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Is the Irregularity a Problem?
Interpreting ECGs without the benefit of any history always is challenging. Such is the case with the figure in this article, which manifests significant irregularity.
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COVID-19 Vaccine, 2023-2024 Formula (Comirnaty, Spikevax)
The newest vaccines target XBB.1.5, which is no longer the dominant circulating variant, but they offer protection against XBB.1.16 and more distant variants (e.g., EG.5.1, FL.1.1.1, and BA.2.86).
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Using Doxycycline as Postexposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infections
In an open-label, randomized study involving men who have sex with men and transgender women, using doxycycline within 72 hours of condomless sex was associated with a two-thirds reduction in the incidence of bacterial sexually transmitted infections vs. those who received standard care.
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Steroids and Pneumonia — So Meta?
In a multicenter, randomized, placebo-controlled trial, hydrocortisone lowered mortality rates among patients with severe community-acquired pneumonia.
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More Reports of Severe Group A Streptococcal Infection
Around the world, rates of severe illness caused by group A Streptococcus are rising. Possible explanations for the increase include immunity-altering, post-pandemic changes in exposure to respiratory pathogens and the emergence of new pathogenic M strains of Streptococcus.
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Emergency Medicine Residents Should Be Aware of Legal Exposure
To alleviate malpractice risks involving residents, attendings should implement a reasonable and adequate plan for the patient along with the resident; review the patient’s lab and imaging results; and, ultimately, be the decision-maker as to the patient’s ultimate disposition.
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Is ED Patient Rude or Insulting? Risk Mitigation Needed
Patients who behave in this manner could be at risk for a missed diagnosis caused by poor communication with the treatment team. They may be so difficult to tolerate that they receive less attention and nursing care than they would have otherwise. The best approach is to recognize the risks with these types of patients and mitigate them.
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Irritable Patient Behavior Affects Emergency Nursing Assessments
For encounters during which the patient exhibited irritable behavior, nurses reported more anger and unease. They also judged the patients as likely to exaggerate pain, as poorer historians, and less likely to cooperate and return to work and recover. In their documentation, nurses were more likely to use negative descriptions of patients and more likely to omit information, such as whether tests were ordered.
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Onsite Pharmacies Can Boost Medication Access to Patients, Surrounding Communities
There are some other possible workarounds, such as leveraging electronic prescribing from the ED so providers will know quickly whether medications are available in a specific outpatient pharmacy, administering first antibiotic doses in the ED, and providing a few days’ worth of medication to patients about to be discharged.
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Was Child Brought to ED by EMS? Medication Dosages May Be Incorrect
ED personnel should ensure a good handoff report is received from EMS providers, and that the dose of any medications administered by EMS is recorded. ED personnel should be mindful in carrying out weight-based dosing calculations, and should follow recommendations of national guidelines.