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Toss Up: A Little Bleeding, or A Lot of Platelets

EM Literature of Note

Platelets, like any blood product, are associated significant risks, not limited to acute lung injury, transfusion-related circulatory overload, allergic reactions, and more. The primary outcome was CVC-related bleeding, graded on a scale of 0 to 4, where Grade 3 and 4 bleeding was associated with significant intervention.

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EM Quick Hits 56 – Nitroglycerin in SCAPE, REBOA, Diverticulitis Imaging, CRAO, Penicillin Allergy, Physician Personality

Emergency Medicine Cases

The post EM Quick Hits 56 – Nitroglycerin in SCAPE, REBOA, Diverticulitis Imaging, CRAO, Penicillin Allergy, Physician Personality appeared first on Emergency Medicine Cases.

EMS 104
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STREAM-2: Half-Dose Tenecteplase vs Primary PCI in Older Patients with STEMI?

RebelEM

neoplasm, aneurysm, intracranial or spinal surgery) or recent trauma to head or cranium (i.e. Primary PCI: 95.7% Stents Placed: Pharmaco-Invasive Treatment: 97.4% Primary PCI: 95.7% ECG Results: Repeat ECG 90min after tenecteplase indicated 70.3% to 1.0mm Median amount of ST deviations declined from 15.0 Primary PCI: 78.4% Primary PCI: 13.3%

EKG/ECG 127
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What the Emergency Clinician Must Know about Remote Monitors in Heart Failure

EMDocs

10 This procedure has well-described rare complications including infection, blood loss, allergic reaction, arrhythmia, pneumothorax if approaching via the internal jugular vein, embolization of the device, and pulmonary artery perforation or dissection. 8 The device itself is 2 x 2.5 Circ Arrhythm Electrophysiol. doi: 10.1161/CIRCEP.120.008693.

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Cetirizine Vs Diphenhydramine For the Treatment of Acute Urticaria in the ED

RebelEM

Background: Diphenhydramine, a first-generation antihistamine, is the most common pharmacologic agent used to treat acute allergic reactions. Health care professional involved in patient management and outcome assessment was completely blinded. The effectiveness of IV cetirizine was determined to be statistically non-inferior.

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The PALACE Trial: Direct Oral PCN Challenge in Patients with Low-Risk PCN Allergy?

RebelEM

Authors determined they would need to enroll 380 patients (190/group) to achieve a statistical power of 80%, assuming an event rate in the control group of 4% of which neither was achieved however if the control group had a lower prevalence of the outcome (i.e. randomization) as per protocol (i.e. randomization) as per protocol (i.e.

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Episode 20 - Emergency Department Management of North American Snake Envenomations

EB Medicine

Nachi: Not only are they out, they actually worsen outcomes, so definitely don’t pursue any of them. Instead, since no treatment has been shown to improve outcome, you should prioritize prompt transport. Fasciotomies have not been shown to improve outcomes and are reserved only for those failing anti-venom treatment.