Is Topical Vancomycin an Option? A Randomized Controlled Trial to Determine the Safety of the Topical Use of Vancomycin Powder in Preventing Postoperative Infections in Total Knee Arthroplasty, as Compared With Standard Postoperative Antibiotics.

Background: The demand for total knee arthroplasties (TKAs) is expected to rise in the coming decades, increasing the burden of periprosthetic joint infections (PJIs). The use of intrawound vancomycin powder (VP) has proven to be effective in reducing the incidence of PJIs after spinal surgery. That said, its effectiveness in TKA remains unclear.

Comparison of Simulation-based Resuscitation Performance Assessments With In-training Evaluation Reports in Emergency Medicine Residents: A Canadian Multicenter Study.

Objective: Simulation stands to serve an important role in modern competency-based programs of assessment in postgraduate medical education. Our objective was to compare the performance of individual emergency medicine (EM) residents in a simulation-based resuscitation objective structured clinical examination (OSCE) using the Queen's Simulation Assessment Tool (QSAT), with portfolio assessment of clinical encounters using a modified in-training evaluation report (ITER) to understand in greater detail the inferences that may be drawn from a simulation-based OSCE assessment.

Methods: A prospective observational study was employed to explore the use of a multicenter simulation-based OSCE for evaluation of resuscitation competence.

Pneumonia in adults: the practical emergency department perspective.

In those patients who are hospitalized with pneumonia, mortality is 15%. Close to 90% of deaths attributed to pneumonia are in patients older than 65 years. This article provides the emergency physician with an understanding of how to make the diagnosis, initiate early and appropriate antibiotic therapy, risk stratify patients with respect to the severity of illness, and recognize indications for admission.