2023
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Feb 10 2023
Angioedema – Who Needs Intubation?
Spoon Feed
In patients presenting with angioedema, history of hypertension, shortness of breath, drooling, and anterior tongue or pharyngeal swelling were risk factors predicting eventual need for intubation.Source
Clinical predictors of endotracheal intubation in patients presenting to the emergency department with angioedema. Am J Emerg Med. 2023 Jan;63:44-49. doi: 10.1016/j.ajem.2022.10.017. Epub 2022 Oct 19. -
Feb 09 2023
VIZIR RCT – Zinc for COVID-19?
Spoon Feed
Zinc supplementation for patients with COVID-19 decreased 30-day ICU admission rate and led to shorter symptom duration. Subgroup analysis showed these effects were especially pronounced for elderly patients and those with comorbid conditions.Source
Twice-Daily Oral Zinc in the Treatment of Patients With Coronavirus Disease 2019: A Randomized Double-Blind Controlled Trial. Clin Infect Dis. 2023;76(2):185-191. doi:10.1093/cid/ciac807 -
Feb 08 2023
PANORAMIC RCT – Molnupiravir…or Mol-NOPE-iravir?
Spoon Feed
Molnupiravir does not decrease death or hospitalization in vaccinated patients with COVID-19 at high risk for progression to severe disease. -
Feb 07 2023
New RCT – High-Dose or Standard-Dose Cephalexin for Cellulitis?
Spoon Feed
In this trial, investigators compared high-dose cephalexin (1000 mg QID) to standard dose (500 mg QID) for the treatment of non-purulent cellulitis. They found that high-dose cephalexin was associated with fewer instances of treatment failure but a higher proportion of adverse events.Source
High-dose cephalexin for cellulitis: a pilot randomized controlled trial. CJEM. 2023 Jan;25(1):22-30. doi: 10.1007/s43678-022-00433-7. Epub 2023 Jan 2. -
Feb 06 2023
Clindamycin or Linezolid for Toxic Shock?
Spoon Feed
Current guidelines dictate that treatment of Group A Streptococcus pyogenes (GAS) necrotizing soft tissue infections (NSTI) and toxic shock syndrome (TSS) include clindamycin in conjunction to a beta lactam in order to inhibit exotoxin production; but might we consider co-treatment with linezolid instead?Source
Should Linezolid Replace Clindamycin as the Adjunctive Antimicrobial of Choice in Group A Streptococcal Necrotizing Soft Tissue Infection and Toxic Shock Syndrome? A Focused Debate. Clin Infect Dis. 2023 Jan 13;76(2):346-350. doi: 10.1093/cid/ciac720. -
Feb 03 2023
Alcoholic Hepatitis – Spoon-Feed Version
Spoon Feed
Patients with alcohol-associated hepatitis have a high rate of complications and short-term mortality of 20-50%. Prompt recognition and treatment, including initiation of treatment for alcohol use disorder, is important to improve patient outcomes.Source
Alcohol-Associated Hepatitis. NEJM. 2022 Dec 29; 387 (26): 2436-2448. -
Feb 02 2023
Inebriation Estimation – Can You Guess Blood Alcohol Levels?
Spoon Feed
ED clinicians are often inaccurate in their estimations of patients’ blood alcohol content (BAC). Overestimation is common, especially in patients arriving by ambulance compared to walk-ins.Source
Clinician assessment of blood alcohol levels among emergency department patients. Am J Emerg Med. 2023 Jan;63:110-112. doi: 10.1016/j.ajem.2022.10.045. Epub 2022 Oct 31. -
Feb 01 2023
WEST – New Blunt Thoracic Aortic Injury Algorithm
Spoon Feed
The Western Trauma Association Algorithms Committee has released new evaluation and management guidelines and a step-by-step algorithm (see below) surrounding blunt thoracic aortic injury. -
Jan 31 2023
Does E-FAST Add Value Before CT Traumagram?
Spoon Feed
An initial diagnostic workup that includes an E-FAST exam and targeted chest and pelvis x-rays allows clinicians an opportunity to assess and intervene appropriately on the majority of patients prior to WBCT in the setting of blunt trauma.Source
Appropriateness of Initial Course of Action in the Management of Blunt Trauma Based on a Diagnostic Workup Including an Extended Ultrasonography Scan. JAMA Netw Open. 2022 Dec 1;5(12):e2245432. doi: 10.1001/jamanetworkopen.2022.45432. -
Jan 30 2023
Xylazine (aka Tranq) – What You Need to Know
Spoon Feed
Xylazine is a non-opioid emerging drug of abuse that can cause significant respiratory and CNS depression in overdose as well as necrotic skin ulcerations. It does not respond to naloxone.Source
Warning About Xylazine, a Veterinary Sedative Found in Illicit Drugs. JAMA. 2022 Dec 20;328(23):2296. doi: 10.1001/jama.2022.20045.