@precordialthump I totally forgot about the EKG library! Awesome stuff. Keep up the great work (when do you sleep?!)
259 days ago
@emeducation Perfect, thanks for the suggestions! Turns out one is co-authored by Jeff Tabas. He already gave them all books.
259 days ago
Recommendations for an EKG resource to review bread & butter cases for senior residents? Pre-graduation panic setting in for our residents.
259 days ago
@danipedia Good point. I use the studies to convince the trauma consults NOT to get c-spine imaging on EVERYONE (citing distracting injury)!
264 days ago
@doctorflash Hi there. Just wanted to drop a note to thank you for all the extra traffic you're sending to blog. Much appreciated!!
275 days ago
Have you heard of the Modified Centor Score for strep pharyngitis? Interestingly, it has been validated in adults and children. The methodology builds on the traditional Centor Score by incorporating the patient's age, because this disease is more prevalent in kids than adults. In fact, you actually lose a scoring point if you are older than 44 years old.
There are 2 schools of thought about whether to use the Modified Centor Scoring system at all. One school (ACP, CDC, AAFP) recommends using the scoring system to guide testing and treatment. For patients with 4 or 5 points, don't even both testing. Just treat.
The other school of thought (AAP and IDSA) recommends testing everyone with ANY symptoms. They don't recommend using the Centor scores for making any clinical judgment, because of the insensitivity of any single sign/symptom.
Which school of thought do you subscribe to?
Personally, I use the Modified Centor Score to determine testing and treatment. It is more cost-effective, time-efficient, and supported by the literature. It eliminates both the very low and very high pre-test probability patients from rapid antigen testing. You either withhold or prescribe antibiotics, respectively.
Feel free to download this card and print on a 4'' x 6'' index card.
Reference
Choby BA (2009). Diagnosis and treatment of streptococcal pharyngitis. American family physician, 79 (5), 383-90 PMID: 19275067