Urgent Updates | March 17, 2022

ORTHOPEDIC URGENT CARE VERSUS THE EMERGENCY DEPARTMENT: COST IMPLICATIONS FOR LOW-ENERGY FRACTURE CARE
In this study, retrospective chart review, A cost analysis of low-acuity patients revealed that an estimated $62,150 USD could have been saved in healthcare costs by the initial diversion of low-acuity patients seen in the ER to I-Care during the study period. These results suggest that the I-Care orthopedic urgent care model is a more cost-effective and more efficient alternative to the ED for patients with fractures requiring procedural treatment and low-acuity patients managed on an outpatient basis.
Full Access: Medscape

WHERE IS THE CULPRIT LESION IN THE NEW ELECTROCARDIOGRAM PATTERN?
Aslanger pattern consists of 3 criteria: (1) STE in leads III and aVR but not in any other inferior lead, (2) STD in any of leads V4 to V6 but not in V2, and (3) an ST in lead V1 higher than ST in lead V2. Aslanger pattern is a reliable sign of acute inferior MI, indicating occlusion of the RCA or left circumflex artery. Leads III and aVR are contiguous in anatomical position; therefore, they should be recognized as contiguous leads on ECG. Aslanger pattern should be evaluated as STEMI.
Full Access: JAMA

A FECAL MICROBIOME SIGNATURE WITH HIGH SPECIFICITY FOR PANCREATIC CANCER
Recent evidence suggests a role for microbiome in pancreatic ductal adenocarcinoma (PDAC) etiology and progression. Researchers analyzed stool samples from Spanish case-control study. Study results indicate that non-invasive, robust and specific fecal microbiota-based screening for the early detection of PDAC is feasible.
Full AccessBMJ

DIFFERENCES IN ANTIBIOTIC PRESCRIBING RATES FOR TELEMEDICINE ENCOUNTERS FOR ACUTE RESPIRATORY INFECTIONS
Health systems are increasingly implementing direct-to-consumer telemedicine for unscheduled acute care, however quality of care may be variable. A retrospective analysis of on-demand telemedicine visits available to health system employees and dependents at a large urban academic health system from March 2018 to July 2019 showed that Of 257 telemedicine encounters related to acute respiratory infection, affiliated physicians prescribed antibiotics in 18% of visits, compared to 37% of visits by vendor physicians. In this study of virtual visits for unscheduled acute care in a single health system, vendor-supplied physicians were predicted to prescribe an antibiotic in 15% more acute respiratory infection visits compared to system-employed emergency physicians (35% vs 19%).
Full AccessJournal of Telemedicine and Telecare