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Few sounds or smells in the emergency department (ED) get our attention as easily as vomiting. In response, we might reflexively order our "one-size-fits-all" standard antiemetic and begin by assuming that this is probably just another case of "gastroenteritis." There are, however, several antiemetics to choose from, each with its own advantages and disadvantages, as well as a myriad of diagnostic possibilities to consider.
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Three recent reports yield different conclusions on the effectiveness of MRSA surveillance on the incidence of healthcare associated MRSA infection.
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In this examination of blood C-reactive protein levels and clinical data in 570 patients hospitalized with community-acquired pneumonia, initial CRP levels < 100 mg/L were associated with fewer complications, less use of mechanical ventilation and/or inotropes, and lower 30-day mortality. Whether these findings provide useful information beyond what is apparent on routine clinical assessment remains to be seen.
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Epidural blood patch is an effective treatment for post dural puncture headache.
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Guillain-Barré syndrome remains a common and serious cause of acute neuropathy in the elderly.
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It has long been taught that lipid levels measured during hospitalization for an acute illness will be artificially low because of an acute-phase metabolic reaction. Consequently, many physicians wait weeks after hospitalization to measure lipids when they have returned to baseline levels and then start appropriate lipid lowering therapy. On the other hand, acute coronary syndrome (ACS) studies have suggested that the early administration of statins may improve outcomes in ACS.
