Abstracts in Urgent Care: March, 2015
Strict Rest Unnecessary After Concussion Key point: strict rest after a concussion offers no advantage over standard stepwise return to play. Citation: Thomas DG, Apps JN, Hoffmann RG, et al. Benefits of strict rest after acute concussion: a randomized controlled trial. Pediatrics 2015;135:213–223. Concussion treatment has been frequently debated. In this prospective study, patients with concussion were treated with either strict rest for 5 days or standard stepwise return to play. A total of 88 …
Read MoreAbstracts in Urgent Care: February, 2015
Duration of Troponin Testing for ACS Key point: No definitive evidence for the 2-hour troponin rule-out for ACS. Citation: Kelly A–M, Klim S. Prospective external validation of an accelerated (2-h) acute coronary syndrome rule-out process using a contemporary troponin assay. Int J Emerg Med. 2014 Oct 16. doi: 10.1136/emermed-2014-204442. [Epub ahed of print.] As with other serious diseases, ruling out acute coronary syndrome (ACS) is a balance between not missing it and over testing or …
Read More
February 2015
Abstracts in Urgent Care: January, 2015
Fatigue and inappropriate antibiotic prescription Key point: As the day goes on, resistance to prescribe potentially inappropriate antibiotics seems to fade. Citation: Linder JA, Doctor JN, Friedberg MW, et al. Time of day and the decision to prescribe antibiotics. JAMA Intern Med. 2014 Oct 6; doi: 10.1001/jamainternmed.2014.5225. [Epub ahead of print] Previous research has shown that resistance to making the easier choice tends to fade as fatigue increases. Physicians make many difficult decisions during …
Read MoreAbstracts in Urgent Care: December, 2014
Pulse oximetry and decision-making on hospitalization Key point: Use of pulse oximetry to decide on necessity of hospitalization may need to be reconsidered. Citation: Schuh, S, Freedman S, Coates A. et al. Effect of oximetry on hospitalization in bronchiolitis, JAMA. 2014; 312(7):712-718. Pulse oximetry has been used to help decide when an infant with bronchiolitis should be hospitalized. The authors of this study postulated that providers may be relying too heavily on it, resulting in …
Read More
December 2014
Abstracts in Urgent Care: November, 2014
Generic medication appearance Key point: When providing generic prescriptions, warn patients about generic medication colors and shapes. Citation: Kesselheim AS, Bykov K, Avorn J, et al. Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: Cohort and nested case–control studies. Ann Intern Med. 2014; 161:96-103. Researchers in this study attempted to determine if changes in color or shape of a generic drug led to discontinuation of that drug. Patients …
Read More
October 2014
Abstracts in Urgent Care: October, 2014
Timing of concussion symptoms Key point: Symptoms of concussion such as sleep disturbance, forgetfulness, and fatigue are late in onset. Citation: Eisenberg MA, Meehan WP 3rd, Mannix R. Duration and course of post-concussive symptoms. Pediatrics. 2014;133(6):999-1006. Estimates of the duration of concussion symptoms in children vary from 1 week to months. This study looks at previous cohorts where the median time to recovery was 13 days and considers symptoms, their duration, and clinical course. The …
Read More