Non-intravenous Midazolam Effectively Terminates Pediatric Seizures Key point: A meta-analysis revelas that non-IV midazolam is as effective as or superior to IV or rectal diazepam for stopping seizures in children and young adults. Citation: McMullan J, Comilla S, Panciolo A, et al. Midazolam versus diazepam for the treatment of status epilepticus in children and young adults: A meta-analysis. Acad Emerg Med. 2010; 17(6): 575-582. Although intravenous (IV) lorazepam is considered first-line therapy for status epilepticus, …
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July/August 2010
June 2010
Abstracts in Urgent Care: June, 2010
Upper Gastrointestinal Tract Hemorrhage, Warfarin, and Urinary Tract Antibiotics Key point: Ciprofloxacin increased GI hemorrhage while on coumadin by twice as much, and cotrimoxazole by four times. Citation: Fischer HD, Juurlink DN, Mamdani MM, et al. Hemorrhage during warfarin therapy associated with cotrimoxazole and other urinary tract anti-infective agents: A population-based study. Arch Intern Med. 2010; 170(7): 617-621. Hemorrhage is a well-known side effect of long-term warfarin use in older patients. Interactions between warfarin and …
Read MoreAbstracts in Urgent Care: May, 2010
Emergency treatment of Anaphylactic Reactions Key point: Early treatment with intramuscular adrenaline is the treatment of choice for patients having an anaphylactic reaction. Citation: Pumphrey R, Cant A, Clarke S, et al. Emergency treatment of anaphylactic reactions – Guidelines for healthcare providers. Resuscitation. 2008; 77(2): 157-169. Patients experiencing an anaphylactic reaction have life-threatening airway and/or breathing and/or circulation problems usually associated with skin or mucosal changes. Such patients should be treated using the ABCDE …
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May 2010
Abstracts in Urgent Care: April, 2010
Diagnostic Medical Errors: What Goes Wrong and Why Key point: Errors often occur because clinicians don’t consider the diagnosis, test for it, or follow up on abnormal test results. Citation: Schiff GD, Hasan O, Kim S, et al. Diagnostic error in medicine: Analysis of 583 physician-reported errors. Arch Intern Med. 2009; 169: 1881-1887. Autopsy data from the past few decades reveal diagnostic error rates of 10% to 15%, but do not inform us about the …
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April 2010
March 2010
Abstracts in Urgent Care: March, 2010
Consequences of Increasing Copayments for Ambulatory Care Key point: Even small increases in cost-sharing were associated with fewer outpatient visits and more inpatient admissions among elders. Citation: Trivedi AN, Moloo H, Mor V. Increased ambulatory care copayments and hospitalizations among the elderly. N Engl J Med. 2010; 62: 320-328. Recently, many health plans have increased copayments for outpatient visits. Although the rationale, presumably, is to minimize unnecessary ambulatory care, the strategy could backfire if higher …
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