EM 2023 LLSA Reading List

Acute Headache

Raam R, Tabatabai RR. Headache in the emergency department: avoiding misdiagnosis of dangerous secondary causes, an update. Emerg Med Clin North Am 2021 Feb;39(1):67-85. doi: 10.1016/j.emc.2020.09.004. PMID: 33218663.

  • The Ottawa Subarachnoid Hemorrhage Rule as a decision rule has high sensitivity to rule out SAH for patients presenting to the ED with a normal neurologic examination result and peak headache severity within one ___________________ of onset of pain symptoms.
  • It is recommended to preferentially use ___________________ medications in the treatment of acute primary headaches in the ED.
Acute Stroke

Powers WJ. Acute ischemic stroke. N Engl J Med 2020 Jul 16;383(3):252-60. doi: 10.1056/NEJMcp1917030. PMID: 32668115.

  • For establishing the time of onset of an acute stroke, the Powers’ article in the New England Journal of Medicine, states the time is established as the time that the patient ___________________.
  • According to the NEJM review article on acute stroke, intravenous thrombolysis with alteplase (a recombinant tissue plasminogen activator) improves outcomes in selected patients with acute ischemic stroke when administered within ___________________ after onset.
  • Endovascular mechanical thrombectomy of occluded large intracranial arteries improves outcomes in selected patients with acute ischemic stroke when performed ___________________.
  • In selected patients with mild acute ischemic stroke who do not qualify for intravenous thrombolysis or mechanical thrombectomy, according to the NEJM Stroke article ___________________ when administered within 24 hours after onset and continued for 21 days lowers the risk of recurrent stroke.
Hospice and Palliative Medicine

Long DA, Koyfman A, Long B. Oncologic emergencies: palliative care in the emergency department setting. J Emerg Med 2021 Feb;60(2):175-91. doi: 10.1016/j.jemermed.2020.09.027. PMID: 33092975.

  • ___________________, ___________________, and ___________________, while important in every patient encounter, are crucial during the interaction of patients nearing end of life.
  • If the patient has no advance directives for health care, the usual hierarchy for determining the health care proxy is the patient’s spouse, adult children, parents, siblings, grandchildren, and close friends. If these individuals are unable to be contacted, the physician should assume the patient wants ___________________.
Nontraumatic Chest Pain

Musey PI Jr, Bellolio F, Upadhye S, Chang AM, Diercks DB, Gottlieb M, et al. Guidelines for reasonable and appropriate care in the emergency department (GRACE): recurrent, low-risk chest pain in the emergency department. Acad Emerg Med 2021 Jul;28(7):718-44. doi: 10.1111/acem.14296. Epub 2021 Jul 6. PMID: 34228849.

  • One of the recommendations from the GRACE recurrent, low-risk chest pain article states that patients with recurrent, low-risk chest pain and prior coronary computed tomographic angiography (CCTA) within the past ___________________ receive no further diagnostic testing other than a single, high-sensitivity troponin below a validated threshold to exclude ACS within that time frame. 
  •  In the GRACE recurrent, low-risk chest pain article, recurrent was defined as ___________________.  
  • In the GRACE recurrent, low-risk chest pain article, the authors defined low-risk as ___________________.
Opioid Withdrawal

Herring AA, Perrone J, Nelson LS. Managing opioid withdrawal in the emergency department with buprenorphine. Ann Emerg Med 2019 May;73(5):481-7. doi: 10.1016/j.annemergmed.2018.11.032. PMID: 30616926.

  • Under Title 21, Code of Federal Regulations, Part 1306.07, discharged patients with opioid withdrawal may return to the ED daily to receive the buprenorphine for up to ___________________ days.
  • Buprenorphine is a unique m-opioid receptor partial agonist with minimal euphoric reward and a ceiling effect on both ___________________ and ___________________.
  • All patients with opioid withdrawal should be provided the ___________________level of care navigation assistance and the ___________________ possible wait time for an appointment to follow-up with a treatment/recovery provider.
Orthopedic Emergencies

Gottlieb M. Shoulder dislocations in the emergency department: a comprehensive review of reduction techniques. J Emerg Med 2020 Apr;58(4):647-66. doi: 10.1016/j.jemermed.2019.11.031. PMID: 31917030.

  • What two variables have been shown to be associated with higher rates of failed reduction ___________________ and ___________________.
  •  The Bokor-Billman Technique, in one study, reported a ___________________% success rate and ___________________ complications.

PSP Investigators. Conservative versus interventional treatment for spontaneous pneumothorax. N Engl J Med 2020 Jan 30;382(5):405-15. doi: 10.1056/NEJMoa1910775. PMID: 31995686.    

  • In the NEJM study comparing conservative versus interventional treatment of first-time spontaneous pneumothorax, the authors found that the conservative approach was ___________________ and ___________________ to the interventional treatment approach.
  • In the NEJM study on pneumothorax, interventions, including chest tube placement, were allowed in the conservative-management protocol under the following conditions: ___________________. 
  • In the NEJM pneumothorax study, the primary outcome was ___________________ within 8 weeks after randomization.
Pulmonary Embolism

Maughan BC, Frueh L, McDonagh MS, Casciere B, Kline JA. Outpatient treatment of low-risk pulmonary embolism in the era of direct oral anticoagulants: a systematic review. Acad Emerg Med 2021 Feb;28(2):226-39. doi: 10.1111/acem.14108. PMID: 32779290.

  • Major adverse outcomes other than mortality were uncommon among studies in the review and similar to or lower than the rate of complications in other ED patients who are often treated on an outpatient basis, such as patients with undifferentiated ___________________, patients with suspected ___________________, and patients with ___________________.   
  • A statistically significant association between ___________________ and rates of major adverse events was not identified.

Wardi G, Brice J, Correia M, Liu D, Self M, Tainter C. Demystifying lactate in the emergency department. Ann Emerg Med 2020 Feb;75(2):287-98. doi: 10.1016/j.annemergmed.2019.06.027. Erratum in: Ann Emerg Med 2020 Apr;75(4):557. PMID: 31474479.

  • Type A lactic acidosis is defined by ___________________ and Type B ___________________.
  • Cryptic Shock describes patients with ___________________ lactate levels and ___________________ blood pressure.
Sexually Transmitted Infection

Williamson DA, Chen MY. Emerging and reemerging sexually transmitted infections. N Engl J Med 2020 May 21;382(21):2023-2032. doi: 10.1056/NEJMra1907194. PMID: 32433838.

  • Lymphogranuloma Venereum(LGV) is caused by what pathogen ___________________ and should be treated with ___________________ for ___________________ days.
  •  N. gonorrhoea infections of the rectum and pharynx are usually ___________________.

Peck KA, Ley EJ, Brown CV, Moore EE, Sava JA, Ciesla DJ, et al. Early anticoagulant reversal after trauma: a western trauma association critical decisions algorithm. J Trauma Acute Care Surg 2021 Feb 1;90(2):331-6. doi: 10.1097/TA.0000000000002979. PMID: 33055578.

  • In patients taking Warfarin with severe injury or bleeding, the recommended reversal agent is ___________________.
  • Dabigitran is reversed by ___________________ ___________________.