Abstracts

The FDA on Cannabidiol Improving Diagnosis of Cluster Headache Making Tympanostomy Tube Placement Office-Friendly Nothing to Fear from NDMA? Counseling Patients on Preventing Cardiovascular Disease FDA Delves Deeper into Use of CBD Products Key point: The FDA is working to answer questions about the science, safety, and quality of products containing cannabis and cannabis-derived compounds, particularly CBD. Citation: U.S. Food & Drug Administration. What you need to know (and what we’re working to find out) …

More Advice on Inquiring About—and Assessing—Vaping and EVALI Key points: Citation: Siegel DA, Jatlaoui TC, Koumans EH, et al. Update: Interim Guidance for Health Care Providers Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use Associated Lung Injury—United States, October 2019.  MMWR Morb Mortal Wkly Rep.  2019;68:919–927.  Key point: Physicians should inquire about e-cig or vaping use in a nonjudgemental but thorough manner. Ask about specific products, frequency, and associated drug use. …

What’s New in Flu Vaccine Information New First-In-Class Pleuromutilin Antibiotic for CAP Abdominal Pain in Patients with IUDs—Watch Out for Ectopic Pregnancy Cancer-Causing Chemical Found in Ranitidine Measles Cases and Outbreaks Cooling Pediatric Burns Occ Med: Severe Silicosis in Stone Fabrication Workers   An Update on Vaccine the 2019-2020 Flu Season Key points: The CDC recommends annual influenza vaccination for everyone 6 months of age and older, with any licensed influenza vaccine that is appropriate …

An Update on Vaccine the 2019-2020 Flu Season Key points: The CDC recommends annual influenza vaccination for everyone 6 months of age and older, with any licensed influenza vaccine that is appropriate for the recipient’s age and health status (IIV, RIV4, or LAIV4) with no preference expressed for any one vaccine over another. All regular dose vaccines are quadrivalent this year. Fluzone (high-dose trivalent vaccine) may provide more protection to those ages 65 and up, …

Report Pulmonary Illness Possibly Involving Vaping to State, Local Health Departments Key point: The CDC is working with state health departments to characterize severe pulmonary disease in patients who use e-cigarettes, also known as vaping. Citations: Centers for Disease Control and Prevention. CDC urges clinicians to report possible cases of unexplained vaping-associated pulmonary illness to their state/local health department. Available at: https://emergency.cdc.gov/newsletters/coca/081619.htm. Accessed September 6, 2019. Caporale A, Langham MC, Wensheng G, et al. Acute …

Practice of Urgent Care: Rude Patients May Do More than Ruin Your Mood Key point: Individual and team performance of clinicians suffer in both quality of diagnostic approach and procedural skills when dealing with rude patients. Citation: Riskin A, Erez A, Foulk TA, et al. The impact of rudeness on medical performance: a randomized trial. Pediatrics.2015;136(3):487-495. Patients in urgent care commonly have unrealistic demands and expectations. When they make disparaging remarks, it’s easy to feel …

Rush for Outpatient Stress Test Recommendation (Finally) Examined Key point: Rapid outpatient stress testing (ie, within 72 hours), which has long been recommended by the American Heart Association, did not decrease the short-term risk of major adverse cardiac events (MACE). Citation: Natsui S, Sun BC, Shen E, et al. Evaluation of outpatient cardiac stress testing after emergency department encounters for suspected acute coronary syndrome. Ann Emerg Med. April 5, 2019. [Epub ahead of print] The …

Practice of Urgent Care: The Illusion of Multitasking and the Cost of Interruptions Key point: True multitasking is not possible. Rather, when we attempt to multitask, our brains are actually rapidly switching focus. Task-switching and interruptions negatively impact our ability to complete tasks accurately and effectively. Minimizing task-switching reduces the likelihood of cognitive errors and, consequently, adverse patient outcomes. Citation: Skaugset LM, Farrell S, Carney M, et al. Can you multitask? Evidence and limitations of …

Mitigating Risk Through Shared Decisionmaking Key point: Shared decision-making appears to mitigate the risk to clinicians of patient complaints and lawsuits in the event of a bad outcome. Citation: Schoenfeld  EM, Mader S, Houghton C, et al. The effect of shared decisionmaking on patients’ likelihood of filing a complaint or lawsuit: a simulation study. Ann Emerg Med. January 3, 2019. [Epub ahead of print]   Missed and delayed diagnoses of dangerous conditions are unavoidable in …