Journal Club: No poke PTA?
Updated: Oct 17, 2021
Urban MJ, Masliah J, Heyd C, Patel TR, Nielsen T. Peritonsillar Abscess Size as a Predictor of Medical Therapy Success. Ann Otol Rhinol Laryngol. 2021 May 12:34894211015590. doi: 10.1177/00034894211015590. Epub ahead of print. PMID: 33980073.
Our first article was a retrospective study to determine if incision and drainage was necessary for peritonsillar abscess treatment or if antibiotics alone were sufficient. The study found similar outcomes (need for I&D within 30 days of initial visit) when PTA size was less than 2cm. When the initial PTA was greater than 2cm, the medically treated group did return more often than the for initial I&D group, however these findings were not statistically significant. We concluded that the study was too small to be practice altering, but that it does show the need for a larger study that could alter future practice.
Put ‘em down
Cole JB, Stang JL, DeVries PA, Martel ML, Miner JR, Driver BE. A Prospective Study of Intramuscular Droperidol or Olanzapine for Acute Agitation in the Emergency Department: A Natural Experiment Owing to Drug Shortages. Ann Emerg Med. 2021 Aug;78(2):274-286. doi: 10.1016/j.annemergmed.2021.01.005. Epub 2021 Apr 9. PMID: 33846015.
Our second article discussed IM droperidol versus IM olanzapine in the treatment of the acutely agitated patient. The study found very similar times to sedation. Important differences included greater EPS side effects with droperidol, greater respiratory depression with olanzapine. It also showed increased need for rescue medications in the olanzapine group as well as longer overall hospital stay. We found that limitations of this study include lack of blinding as well as subjective sedation parameters and a target population of mostly alcoholics.
October Journal Club Discussion Leader: Jonathan Hund, MD (PGY-2)
2021-2022 Academic Year Journal Club Leaders: Rose Solomon, MD (PGY-3); Jarred Worthy, DO (PGY-2); David Andonian, MD (Faculty Advisor)