Skin and soft tissue abscesses are a common emergency department (ED) presentation. The approach to management has changed little in recent decades: incision and drainage (I+D) and then discharge home with follow up. However, increasing rates of methicillin-resistant staph aureus (MRSA) over the last decade have led to further consideration of adjunct therapy with oral antibiotics to improve cure rates.
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Journal Review
Utility of Adjunct Antibiotics After I+D – Systematic Review + Meta-Analysis
Journal Review
Tenecteplase vs Alteplase Before Endovascular Therapy for Ischemic Stroke (EXTEND-IA TNK)
This review is cross-posted on REBEL EM.
Alteplase is a tissue plasminogen activator that is approved for use prior to thrombectomy in ischemic strokes with the goal of reperfusion to ischemic areas of the brain. Tenecteplase is a recombinant enzyme derived from alteplase that is more specific to fibrin and more resistant to inactivation by alteplase inhibitors.
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Core
Biceps and Triceps Tendon Rupture
This post reviews the presentation and management of biceps and triceps tendon ruptures.
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Journal Review
Succinylcholine vs. Rocuronium for 1st Pass Success Rate
This post was also featured on REBEL EM.
Administration of a neuromuscular blocker (NMB) is an essential part of Emergency Department (ED) airway management for facilitating ideal airway conditions and is most commonly performed with either succinylcholine or rocuronium. Despite extensive debates between providers, one agent has not been shown to be superior to other.
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Core
Wernicke Encephalopathy
This post explores Wernicke Encephalopathy with a focus on diagnosis and management.
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Journal Review
Corticosteroids in Pharyngitis – Systematic Review + Meta-Analysis
Sore throat is among the most common complaints in the emergency department (ED). Sometimes, the etiology is bacterial, and in those cases antibiotics may shorten the duration of disease and provide symptomatic relief. The majority of cases are viral and though most are appropriately treated with symptom management in the forms of NSAIDS and acetaminophen,
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Journal Review
Balanced Solutions vs 0.9% Saline in Critical Care (SMART)
Although 0.9% sodium chloride (“normal” saline) is traditionally the most commonly used intravenous fluid, it is unclear if “normal” saline is the best fluid. Data from prior studies suggests 0.9% saline use may result in hyperchloremic acidosis. Additionally, 0.9% saline is associated with the development of acute kidney injury (AKI). There have been several observational studies and a before-and-after trial comparing 0.9% saline and “balanced” crystalloids like lactated Ringer’s and Plasma-Ltye A,
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