RAP 56

1) Reduced Insulin Dosing in Hyperkalemia

Review Summary

  • Source: EMA
  • Author: Sanjay Arora, MD
  • Reviewer: Graci Gorman, MD
4
/ 7
BEEM Rater Scale
5
/ 7
BEEM Rater Scale
6
/ 7
Evidence Based Medicine

Takeaway

Using smaller doses of insulin may effectively reduce potassium while decreasing the risk of iatrogenic hypoglycemia.

2) The FAST Exam: Overused and Overrated?

Review Summary

  • Source: First10EM
  • Author: Justin Morgenstern, MD
  • Reviewer: Liz DeYoung, DO
4
/ 7
BEEM Rater Scale
3
/ 7
Educational Utility
3
/ 7
Evidence Based Medicine

Takeaway

FAST is most beneficial in the hemodynamically unstable adult patient with less utility in pediatric/ stable patients.

3) The BaSICs Trial: Normal Saline Has Been Fine All Along

Review Summary

  • Source: First10EM
  • Author: Justin Morgenstern, MD
  • Reviewer: Brett Milbrandt, MD
3
/ 7
BEEM Rater Scale
5
/ 7
Educational Utility
6
/ 7
Evidence Based Medicine

Takeaway

In ICU patients there was no difference in 90-day mortality when using normal saline or plasma-lyte.

4) The Latest AAP Changes for Febrile Neonates

Review Summary

  • Source: emDocs
  • Author: Nathaniel White
  • Reviewer: Nathan Baggett, MD
6
/ 7
BEEM Rater Scale
6
/ 7
Educational Utility
5
/ 7
Evidence Based Medicine

Takeaway

All febrile neonates under 28 days should receive a full septic workup. Select patients can be risk stratified with inflammatory markers and urinalysis.

5) Domestic Booster Vaccines

Review Summary

  • Source: JAMA Network Open
  • Author: Own Schaefer, et al.
  • Reviewer: Joe Walter, MD
5
/ 7
BEEM Rater Scale
5
/ 7
Educational Utility
3
/ 7
Evidence Based Medicine

Takeaway

COVID booster vaccinations will likely exacerbate global vaccine disparities and may result in new variants.