Background: Intravenous vancomycin treatment is often necessary beyond hospitalization. Peripherally inserted central catheters (PICCs) are usually placed for this indication. Whether the less invasive midline catheters (midlines) are safe alternatives for outpatient parenteral antimicrobial therapy (OPAT) with vancomycin is unclear. We compared the safety of midlines and PICCs among patients receiving vancomycin for OPAT. Methods: [...]

Background: At the time of hospitalization, a physician must place an admission status order designating inpatient, outpatient, or observation care. If a patient requires medically necessary hospital care for at least 2 midnights, an inpatient admission order is appropriate. If care is expected to last fewer than 2 midnights or if there is uncertainty about [...]

Case Presentation: A 23-year-old female presented to the ED, 6 days postpartum with weakness, vomiting, and jaundice following a delivery complicated by preeclampsia. On examination, she had scleral icterus, and labs showed hemoglobin of 6 (normal 12.1- 15.1 g/dL), platelets of 8 (normal 150 – 400× 10^9/L), elevated LDH, low haptoglobin, and schistocytes, suggesting hemolysis. Creatinine was [...]

Case Presentation: Arterial air embolism is a serious condition that can lead to acute ischemic stroke. It is usually an iatrogenic process, during which air is introduced to the arterial system directly or through a pressure gradient. Although rare, air emboli can have drastic neurologic and cardiac complications and have been shown to be fatal [...]