Welcome to the March 2015 REBELCast, where Swami, Matt, and I are going to tackle a couple of topics that come up frequently in clinical practice in the emergency department. Today we are going to specifically tackle:
- Topic #1: Oseltamivir (Tamiflu) in the Treatment of Influenza
- Topic #2: Use of the HEART Score in Low Risk Chest Pain Patients
March 2015 REBELCast Podcast
What clinical questions will be covered in the March 2015 REBELCast?
- Question #1: Does oseltamivir significantly decrease symptoms in patients with influenza like illness (ILI)?
- Question #2: Does use of the HEART Score safely reduce stress testing and cardiac imaging in patients at low risk for major adverse cardiac events (MACE)?
What specific articles will we be covering?
- Article #1: Dobson J et al. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet 2015 (24963149)
- Article #2: Mahler SA et al. Can the HEART Score Safely Reduce Stress Testing and Cardiac Imaging in Patients at Low Risk for Major Adverse Cardiac Events? Crit Pathways in Cardiol 2011; 10: 128 – 133 (24830868)
What is the clinical bottom line for the above clinical questions:
- Bottom Line #1: The use of oseltamivir is associated with an 18-hour reduction in time to symptom resolution in patients with ILI in comparison to placebo. However, this minor reduction comes with significant increases in side effects namely nausea and vomiting which obviates the modest benefit.
- Bottom Line #2: The HEART Score in combination with cardiac enzyme testing, safely reduces cardiac testing in a population of chest pain patients with a low pretest probability of ACS
What is the HEART Score?
March 2015 REBELCast Show Notes
For more on the above topics checkout:
- Salim R. Rezaie at REBEL EM: The HEART Score – A New ED Chest Pain Risk Stratification Score
- Ryan Radecki at EMLit of Note: Time to Move to the HEART Score
- Ryan Radecki at EMLit of Note: Which Review of Tamiflu Data do You Believe?
- Anand Swaminathan at ALiEM: Neuraminidase Inhibitors for Influenza – The Truth The Whole Truth, and Nothing But the Truth Finally