Emergency Medicine
M-A | Routine anaerobic coverage for aspiration pneumonia: limited evidence of benefit
13 Mar, 2023 | 15:03h | UTCSummary: Treating aspiration pneumonia with antibiotics that cover anaerobic bacteria has become common practice in many services, but recent studies suggest that this may not necessarily improve prognosis.
Out of 2523 publications, this systematic review and meta-analysis only included one randomized control trial and two observational studies. The study found no clear benefit of anaerobic coverage and concluded that there is not enough data to evaluate the necessity of anaerobic coverage in the antibiotic treatment of aspiration pneumonia.
The authors suggest that covering anaerobic bacteria with antibiotics may not be needed as an initial treatment for aspiration pneumonia if there is no formation of abscess or empyema and the patient has good oral hygiene.
Related: BTS clinical statement on aspiration pneumonia – Thorax
Brief Review | How we escalate vasopressor and corticosteroid therapy in patients with septic shock
13 Mar, 2023 | 15:04h | UTCHow We Escalate Vasopressor and Corticosteroid Therapy in Patients With Septic Shock – CHEST (free for a limited period)
ISCCM Guidelines for the use of procalcitonin for rational use of antibiotics
13 Mar, 2023 | 14:57h | UTC
ESC 0/1-hour algorithm unable to safely exclude 30-day cardiac death or MI in patients with known coronary artery disease, study finds
8 Mar, 2023 | 14:12h | UTCSummary:
The study aimed to determine if the European Society of Cardiology (ESC) 0/1-hour algorithm using high-sensitivity cardiac troponin T (hs-cTnT) could achieve a negative predictive value of 99% or higher for 30-day cardiac death or myocardial infarction (MI) among emergency department patients with chest pain and known coronary artery disease (CAD).
The study included 1430 adults, and the algorithm had a negative predictive value of 96.6% for 30-day cardiac death or MI among patients with known CAD, suggesting that the algorithm may not be able to safely exclude 30-day cardiac death or MI in these patients.
These findings suggest that clinicians should be cautious when using the ESC 0/1-hour hs-cTnT algorithm in patients with known CAD.
Article: Performance of the European Society of Cardiology 0/1-Hour Algorithm With High-Sensitivity Cardiac Troponin T Among Patients With Known Coronary Artery Disease – JAMA Cardiology (link to abstract – $ for full-text)
Related:
Performance of the European Society of Cardiology 0/1-Hour, 0/2-Hour, and 0/3-Hour Algorithms for Rapid Triage of Acute Myocardial Infarction: An International Collaborative Meta-analysis – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In this diagnostic study of 1430 adults, the high-sensitivity troponin T (hs-cTnT) ESC 0/1-hour algorithm had a negative predictive value of 96.6% for 30-day cardiac death or MI among patients with known coronary artery disease. https://t.co/FnILIazEnU
— JAMA Cardiology (@JAMACardio) March 1, 2023
M-A | Real-time ultrasound guidance as compared to landmark technique for subclavian central venous cannulation
8 Mar, 2023 | 14:04h | UTCReal-Time Ultrasound Guidance as Compared to Landmark Technique for Subclavian Central Venous Cannulation: A Systematic Review and Meta-Analysis With Trial Sequential Analysis – Critical Care Medicine (link to abstract – $ for full-text)
Review | Acquired disorders of hypomagnesemia
7 Mar, 2023 | 13:09h | UTCAcquired Disorders of Hypomagnesemia – Mayo Clinic Proceedings
SR | The effects of flow settings during high-flow nasal cannula support for adult subjects
7 Mar, 2023 | 12:40h | UTC
M-A | Early vs. delayed coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation
6 Mar, 2023 | 14:12h | UTCSummary:
This systematic review and meta-analysis of randomized controlled trials evaluated the efficacy and safety of early vs. delayed coronary angiography following an out-of-hospital cardiac arrest in patients without ST elevation on the ECG.
The review included six trials with 1,590 patients and found that early angiography probably has no effect on mortality, survival with good neurologic outcomes, and ICU length of stay, indicating that the procedure should not be routinely recommended for these patients.
Related:
Emergency vs Delayed Coronary Angiogram in Survivors of Out-of-Hospital Cardiac Arrest: Results of the Randomized, Multicentric EMERGE Trial – JAMA Cardiology (link to abstract – $ for full-text)
Nitrous oxide-induced subacute combined degeneration of the cord: diagnosis and treatment
3 Mar, 2023 | 14:01h | UTC
Review | Practical guide for anticoagulant and antiplatelet reversal in clinical practice
3 Mar, 2023 | 13:42h | UTCPractical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice – Pharmacy
The European guideline on management of major bleeding and coagulopathy following trauma
2 Mar, 2023 | 13:04h | UTC
Review | The golden grapes of wrath – Staphylococcus aureus bacteremia
1 Mar, 2023 | 13:46h | UTC
M-A | Which adverse events and which drugs are implicated in drug-related hospital admissions
28 Feb, 2023 | 13:59h | UTCSummary: This systematic review and meta-analysis aimed to provide an updated estimation of drug-related hospital admissions, the types and frequency of drug-induced harm, and the drugs involved. The review included 17 studies that examined acute admissions to emergency departments or inpatient wards resulting from drug-induced harm in the general population. These studies were published between January 2012 and December 2021. The estimated rates of admissions resulting from adverse drug reactions* (ADRs) and adverse drug events* (ADEs) were 8.3% and 13.9%, respectively. Almost half of the admissions related to ADRs and over two-thirds of those related to ADEs were possibly preventable. Gastrointestinal disorders, electrolyte disturbances, bleeding events, and renal and urinary disorders were the most frequently involved categories of drug-induced harm. The most frequently involved drug groups were nervous system drugs, followed by cardiovascular and antithrombotic agents.
*Adverse drug events (ADEs) and adverse drug reactions (ADRs) are two terms that are often used interchangeably, but they actually have different meanings. Adverse drug events (ADEs) refer to any negative effect that results from medication exposure and can be caused by a variety of factors, including medication errors, overdose, drug interactions, or allergic reactions. In contrast, adverse drug reactions (ADRs) are a specific type of ADE that occur as unintended effects of medication at normal therapeutic doses.
Guidelines | Efficacy and safety of non-steroidal anti-inflammatory drugs for the treatment of acute pain after orthopedic trauma
28 Feb, 2023 | 13:48h | UTC
Consensus Report | Sepsis-associated acute kidney injury
27 Feb, 2023 | 13:05h | UTCSepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup – Nature Reviews Nephrology (if the link is paywalled, try this one)
Commentary on Twitter
A Primer in @DiseasePrimers summarizes the epidemiology, mechanisms, diagnosis and treatment of pre-eclampsia, and discusses patient quality of life and open research questions for this condition. https://t.co/IO3uchSl8b pic.twitter.com/Y7Ij6jmy5a
— Nature Portfolio (@NaturePortfolio) February 25, 2023
Consensus Paper | Early management of isolated severe traumatic brain injury in a hospital without neurosurgical capabilities
24 Feb, 2023 | 13:49h | UTC
Commentary from the author on Twitter
Great to see our consensus published. Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES).https://t.co/k9hwI82dOW pic.twitter.com/pIp5gFRnPa
— Deepak Sharma (@deepak_neuro) January 14, 2023
Review | When and how to use MIC in clinical practice?
24 Feb, 2023 | 13:28h | UTCWhen and How to Use MIC in Clinical Practice? – Antibiotics
Commentary on Twitter
https://twitter.com/ABsteward/status/1616852667124400129
Acute pain management pearls: a focused review for the hospital clinician
23 Feb, 2023 | 13:15h | UTCAcute Pain Management Pearls: A Focused Review for the Hospital Clinician – Healthcare
Bacteremia | ED presentations, evaluation, and management
22 Feb, 2023 | 12:25h | UTCBacteremia: ED Presentations, Evaluation, and Management – emDocs
Guideline Synopsis | Management of thoracic aortic dissection
21 Feb, 2023 | 11:48h | UTCManagement of Thoracic Aortic Dissection – JAMA (free for a limited period)
Original Guidelines:
Acute pain management pearls: a focused review for the hospital clinician
17 Feb, 2023 | 12:42h | UTCAcute Pain Management Pearls: A Focused Review for the Hospital Clinician – Healthcare
RCT | Rivaroxaban shows promise compared to Enoxaparin in the acute phase of an acute coronary syndrome
16 Feb, 2023 | 15:20h | UTCInvited Commentary: Rivaroxaban for Patients With Acute Coronary Syndromes—Where Do We Stand? – JAMA Network Open
Commentary on Twitter
The H-REPLACE RCT: short-term rivaroxaban (5mg 2x/day) was noninferior to enoxaparin in safety + efficacy during 6-month follow-up among patients with acute coronary syndrome who missed the primary reperfusion window and before selective revascularization. https://t.co/TIHOwGSWjJ
— JAMA Network Open (@JAMANetworkOpen) February 10, 2023
Guideline | Diagnosis and management of subarachnoid hemorrhage caused by a ruptured aneurysm
16 Feb, 2023 | 15:23h | UTC
M-A | Efficacy of endovascular therapy for basilar and vertebral artery occlusion
16 Feb, 2023 | 14:50h | UTCRelated:
M-A | Mechanical thrombectomy in acute basilar artery stroke.
Review | Indications, clinical impact, and complications of critical care transesophageal echocardiography
15 Feb, 2023 | 15:45h | UTC