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Coronary CT Angiography, Perfusion Imaging Effective for Evaluating Patients With Chest Pain
November 4, 2015
Clinical question: When evaluating the intermediate-risk patient with chest pain, should coronary computed tomography angiography (CCTA) be used instead of myocardial perfusion imaging (MPI)? Background: CCTA has been shown in prior randomized controlled trials to save time and money compared to
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ED Lung Ultrasound Useful for Differentiating Cardiogenic from Noncardiogenic Dyspnea
November 4, 2015
Clinical question: Is lung ultrasound a useful tool for helping to diagnose acute decompensated heart failure (ADHF)? Background: Lung ultrasound is an emerging bedside tool that has been promoted to help evaluate lung water content to help clinicians differentiate ADHF from other causes of dyspn
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When Should Hospitalists Order Continuous Cardiac Monitoring?
November 4, 2015
Case Two patients on continuous cardiac monitoring (CCM) are admitted to the hospital. One is a 56-year-old man with hemodynamically stable sepsis secondary to pneumonia. There is no sign of arrhythmia on initial evaluation.
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Antimicrobial Stewardship Resources Often Lacking in Hospitalists’ Routines
November 4, 2015
The best antibiotic stewardship programs weave improvements into the routines of hospitalists. But at the end of the day, developing and overseeing these important programs does require some level of time and money.
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Chemotherapy Does Not Improve Quality of Life with End-Stage Cancer
November 3, 2015
Clinical question: Does palliative chemotherapy improve quality of life (QOL) in patients with end-stage cancer, regardless of performance status? Background: There is continued debate about the benefit of palliative chemotherapy at the end of life.
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Post-Operative Transfusions after Noncardiac Surgery Associated with Increased Adverse Outcomes
October 29, 2015
Clinical question: Do transfusions affect post-operative outcomes after noncardiac surgery? Background: Studies have demonstrated that a restrictive transfusion strategy is probably superior to a liberal transfusion strategy in many clinical settings.
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Easing the Grieving Process for Families of Patients Dying in the ICU
October 29, 2015
Clinical question: Can we dignify death in the ICU and ease the grieving process by soliciting wishes from patients, families, and care team members? Background: The death of the critically ill patient in the ICU can be dehumanizing and overwhelming for the patient’s family and friends, leading t
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Pediatric Trigger Tool Helps Identify Inpatient Pediatric Harm
October 29, 2015
Clinical question: Can a trigger tool identify harms for hospitalized children? Background: An estimated 400,000 people die annually in the United States as a result of hospital-associated harm.
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Left Atrial Appendage Closure Favorable Over Warfarin for Atrial Fibrillation
October 29, 2015
Clinical question: Is there a favorable risk-benefit ratio for left atrial appendage closure (LAAC) compared to warfarin for prevention of stroke, systemic embolism, and cardiovascular death in nonvalvular atrial fibrillation? Background: LAAC with the WATCHMAN device was shown to be noninferior
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Thrombosis Management Demands Delicate, Balanced Approach
October 22, 2015
The delicate balance involved in providing hospitalized patients with needed anticoagulant, anti-platelet, and thrombolytic therapies for stroke and possible cardiac complications while minimizing bleed risks was explored by several speakers at the University of California San Francisco’s annual Man
