Author: Aaron Lessen, MD Educational Pearls: 5-year follow up study on antibiotic treatment for uncomplicated appendicitis showed 39.1% recurrence rate requiring appendectomy by 5 years Nearly 60% chance then of preventing an appendectomy by using antibiotics only for uncomplicated appendicitis Editor’s note: not surprisingly, complications were much higher in the group receiving surgery, which…
Read MoreAuthor: Kasey Champion, MD Educational Pearls: Transgender populations are frequent victims of discrimination in healthcare. Ask transgender patients what their preferred pronoun is. It is sometimes important to ask about transition status (i.e. on hormones, surgery). References: Chisolm-Straker M, Willging C, Daul AD, McNamara S, Sante SC, Shattuck DG 2nd, Crandall CS. Transgender and Gender-Nonconforming…
Read MoreAuthor: Sam Killian, MD Educational Pearls: Patients may have certain fears or expectations about the flu based on hearsay and other less reliable sources Taking extra time explaining the risks of the flu may help base these expectations more in reality This includes providing good return precautions and acknowledging that the disease can still be…
Read MorePodcast # 366: Ehlers Danlos Author: Gretchen Hinson, MD. Educational Pearls: Heritable mutation in collagen synthesis and expression commonly resulting in joint hyperextension and skin elasticity. Vascular type can result in aneurysm formation and rupture in young patients. Patients are also at risk for spontaneous bowel rupture. Pregnant women can present with uterine rupture. …
Read MoreAuthor: Sam Killian, MD Educational Pearls: Recent study examining fasting and adverse events during procedural sedation found no association between fasting duration and any type of adverse event. Of the 6,183 children in the study, about 6 vomited during the procedure, and about 300 vomited recently after the procedure, and there were no episodes…
Read MoreAuthor: Sam Killian, MD Educational Pearls: Insufficient sleep and disrupted circadian rhythms are a major health problem today Millions of dollars, thousands of deaths, and millions of injuries are related to sleep deprivation every year 56 billion dollars – 24,000 deaths – 2.5 million disabiling injuries related to a sleep-type deprivation Exxon valdez, challanger, chyrnobel…
Read MoreAuthor: Dylan Luyten, M.D. Educational Pearls Hypoglycemia is very common in type 2 diabetics, and is often caused by insulin overdose or missed meals. Knowing the peak time of action for common diabetes medications can help inform treatment and disposition. Regular insulin’s action peaks around 60 minutes. By the time most of these patients present…
Read MoreAuthor: Rachel Beham, PharmD, Advanced Clinical Pharmacist – Emergency Medicine Educational Pearls Tetanus Ig is indicated in those who have no or unknown tetanus vaccination history who present with contaminated cuts that or dirty puncture wounds The tetanus vaccine is a 5 shot series (DTAP) for children, TDAP is used for adults There is no…
Read MoreAuthor: Pete Bakes, M.D. Educational Pearls One of the roles of the ER provider is to discharge patients only after life-threatening conditions have been ruled out. However, some patients that are discharged from the ED die within days of their discharge. One recent study sought to investigate the factors and diagnoses associated with death within…
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