Emergency Medicine
ASH Guideline issued a conditional recommendation against routine use of outpatient anticoagulant prophylaxis in patients with COVID-19 being discharged from the hospital.
4 Nov, 2021 | 10:03h | UTC
Short Review: Cardiac injury in Covid-19.
3 Nov, 2021 | 10:04h | UTCCardiac injury in COVID-19 – Intensive Care Medicine
Commentary on Twitter
Myocardial injury in #COVID19, many potential mechanisms:
?myocardial DO2/VO2 imbalance
?ARDS & MV
?cytokine storm
?direct viral lesion.
Variable clinical presentations, with high complications rates, mortality & risk of long-term cardiac impairment.https://t.co/wxPDDrtEoY pic.twitter.com/vOx1B4cwY2— Intens Care Med (@yourICM) November 2, 2021
Review: The role of chest imaging in the diagnosis, management, and monitoring of Covid-19.
3 Nov, 2021 | 10:05h | UTC
RCT: Among children with community-acquired pneumonia discharged within 48 hours from the ED or hospital, lower-dose outpatient oral amoxicillin was noninferior to a higher dose, and a 3-day duration course was noninferior to 7 days.
3 Nov, 2021 | 09:56h | UTCEffect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia: The CAP-IT Randomized Clinical Trial – JAMA (free for a limited period)
Related:
ACP Guidance: Appropriate Use of Short-Course Antibiotics in Common Infections
RCT: 7 days of antibiotic therapy as good as 14 days for afebrile men with urinary tract infection.
Commentary on Twitter
?Just published?
CAP-IT RCT
Children w CAP discharged from ED or hospital (w/in48 hrs)
lower-dose outpatient oral amoxicillin was noninferior to higher dose& 3d was noninferior to 7 d, w regard to need for Abx re-treatment @BradSpellberg table update ? https://t.co/VkxBmJaEeW pic.twitter.com/fKzpGp1XM7— Antibiotic Stewa®️x? Bassam Ghanem (@ABsteward) November 2, 2021
A comprehensive review of vascular complications in COVID-19.
2 Nov, 2021 | 03:01h | UTC
Short Review: Ketamine for the treatment of acute pain.
2 Nov, 2021 | 02:43h | UTCKetamine for the treatment of acute pain – Canadian Medical Association Journal
Commentary on Twitter
If you manage pain in hospital, low-dose ketamine should be in your toolkit. And not just in the ED.
Quick overview with @WKSilverstein & @JonZipursky in @CMAJ: https://t.co/w5h3vIMiEK pic.twitter.com/gVO7W9dcYY
— David Juurlink (@DavidJuurlink) November 1, 2021
Cohort Study: Among patients with ST-segment elevation myocardial infarction, a concomitant Covid-19 diagnosis is associated with increased in-hospital mortality.
31 Oct, 2021 | 20:10h | UTCEditorial: Myocardial Infarction During the COVID-19 Pandemic – JAMA
Commentary: STEMI and COVID-19 Often a Lethal Combo, Affirms Largest Study Yet – TCTMD
Commentary from the author on Twitter (thread – click for more)
1/8 It was not unexpected that pts w/ #STEMI would fare worse w/ than w/o #COVID19 https://t.co/B7oWnJunEa
— Herb Aronow, MD, MPH (he/him/his) (@herbaronowMD) October 29, 2021
Review: How I manage a patient with MRSA bacteremia.
31 Oct, 2021 | 19:54h | UTCHow I manage a patient with MRSA bacteraemia – Clinical Microbiology and Infection
2021 AHA/ACC Guideline for the Evaluation and Diagnosis of Chest Pain.
29 Oct, 2021 | 09:57h | UTCExecutive Summary: 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain – Journal of the American College of Cardiology
News Release: First-Ever Guideline Focused Solely on Chest Pain Evaluation, Diagnosis Released
Guideline Hub: Guideline for the Evaluation and Diagnosis of Chest Pain
Key Points: 2021 AHA/ACC Chest Pain Guideline – American College of Cardiology
Commentary: New Chest Pain Guidelines Out at Last: Most Tests Have a Role – TCTMD
Commentary on Twitter (thread – click for more)
The Chest Pain Guidelines are now released!https://t.co/xQxCWzReEN
Top 10: CHEST PAINS
Thanks to the entire writing group and my co-cahirs: Deb Murkerjee & Phil Levy
?First Chest Pain Guidelines @AHAScience @ACCinTouch pic.twitter.com/s17piamrKR— Dr. Martha Gulati “Get Vaccinated Please” (@DrMarthaGulati) October 28, 2021
Brain injury after cardiac arrest: pathophysiology, treatment, and prognosis.
29 Oct, 2021 | 09:49h | UTC
Commentary on Twitter
Post-cardiac arrest brain injury, narrative review:
?pathophysiology: primary (ischemic) & secondary (reperfusion)
?treatment options
?outcomes
?neuroprognostication
?@ERC_resus @ESICM 2021 algorithm for prognostication
Open #FOAMcc #FOAMres @yourICM https://t.co/b8GRhE3MuF pic.twitter.com/q10DJVRJOp— Intens Care Med (@yourICM) October 27, 2021
RCT: Early treatment of Covid-19 with SARS-CoV-2 neutralizing antibody Sotrovimab is associated with reduced risk of hospitalization.
28 Oct, 2021 | 10:20h | UTC
Commentary on Twitter
In this phase 3 trial, sotrovimab or placebo was administered to outpatients within 5 days after the onset of #COVID19 symptoms. Patients receiving sotrovimab had a lower incidence of hospitalization for any reason. #IDTwitter https://t.co/4VcgoK3xac pic.twitter.com/W82v3jNRmB
— NEJM (@NEJM) October 27, 2021
RCT: Early treatment with fluvoxamine reduced the risk of emergency care and hospitalization among patients with COVID-19.
28 Oct, 2021 | 10:22h | UTCCommentaries:
The TOGETHER Trial: COVID-19 and Fluvoxamine Take Two – REBEL EM
The antidepressant fluvoxamine can keep COVID-19 patients out of the hospital – ScienceNews
Related:
Commentary on Twitter
NEW in @LancetGH: Using SSRI #fluvoxamine to treat high-risk outpatients with early-diagnosed #COVID19 reduced the need for prolonged observation in an emergency setting or hospitalisation: largest trial to date. https://t.co/BVtMju74lp @TogetherTrial pic.twitter.com/F1FnZuyqdY
— The Lancet (@TheLancet) October 27, 2021
Anticoagulants and diabetes agents are among the most frequent causes of emergency department visits attributed to medication harms.
27 Oct, 2021 | 01:15h | UTCUS Emergency Department Visits Attributed to Medication Harms, 2017-2019 – JAMA (link to abstract – $ for full-text)
Commentaries:
Number of emergency room visits for medication harms increases with age – MedicalResearch.com
Blood thinners, diabetes meds among top causes of drug-related ER visits – UPI
Systematic Review: Antibiotics for the treatment of COVID‐19 – “We are certain that risk of death in hospitalized COVID‐19 patients is not reduced by treatment with azithromycin after 28 days”.
26 Oct, 2021 | 02:07h | UTCAntibiotics for the treatment of COVID‐19 – Cochrane Library
Commentary on Twitter
JUST PUBLISHED – Are #antibiotics an effective treatment for #COVID19 & do they cause unwanted effects? https://t.co/EVHduxmtdD New Cochrane Review looked at evidence from 11 studies: ❌ antibiotic azithromycin is not an effective treatment, ?not enough research on other types.
— The Cochrane Library (@CochraneLibrary) October 22, 2021
Cohort Study: Bacterial Superinfection Pneumonia in Patients Mechanically Ventilated for COVID-19 Pneumonia – “Bacterial superinfection within 48 hours of intubation was detected in 21 percent of patients”.
26 Oct, 2021 | 01:59h | UTC
Commentary on Twitter
Bacterial Superinfection Pneumonia in Patients Mechanically Ventilated for COVID-19 Pneumonia
? Open Access
? https://t.co/MaCZkKrQdQ pic.twitter.com/sscICvqYjS— ATS Blue Journal (@ATSBlueEditor) October 19, 2021
Opinion | COVID STEROID-2: Double the steroid, double the fun? – “Dexamethasone 6 mg/day alone is likely suboptimal for most patients with severe COVID pneumonia. Dexamethasone 12 mg/day may provide a reasonable intensity of immunomodulation”.
25 Oct, 2021 | 00:01h | UTCCOVID STEROID-2: Double the steroid, double the fun? – PulmCrit
Commentary on Twitter
COVID-STEROID 2
?5% lower mortality with 12 mg dexamethasone (vs 6 mg) – which is *huge* – but p=0.09 ?
?RCTs with toci/bari show that 6 mg dex alone is suboptimal.
?If using dex monotherapy, 12 mg is now a sensible dose for sicker pts.
Fresh blog: https://t.co/oPz7vAYHGN pic.twitter.com/diDqqUxSTC— ???? ?????? ? (@PulmCrit) October 23, 2021
Review: Cardiac involvement in the long-term implications of COVID-19.
24 Oct, 2021 | 23:59h | UTCCardiac involvement in the long-term implications of COVID-19 – Nature Reviews Cardiology
2021 Interim Guidance to Health Care Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19.
24 Oct, 2021 | 23:49h | UTCCommentary: CPR on a COVID Patient: Not a Moment to Waste Looking for PPE: Updated AHA guidance says resuscitation should not be delayed by mask availability – MedPage Today (free registration required)
Commentary on Twitter (thread – click for more)
(1/2) NEW! The AHA has published its 2021 interim CPR guidance for #HCPs who treat cardiac arrest patients with suspected or confirmed #COVID19. The paper in @CircOutcomes is an update to the 2020 Interim CPR Guidance: https://t.co/tuTwWkE0dL. pic.twitter.com/B1el7dCKJM
— AHA CPR & First Aid (@HeartCPR) October 13, 2021
RCT: In comatose survivors of out-of-hospital cardiac arrest, there was no difference in mortality and neurologic outcomes with mild (target temperature of 34 °C) vs. moderate therapeutic hypothermia (target temperature of 31 °C).
24 Oct, 2021 | 23:46h | UTCEffect of Moderate vs Mild Therapeutic Hypothermia on Mortality and Neurologic Outcomes in Comatose Survivors of Out-of-Hospital Cardiac Arrest: The CAPITAL CHILL Randomized Clinical Trial – JAMA (free for a limited period)
Related:
Study commentary: a history of hypothermia for cardiac arrest, 2002-2021 (RIP).
Commentary on Twitter
therapeutic hypothermia after cardiac arrest is a nonbeneficial form of iatrogenesis that prolongs ICU length of stay (findings entirely consistent with TTM & TTM2). currently it should not be performed outside the context of an RCT. https://t.co/GZbpgHXWoD https://t.co/kRwRpLz6hV
— ???? ?????? ? (@PulmCrit) October 20, 2021
Guideline: Transfusion strategies in bleeding critically ill adults.
24 Oct, 2021 | 23:47h | UTC
Commentary on Twitter
Transfusion strategies in bleeding critically ill adults current evidence/research areas from @ESICM clinical practice guideline
?massive bleedings
?non‑massive bleedings
?tranexamic acid in traumatic/non‑traumatic hemorrhages
Open #FOAMcc on @yourICM
?️https://t.co/LtEzrLcaM5 pic.twitter.com/Po7eFYpdeW— Intens Care Med (@yourICM) October 22, 2021
The cost-effectiveness of cefazolin compared to anti-staphylococcal penicillins for the treatment of methicillin-sensitive Staphylococcus aureus bacteremia.
24 Oct, 2021 | 23:41h | UTCRelated:
Meta-Analysis: Cefazolin vs. Antistaphylococcal Penicillins for MSSA Bacteremia
Commentaries on Twitter
While Cefazolin and anti-staphylococcal penicillins (ASPs), such as nafcillin, are the preferred treatments for MSSA bacteremia it looks more and more like Cefazolin is really the preferred approach. https://t.co/6FVVEWMxBY
— Daniel Griffin MD PhD (@DanielGriffinMD) October 8, 2021
New in OFID: The use of cefazolin is a cost-effective strategy for the treatment of methicillin-sensitive S. aureus bacteremia and, when clinically appropriate, results in health care cost-savings.
?: https://t.co/lRfsZdMjLJ#IDSAJournals @PaulSaxMD @DrJLi @ElMylonakis pic.twitter.com/hhzik4ppUW
— IDSA (@IDSAInfo) October 8, 2021
M-A: In patients with Staphylococcus aureus bacteremia, combination therapy does not reduce mortality and is associated with increased risks of adverse events.
24 Oct, 2021 | 23:42h | UTC
RCT: In adults with Covid-19 and severe hypoxemia, 12 mg vs. 6 mg of Dexamethasone did not result in a statistically significant difference in the number of days alive without life support.
22 Oct, 2021 | 10:32h | UTCEditorial: Glucocorticoid Dose in COVID-19: Lessons for Clinical Trials During a Pandemic – JAMA
Commentary on Twitter
In a randomized trial of patients with #COVID19 and severe hypoxemia, compared with 6 mg of dexamethasone, 12 mg of dexamethasone did not statistically significantly reduce the number of days alive without life support at 28 days https://t.co/BMgLTel4aU pic.twitter.com/WKwI8xCUYO
— JAMA (@JAMA_current) October 21, 2021
M-A: Diagnostic accuracy of handheld cardiac ultrasound device for assessment of left ventricular structure and function.
22 Oct, 2021 | 10:15h | UTC
COVID-19 pneumonia: pathophysiology and management.
21 Oct, 2021 | 10:12h | UTCCOVID-19 pneumonia: pathophysiology and management – European Respiratory Review