for the diagnosis of shoulder dislocation and reduction: A systematic review and meta-analysis

• Overall, POCUS was 100% (95% confidence interval [CI], 85.6%–100%) sensitive and 100% (95% CI, 79.4%–100%) specific for the diagnosis of shoulder dislocation
• 5 min sono has a great video

Normal shoulder above

Dislocated above

American Journal of Emergency Medicine

None

Annals of Emergency Medicine

Acute Opioid Withdrawal Following Intramuscular Administration of Naloxone 1.6 mg: A Prospective Out-Of-Hospital Series

• Severe agitation was uncommon following the administration of 1.6 mg IM naloxone and rarely required chemical sedation.
• A single 1.6 mg dose of naloxone reversed respiratory depression in 192 (97% [95% CI: 94% to 99%]) presentations.

BMJ

Gout: diagnosis and management—summary of NICE guidance

• allopurinol or febuxostat to lower uric acid which prevents long term progression
• for acute attacks use steroids or saids depending on pt preference, colchicine is second line for folks who cannot take nsaids (pud risk) or steroids (dm, info risk)

Acute vertigo: getting the diagnosis right

Circulation

None

CJEM

The impact of post-intubation hypotension on length of stay and mortality in adult and geriatric patients: a cohort study

• Post-intubation hypotension was recorded in one out of three patients in the ED but we found no association between post-intubation hypotension and 48-h in-hospital mortality overall in adults or geriatric patients.

EMCRIT

Neuromuscular Disorders

Approach to CNS infection

Emergency Medicine Journal

None

EMRAP

Critical Care Mailbag: Tracheostomy Complications

• Tracheostomy replacement
  • Can be still be replaced if <7-10d old (mature) but use more caution, ENT consult if time permits, ideally use flexible endoscope, if none then use a bougie.
  • Replacement of a Trach with a mature track can be done blindly, assisted by a bougie, or with a flexible endoscope.

Pediatric Pearls: Asthma Smackdown – Part 1 and Part 2

Rural Medicine: Delivery on a plane

Bleeding AV Shunt

• Video Bleeding AV Shunt
• Hold pressure both above and below the site of bleeding.
  • Can use figure of 8 suture that takes a bite of both skin and dialysis graft with a non cutting needle (taper needle).

JAMA

What Is Carpal Tunnel Syndrome?

Association of COVID-19 vs Influenza With Risk of Arterial and Venous Thrombotic Events Among Hospitalized Patients

• Hospitalization with COVID-19 before and during vaccine availability, vs hospitalization with influenza in 2018-2019, was significantly associated with a higher risk of venous thromboembolism within 90 days, but there was no significant difference in the risk of arterial thromboembolism within 90 days ((adjusted HR, 1.60 [95% CI, 1.43-1.79]) and during vaccine availability (adjusted HR, 1.89 [95% CI, 1.68-2.12]).

Journal of Emergency Medicine

Ring Removal: A Comprehensive Review of Techniques

Lancet

None

NEJM

Bronchiectasis — A Clinical Review

Confronting Health Worker Burnout and Well-Being

PEDIATRICS

None

REBELEM

The DINAMO Study: Efficacy and Safety of Non-Antibiotic Outpatient Treatment in Mild Acute Diverticulitis

• Clinical Question: Is it necessary to prescribe antibiotics to all patients undergoing outpatient management for mild diverticulitis as identified on CT scan?
• Author Conclusion: “Nonantibiotic outpatient treatment of mild AD is safe and effective and is not inferior to current standard treatment.”

Resuscitation

Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care

• Hospital availability of TCC was not associated with improved outcomes for in-hospital cardiac arrest.