Toddlers are more susceptible to seasonal flu and tend to get sicker than older kids and adults. Should they get antivirals? The CDC says yes.
The use of non-invasive positive pressure ventilation (NIPPV), especially CPAP, in decompensating patients with acute cardiogenic pulmonary edema (ACPE), can reduce the need for intubation, resolve symptoms faster, and reduce the hospital/ICU length of stay and mortality significantly. Only 13 patients with ACPE need to be treated in order to save one extra life, and 9 patients to avoid an extra intubation.
2009 Influenza Update // Best Evidence in Emergency Medicine
Do Facemasks Work at Home? New study shows facemasks and hand washing decrease flu transmission at home if caught early.
The Setup:
A young woman finds her 59-year-old father in his bedroom, absent of vital signs. Upon EMS arrival, CPR is initiated. In the midst of your busy evening shift, you receive a radio patch from EMS personnel.
Although diagnosing urinary tract infection (UTI) in a pediatric population can be challenging, pre-test probability can be guided by specific risk factors in the history and physical examination. Among low-risk children, further laboratory testing can be deferred in favor of a conservative approach.
The Setup
You've spent your morning locked in administrative meetings. After being serenaded at length by the budgetary mantra to cut costs while maintaining high-quality patient care, the chaos of your subsequent afternoon ED shift is almost a welcome contrast. The next chart in the rack, though, brings back memories of the morning's subject matter...
Extending the window for t-PA (alteplase) thrombolysis in acute ischemic stroke within 4.5 hours of symptom onset is not associated with an increased risk of symptomatic intracranial hemorrhage or death and does improve good outcomes at 90-days.
The Case
A 75-year-old female with a history of hypertension and a left-sided stroke 10-years ago presents 2.5 hours after the onset of left arm and leg weakness while playing bridge. After obtaining her head CT, labs, and history you note no contraindications to thrombolytic therapy (Table). Unfortunately, 3.5 hours have now passed since her symptoms began. Her husband, a retired Pediatrician, astutely notes recent professional organizations and newswire reports advocating thrombolysis for acute ischemic stroke at up to 4.5 hours.
The Case:
A 65-year-old male presents to your ED complaining of increasing exertional dyspnea and orthopnea limiting daily activity...
Best Evidence Says: The PERC Score Can Help EPs Avoid Unnecessary Tests
A 75-year old male with no reported past medical history is found in his apartment by his grandson with confusion and generalized weakness...
altEPM presents the ACEP White Paper on how emergency departments can prepare for the geriatric tsunami.  

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