This January 1, 2014 JAMA article studies Mechanical Chest Compressions and Simultaneous Defibrillation vs Conventional Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest There are clearly many factors that affect the chances of survival after a cardiac arrest, including early recognition of arrest, effective cardiopulmonary resuscitation (CPR), timely defibrillation, and postresuscitation care. One important link is thought… Read More
This March 2014 CDC report shows a high incidence of tick borne pathogens causing including the usual Borrelia burgdorferi, the spirochete that causes Lyme disease and also a relatively new B. miyamotoi, which causes a similar syndrome and relapsing fever. B. miyamotoi has also been found in the Midwest and East Coast U.S. This CDC… Read More
Most Americans support requiring the measles, mumps and rubella vaccine for public school children in order to protect public health. They see high preventive health benefits of such vaccines, and low risk of side effects, and they consider the benefits of the vaccine to outweigh the risks.Yet, public concerns about childhood vaccines linger in the… Read More
This article from the January 30, 2017 issue of Canadian Medical Association Journal looks at which patients with chest pain can be safely discontinued from telemetry/cardiac monitoring after an initial evaluation. Although this article may not persuade me from discontinuing patients when we have enough monitors in the Emergency Department, but this study in conjunction… Read More
This ACEP Clinical Policy published in Annals of Emergency Medicine looked at the management of patients with suspected Carbon monoxide poisoning. The policy reviewed the literature to answer several questions. 1. In ED patients with suspected acute CO poisoning, can noninvasive COHb measurement be used to accurately diagnose CO toxicity? Level B recommendations: Do not… Read More
This 2017 ACEP Clinical Policy examines two questions in patients that present to emergency department with a positive pregnancy test. The policy reviews the literature and looks at HCG values and makes recommendations on the use of ultrasound and HCG levels. All these policies should be used in conjunction with clinical judgment. 1. Should the… Read More
“Superbug” Klebsiella Pneumoniae, a carbapenem-resistant Enterobacteriaceae (CRE) claimed the life of a Reno Nevada woman in 2016. This was in the heals of two highly publicized deaths at UCLA Medical Center in 2015. That strain was resistant to all available (26) antimicrobial drugs. Although the patient was hospitalized in Nevada, the pathogen was reportedly contracted in… Read More
This study in the April 15, 2016 issue of Elife examines and concludes the estrogen blockers may be helpful in the treatment of seizures. Most anti-seizure medications work by globally reducing brain activity leading to side effects like drowsiness, dizziness and difficulty concentrating. Estrogen was been found to be elevated in both men and women after seizures. The… Read More
A January 10, 2017 JAMA Viewpoint article looks at Altmetrics. The article makes note that there are over 2.5 million articles published every year and the number of articles in the literature more than doubles every decade. Clearly differentiating the relevant from the irrelevant is crucial. Typically, the influence of a published article would primarily… Read More
