Description
Contributor: Nick Tsipis MD
Educational Pearls:
The review article assessed 16.3 million patients across six states to identify those at high-risk for critical revisit
Criteria for critical revisit was ICU admission or death within three days of discharge from the ED
Critical revisits are extremely rare
0.1% of patients have a critical revisit after discharge
0.00001% die after revisit
Of the patients that do experience critical revisits, the two major risk factors are
Asthma - relative risk 2.24
Chronic medical conditions - incidence rate ratio 11.03
Of the top ten diagnoses that lead to critical revisits, 5 are respiratory
Others include cellulitis, seizures, gastrointestinal disease, appendectomy, and sickle cell crisis.
References
1. Cavallaro SC, Michelson KA, D’Ambrosi G, Monuteaux MC, Li J. Critical Revisits Among Children After Emergency Department Discharge. Ann Emerg Med. 2023;82(5):575-582. doi:10.1016/j.annemergmed.2023.06.006
Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit, OMSII
Contributor: Travis Barlock MD
Educational Pearls:
How do you differentiate between compensated and decompensated cirrhosis?
Use the acronym VIBE to look for signs of being decompensated.
V-Volume
Cirrhosis can cause volume overload through a variety of mechanisms such as by increasing...
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Contributor: Aaron Lessen MD
Educational Pearls:
Lorazepam (Ativan) is dosed at 0.1 mg/kg up to a maximum of 4 mg in status epilepticus
Some ED protocols only give 2 mg initially
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In one retrospective study,...
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