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REBEL Core Cast 107.0 – Vertebral Osteomyelitis

REBEL EM

Take Home Points Clinical presentation is very nonspecific; evaluate all patients presenting with back pain for infectious risk factors. MRI is key to diagnosis, obtain this imaging in all patients who raise clinical suspicion Patients with hemodynamic instability and neurologic compromise warrant empiric antibiotics.

Myelogram 103
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Don’t Forget About the IO in the Critically Ill Patient

REBEL EM

Additional sites such as the sternal, iliac crest, distal femur, and distal tibia have also been utilized, and the use of these alternative sites should be considered based on the clinical presentation. Clinical Management of Intraosseous Access in Adults in Critical Situations for Health Professionals. Healthcare. Trauma 1996.

Hospital 104
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Short Course Antibiotics for Peds CAP: A Systematic Review and Meta-Analysis

REBEL EM

PMID: 35579504 Clinical Question: Is short-course antibiotic therapy, for 3–5 days, safe and effective in children with community-acquired pneumonia stable for outpatient management, compared to the current guidelines of 7–10 days? requiring inpatient treatment) Intervention: Shorter antibiotic treatment duration (3–5 days).

X-ray 52
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AuntMinnie 2007: Gadolinium: A 'necessary factor' in the development of NSF?

AuntMinnie

The ACR and the FDA recommend immediate hemodialysis directly from the MR scanner," Kanal said, plus another dialysis session within 24 hours if it's clinically safe to do so. But Berlin cautioned that the lack of definitive answers in NSF may make informed consent a moot point. It can't be a generic or a standing order.

Disease 116
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Pediatric UTIs: Short-Course vs. Standard-Course Antibiotics — Is It Time for a Change?

REBEL EM

Short-Course Therapy for Urinary Tract Infections in Children: The SCOUT Randomized Clinical Trial. What They Did: Study Design: Multicenter, randomized, double-blind, placebo-controlled, non inferiority clinical trial. Investigators assessed clinical outcomes via 2 in-person visits on days 11–14 and days 24–30. JAMA Pediatr.

IT 80
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Impact of Emergency Department Crowding on Lung Protective Ventilation

REBEL EM

Background Information: Obtaining definitive control of the airway, when indicated, is the responsibility of the emergency medicine physician. 2019 Aug; PMID: 30954692 Clinical Question: What is the impact of system factors in the implementation of standard-of-care LPV in critically ill ED patients admitted to the ICU? J Crit Care.

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Journal Scan – This Month in Other Journals, May 2023

AJNR

Main reasons for DAWN ineligibility were the absence of clinical-imaging-mismatch, low baseline NIHSS score (ie, <10 points), and premorbid functional disability (ie, mRS score >1 point). 14432 RCVS is a cerebrovascular phenomenon that presents clinically as recurrent TCHs predominantly affecting females. 2 figures, 4 tables 2.