Migraine Cocktail: over IV fluids or neat?

Author: Dr. Calloway Pichette Article: IV Fluids for the treatment of Emergency Department patients with migraine headache: a randomized controlled trial  Background: Headache, a common complaint in the ED. Many times a day we see patients with migraine headaches in the ED. Give them a migraine cocktail (sadly, no martinis involved…) and then viola! They

Central Line Placement

Author:  Lauran Wirfs

Background:

Central venous access is an important procedure for critically ill patients. One consideration when placing a venous catheter is the risk of catheter-related bloodstream infections (CRBIs), which can be a significant cause of morbidity and mortality in hospitalized patients. In 2012, there were 15 million central venous catheter (CVC) days per year in the US in ICUs, and the rate of infections per catheter days is 3/1000. This post looks at a systematic review done by Marik et. al. that examines CRBIs among internal jugular, subclavian, and femoral central venous sites.

Journal: Canadian C-Spine

Author:  Dr. Keya Patel

Background

Each year, more than 1 million patients are treated in the emergency department for blunt trauma and potential C-spine injury. Cervical CT remains the mainstay of imaging in assessing for injury. Here, we review the Canadian C-spine Rule in determining the need for advanced imaging such as CT.

Journal: Kocher Criteria for Septic Arthritis

This week’s 5-minute Journal Article discussion covered

“Validation of a Clinical Prediction Rule for the Differentiation Between Septic Arthritis and Transient Synovitis of the Hip in Children” by Kocher et al.

 

Why is it important to differentiate between septic arthritis and transient synovitis in pediatric patients? Because both diseases can present similarly with acute onset of pain, fever, limp or inability to bear weight and patients holding their hip in the flexed, abducted, externally rotated (FABER) position. The difference is transient synovitis is exactly that, transient, while septic arthritis can lead to permanent joint damage and disability if not treated aggressively with surgical intervention and IV antibiotics.