Rob and Ryan discuss using the NEXUS criteria, more dog bites and what happens to your face if you wait more than 8 hours to see a doctor, and if want to "up" your chances of not dying but you're in a coma from cardiac arrest, just chill out and have a tube put in your heart.
Brian T. - March 8, 2014 7:25 AM
I just wanted to make sure the community knew that the Colchicine for Acute Pericarditis NEJM paper reviewed on EM:RAP is in-fact a repeat and confirmation of previous findings (mostly). The same group ran essential the same trial, randomized but not blinded in 2005, and had essentially identical findings:
•Decreases symptoms at 72 hrs, 12 vs. 37%
•Decreases recurrence, 11 vs. 32 %
•NNT = 5
http://circ.ahajournals.org/content/112/13/2012.short
brendan c. - March 8, 2014 9:36 AM
Thank you for finally discussing infected stone! The next obvious question is: what do you do with these people? My current practice, that urology won't always do @ first suggestion, is fever, pyelo, anything "sick" goes to OR. The remainder (who urology says to d/c) go to observation. There are always exceptions, but this seems the safest approach. Mostly based on nothing except personal experience. BTW we run our own OBS unit.
Thoughts?
Jerry J., M.D. - March 24, 2014 8:48 PM
I tried to look up the c-spine article discussed on the "Literature Review" topic #1. The article reportedly from "The Journal of Trauma" Sept 2012 with a title of : "Clinic Clearance of the c-spin in a patient with distracting injury. Is it time to dispel the myth?"
There is a discussion between our surgeons and myself about c-spine clearance. I went to the website to find the article and page number to give the surgeon. I searched old editions, Sept 2012 and found no such article! Was their a misquote in the date? The journal?
Your help would be appreciated.
Mel H. - March 25, 2014 8:19 AM
Here is the reference from PubMed:
J Trauma Acute Care Surg. 2012 Aug;73(2):498-502. Clinical clearance of the cervical spine in patients with distracting injuries: It is time to dispel the myth. Rose MK1, Rosal LM, Gonzalez RP, Rostas JW, Baker JA, Simmons JD, Frotan MA, Brevard SB.