Research and Reviews in the Fastlane 095

This article reveals the lack of knowledge about contrast reactions, but also reinforces the real risk of repeat reactions despite treatment. The authors found that despite premedication, patients with a history of a prior reaction were still at a significantly increased risk of a recurrent reaction. The bottom line is that premedication may not work. Be ready to treat these patients aggressively if symptoms occur. Recommended by:Daman Langguth Emergency Medicine, RespiratoryRaja AS, et al. Effects of Performance Feedback Reports on Adherence to Evidence-Based Guidelines in Use of CT for Evaluation of Pulmonary Embolism in the Emergency Department: A Randomized Trial. Am J Roentgenol. 2015;1-5. PMID: 26204114 We know we order too many CTPAs for pulmonary embolism (PE) in the United States but changing provider behavior is difficult. These authors randomized providers to a control group or to an intervention of quarterly, individualized feedback on adherence to guidelines for CTPA ordering. They found a statistically significant 6.9% absolute increase in ordering adherence in the intervention group, with 85% adhering to the guidelines following the intervention. Timely, individualized feedback is likely one component to improving the implementation of evidence based guidelines for PE workup. Recommended by: Lauren Westafer Wilderness MedicineHew-Butler T et al. Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Car...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Education Emergency Medicine Intensive Care Respiratory Resuscitation Urology Wilderness Medicine critical care EBM literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs