Angiotensin Converting Enzyme Inhibitors (ACE-I) are prescribed to millions of patients in the US. Though they are relatively safe, upper airway angioedema is one of the life-threatening adverse effects that we see frequently in the Emergency Department. Though this disorder is routinely treated with medications for anaphylaxis (i.e. epinephrine, histamine blockers, corticosteroids) the underlying mechanism of action predicts that these medications will fail.
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Journal Review
Icatibant Doesn’t Improve Outcomes in ACE-I Inuduced Angioedema
Journal Review
Effect of Listing Test Prices in the EMR
In the US, vast differences in pricing exist for the same medical services across the country, with no correlation shown between price and quality (Sinaiko 2017). Previous studies on price transparency in medicine have shown that many patients would like to know “the price of medical services in advance and are willing to look for ‘better-value care’” (Sinaiko 2017).
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Core
Acute Rhinosinusitis
This post dives into acute rhinosinusitis with a focus on clinical identification and determining the benefits of antibiotic therapy.
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Journal Review
Initial Antibiotic Choice in Uncomplicated Cellulitis
Cellulitis is a common emergency department (ED) presentation. Despite the fact that diagnosis remains relatively straight forward, complexity remains in management in terms of the causative agent and appropriate antibiotic regimen. Though beta-hemolytic Streptococci are the most common causative agents there is increasing prevalence of community acquired methicillin-resistant Staphylococcus aureus (MRSA). Cephalexin has long been used to treat uncomplicated cellulitis because of it’s activity against streptococci and methicillin-sensitive S.
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Core
Pelvic Vertical Shear Fractures
This week’s post explores the pelvic shear fracture focusing on identification + management.
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Journal Review
Effect of Changing Post-ROSC Target Temperature
In 2002, the New England Journal of Medicine published two studies that changed the management of post-cardiac arrest patients by showing improved outcomes in patients treated with therapeutic hypothermia (32°C-34°C) for at least 24 hours. (Bernard 2002, Hypothermia 2002) The landscape changed again in 2013 with the publication of the Targeted Temperature Management (TTM) trial in the New England Journal,
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