#1: Keith Wrenn Always Said, “Presyncope IS Syncope.” He Was Right
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This systematic review found that approximately 4%-27% of patients presenting to the ED with presyncope experienced serious outcomes within a 30-day period.
Source
Serious outcomes among emergency department patients with presyncope: A systematic review. Acad Emerg Med. 2024 Jun 9. doi: 10.1111/acem.14943. Online ahead of print. PMID: 38853536
#2: Why So Much UFH for Acute PE? Can We Just Stop…
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This retrospective study found increased use of unfractionated heparin (UFH) relative to low-molecular weight heparin (LMWH) and direct oral anticoagulants (DOACs) over time, despite guidelines recommending LMWH or DOACs as first-line treatment for most patients with acute pulmonary embolism (PE).
Source
Trends in Initial Anticoagulation Among US Patients Hospitalized With Acute Pulmonary Embolism 2011-2020. Ann Emerg Med. 2024 Jun 18:S0196-0644(24)00277-4. doi: 10.1016/j.annemergmed.2024.05.009. PMID: 38888528.
#3: I Don’t CIWA We Can Use RASS Instead
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The first direct comparison of the Clinical Institute Withdrawal Assessment-Alcohol Revised (CIWA-Ar) scale to a slightly modified Richmond Agitation and Sedation Scale (mRASS-AW) in a pre-post quality assurance study found mRASS-AW to not compromise length of stay or safety for the evaluation of alcohol withdrawal syndrome (AWS), while we already know it to be faster and more intuitive.
Source
Replacing the Clinical Institute Withdrawal Assessment-Alcohol revised with the modified Richmond Agitation and Sedation Scale for alcohol withdrawal to support management of alcohol withdrawal symptoms: potential impact on length of stay and complications. CJEM. 2024;26(6):431-435. doi:10.1007/s43678-024-00710-7