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2026 lit review: SRMA: all the usual things except bicarb seem to help in hyperK no, prenatal APAP is not linked to autism @thesgem.bsky.social at #acep26

2026 lit review: no, prenatal APAP is not linked to autism — the big study that includes a sibling analysis make the potential association go away @thesgem.bsky.social at #acep26

2026 lit review: SRMA of 4 RCTs: no improved functional outcomes for tpa/TNK in minor strokes, 5x higher risk of symptomatic ICH (still low but risk >> 0 benefit @thesgem.bsky.social at #acep26

violent words, threats, and actions against ER health acre workers are both common and underreported lots of intoxication this study was among agitated patients so the numbers aren’t representative bit having observers record violence = shows underreporting @thesgem.bsky.social at #acep26

comprehensive review of c-collars in trauma- surprise!- no definitive evidence of benefit, + evidence of harm @thesgem.bsky.social at #ACEP26

900k ED visits/y for asymptomatic elevated BP 0.7% adverse outcomes after DC which is not long term hypertension – may be reasonable to start BP meds this obs study showed 1 mo supply assoc w slightly better 30d CV outcomes @thesgem.bsky.social at #acep26

more RCT (preprint) data showing tamiflu doesn’t help for sicker (eg oxygen, pressors, intubated) hospitalized patients (0, 5 or 10d) with flu @thesgem.bsky.social at #ACEP26

(I think for that back of the envelope NNH calculation you should subtract the placebo 13.7% from the 19.8%, so 1/6.1% =16.393) @thesgem.bsky.social at #ACEP26

another small RCT showing IM ketorolac is no more effective than oral ibuprofen @thesgem.bsky.social at #ACEP26

some limitations but overall this SRMA shows peripheral pressors are probably pretty safe @jamanetworkopen.com jamanetwork.com/journals/jam... @thesgem.bsky.social at #ACEP26

higher LOS, resource use by NPs may outweigh the (salary) cost savings, lots of limitations and intra-group variation @thesgem.bsky.social at #ACEP26

important #GeriEM questions, SRMAs and #GeriED guidelines 2.0 are trying to answer #ACEP26

first #GeriED guideline is out on delirium good questions, imperfect data to answer #ACEP26

next #GeriED guideline on medication safety is almost ready for submission #ACEP26

current #GeriED guidelines 2.0 status #ACEP26

get all your #GeriED guidelines 2.0 publications at the GEAR website

lots of challenges with #misinformation #ACEP26

we might not be able to convince someone out of their #misinformation but we might be the first step on their path in the right direction #ACEP26

consensus framing works set up for success with banality #ACEP26

when someone pushes back on recommended care due to #misinformation: #ACEP26

work with patients and their often understandable (even if based on #misinformation) to help get them the best care #ACEP26

#misonformation summary from Dr. Bernice Fokum, MD, MPP #ACEP26

we do a LOT of reproductive health care in the ER aortic dissection, PTX, tamponade, ruptured AAA: each *well* below 1% of ED visits each ER doc treats 800 patients with early pregnancy loss in their career #ACEP26