In this episode, I’ll discuss the recent conflict between ATS and IDSA over the Community Acquired Pneumonia guidelines. New guidelines for treating patients with community-acquired pneumonia were published earlier in 2025 by the American Thoracic Society, but unlike previous versions, these were not endorsed by the Infectious Disease Society of America. The reason for IDSA’s…
In this episode, Scott sits down with Candice to unpack how experienced emergency resus nurses manage overwhelming workloads in real-world conditions. Candice walks us through how she prioritizes care, uses geography and technology to maintain situational awareness, and builds redundancy through teamwork. The conversation covers practical strategies for time management, monitoring, charting, nurse autonomy, and…
Pediatric osteomyelitis is common enough to be missed and serious enough that missing it matters. Over the last decade, however, how we diagnose and treat acute hematogenous osteomyelitis (AHO) in children has changed substantially. Prolonged intravenous antibiotics, fixed treatment durations, and reflexive surgery are no longer the default for uncomplicated disease. What follows is a…
A 10-year-old boy with a history of type 1 diabetes mellitus presented to the emergency department (ED) with fevers for five days. Symptoms began with temperatures as high as 104⁰F with ketones in the urine noted on a home test. The patient did not have any associated symptoms. His mom stated that he had a…
This year’s top article selections from Annals Editor in Chief Dr. Yealy cover areas encountered in the daily routines of emergency physicians and explore clinical topics critical for patient care. Commenting on one article about boarding, Dr. Yealy noted, “We’ve talked about inpatient hallway boarding for years. Yet, it always seems like something that can’t…
This Phase 2 trial exhibited an atypical primary focus on safety outcomes, specifically bleeding risks. While Phase 2 trials commonly assess a drug’s efficacy in treating the targeted condition (e.g., stroke prevention), this study did not align with that norm (however, did in part examine dose-dependent differences). Ultimately, clinicians will require an understanding of this…
You are at a conference. You had 1 glass of wine too many last night, so you had to add an extra coffee to get moving this morning. Then you feel a slight flutter in your chest. Caffeine is a stimulant, right? Could it be causing atrial fibrillation? The paper Wong CX, Cheung CC, Montenegro…
In 2001: A Space Odyssey, Dave returns to the spacecraft to find himself locked out. The onboard AI, HAL, has decided Dave is a threat to the mission. Dave pleads, reasons and commands. But HAL has already made up its mind; and won’t be moved. Last week I attended a patient with chest pain; anxious…
In this episode, I’ll discuss whether it is ever appropriate for a patient to be on vancomycin by more than one route of administration. While IV vancomycin is indicated for a variety of infectious diseases, oral vancomycin is primarily used to treat Clostridioides difficile infection (CDI). Unlike IV metronidazole, which achieves therapeutic levels in the…
Influenza A and B infections in children are clinically similar in presentation and severity, with no consistent differences in symptoms, disease duration, or outcomes, though some studies suggest subtle variations in specific manifestations and age distribution. Clinical Presentation The clinical presentations of influenza A and B are largely indistinguishable. Both types cause acute onset of…