This month we will be focusing our attention on a few novel topics one might see in a split flow or fast track setting. First, those of us who have had a corneal abrasion know how effective a bit of topical anesthetic can be in relieving uniquely miserable eye pain. In fact, I expect a handful of us have a bottle of long-expired Alcaine sitting in our refrigerators “just in case” so, how about extending that courtesy to our patients? Second, does every “burn patient” really need a throughput destroying “Trauma consult” before getting discharged? Seems like we think so at SNGH. We will take a look at how to approach partial thickness burns and I expect some will offer a few great pearls (Hydrogel) and avoid unnecessary consults. Finally, we will look at how we approach the typical low Centor/non-strep sore throat patient. Should we be using oral steroids in all of these patients? All three studies will give us an opportunity to engage our newbies and review basic EBM topics like confidence intervals (wide vs narrow), sample size and bias so, come prepared. It will also give us an opportunity to expand our discussion to include how to be more efficient in the split flow setting or, how to avoid thoughts of self-harm after doing consecutive shifts in split flow. Two big thanks go out this month. First to Dr. Klinkhammer for offering to moderate as I will be taking a brief sojourn into the backcountry. And, to our dear friends (thanks Dr. Knapp) at Smartmouth who remain our Covid-19 waystation for JC. Looking forward to hearing how amazing JC was in my absence! Charlie    

 Shipman S et al., Short-Term Topical Tetracaine Is Highly Efficacious for the Treatment of Pain Caused by Corneal Abrasions: A Double-Blind, Randomized Clinical Trial. Ann Emerg Med. 2021 Mar;77(3):338-344.

 Ro HS et al., Effectiveness of aspiration or deroofing for blister management in patients with burns: A prospective randomized controlled trial. Medicine  2018 Apr;97(17)

 Hayward GN et al., Effect of Oral Dexamethasone Without Immediate Antibiotics vs Placebo on Acute Sore Throat in Adults: A Randomized Clinical Trial. JAMA. 2017 Apr 18;317(15):1535-1543.