Single-Dose Etomidate Is Not Associated With Increased Mortality in ICU Patients With Sepsis: Analysis of a Large Electronic ICU Database

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Diagnosing pneumonia in patients with acute cough: clinical judgment compared to chest radiography.

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A randomized, controlled trial to evaluate topical anesthetic for 15 minutes before venipuncture in pediatrics

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A standardized rapid sequence intubation protocol facilitates airway management in critically injured patients

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CPR longer than 20 minutes for pediatric in-hospital arrest was considered futile, but this study may challenge that.

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Want to save $1million? Simple strategies to reduce blood culture contamination drastically cut contamination rates.

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Your penetrating trauma patient has normal vitals.  Relax, they're fine, right? Vitals correlated poorly with lactate in this cohort.

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As nasal cannula EtCO2 falls, lactate rises in penetrating trauma patients. This is an easy, non-invasive way to tell which of these patients is sicker.

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If you think the non-latex gloves adequately protect you from shock during defibrillation, think again.

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Low dose lytics were a smashing success for moderate PE patients.

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How did the cases of fungal meningoencephalitis present after receiving contaminated steroid injections?  This NEJM case series gives you the details.

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What causes prolonged acidosis in DKA? Maybe too much chloride is the cause.

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Do psychiatric patients presenting for medical clearance benefit from screening labs? Nope, and it's expensive.

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Are we billing more level 5 E/M codes because patients are sicker and more complex or is it fraudulent?

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Survival was worse if prehospital providers inserted an advanced airway in arrest victims. This is a landmark study.

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Patients fare poorly if no ROSC in the prehospital arena.

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Wait and see prescriptions for otitis reduce antibiotic use, but what is the downside?

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Is a vulvovaginal swab as good or better than an endocervical sample? Turns out, patient-collected vulvovaginal swabs were better than physician-collected swabs.

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Are ED providers aware of the risk of radiation? Those in this study were not.

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Are you looking at the pain score in kids? If so, does it prompt you to treat pain? Surprising how often pain was not treated in this study.

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Obviously, clearing lactate faster is a good thing in trauma patients. But as Chris points out in this summary, a more important question is whether this is a modifiable variable or simply a bad prognostic sign.

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This gives you the details on the first case of fungal meningitis from contaminated epidural steroid injections. This occurred at Vanderbilt and was written up for the NEJM by our own Vandy team.

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Do you think a plain x-ray will detect contraband in a suspected body-packer? Think again!

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New group A strep guidelines have just been released by the IDSA. Check them out here and save yourself an hour of reading.

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Head lice are yucky.  Mutant, insecticide-resistant head lice are even worse! Here is a new lotion to kill lice, although you have to be rich to buy it.

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Could we use PERC and Wells-D-dimer more effectively and order fewer CT scans? Yes, but this article probably inflates the number of scans we could prevent.

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How do you stop bleeding when a patient is taking dabigatran? Saralyn walks us through this review article and gives you some ideas.

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High flow nasal cannula is a non-invasive way to keep kids with respiratory distress, from a number of causes, off the ventilator.  This may come in handy this winter.

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Ondansetron given orally plus oral rehydration keeps kids out of the hospital (NNT = 8) and keeps kids from needing an IV. Are you using it?

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Procalcitonin was a good predictor of non-UTI serious bacterial infection in kids younger than 3 months.

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