I have been working on a deep dive into steroids for community acquired pneumonia for a long time. The content of that evidence review was just recorded as an episode of the EM Cases Journal Jam, which will be out soon. My focus was on steroids for community acquired pneumonia, […]
EBM reviews
86 posts
In early April, I wrote a long post covering all the science I could find about aerosols and droplets. The basic summary was that this is an area of medicine with lots of misconceptions, poor assumptions, and incomplete science. There was good evidence that previous coronaviruses were spread by aerosols. […]
COVID-19 has resulted in many conflicting messages. One area of extreme importance is the health and safety of healthcare workers. I have repeatedly heard that our infection control measures are perfect, and cannot be questioned, while simultaneously seeing numerous colleagues contract the virus. When it comes to the safety of […]
I’ve been posting about the hydroxychloroquine literature since the beginning of this pandemic. The message at the outset was pretty clear: “there is no reason to be using chloroquine at this point.” I have updated that primary post a number of times and the message has remained unchanged. There was […]
We have discussed evidence that antibiotics may not help diverticulitis multiple times on this blog (for example here and here). After another negative RCT, it is time to tackle the difficult question of how much evidence we need to overturn long standing medical practices.
Headache is a very common presenting complaint in emergency medicine, and most patients have a benign cause. (Davenport 2002) However, approximately 1% of patients will be diagnosed with a subarachnoid hemorrhage. (Goldstein 2016; Carpenter 2016) Subarachnoid hemorrhage has a high mortality, with 25% of patients dying within 24 hours and […]
“Medical clearance” for psychiatric patients has long been a problem for emergency medicine. Despite a clear consensus in the medical literature and guidelines that routine laboratory testing is not required for psychiatric patients, many hospitals are still requiring this testing. (I know from first hand experience.) This is harmful to […]
I have dedicated a number of posts to the workup of low risk chest pain. There is the 5 part series demonstrating that our use of stress tests doesn’t make any sense. There is also a post demonstrating that CCTA has no role in these patients at this time. One […]
I have avoided commenting on vitamin C for sepsis, because commentary seemed rather unnecessary. The hype was obviously ridiculous. The chances of it helping were clearly low. The evidence of benefit was negligible. Others had widely discussed the papers, and most people seemed to be ignoring this “miracle cure.” However, […]