Point of Care Ultrasound (POCUS) is becoming increasingly prevalent in Emergency Departments (EDs) for diagnostic, procedural, and management purposes. In this post, we will examine some less known, but extremely useful, indications for POCUS. For further information, please visit our POCUS archives and see Dr. Rajiv Thavanathan’s previous Grand RoundsRead More →
Journal Club Methodology Score: 4/5 Usefulness Score: 3/5 Sprigg N, et al. Lancet. 2018 May 26;391(10135):2107-2115 Question and Methods: Multicenter, double-blinded, randomized, placebo-controlled trial comparing if IV TXA vs placebo, given within 8h of spontaneous (non-traumatic) ICH onset, decreased death or dependence at 90 days. Findings: No difference in 90dRead More →
Mechanical CPR is a technology whereby a machine performs chest compressions in place of a human provider. These devices are becoming increasingly prevalent in the prehospital and in-hospital arenas, and it is inevitable that healthcare providers will interact with them in some capacity. Given the variable evidence in the literature,Read More →
Hemorrhage is the leading cause of preventable death on the battlefield. Damage Control Resuscitation (DCR) works synergistically with Damage Control Surgery (DCS) and prioritizes non-surgical interventions that reduce morbidity and mortality due to trauma and hemorrhage. DCR aims to restore homeostasis and prevent or mitigate tissue hypoxia and coagulopathy. ThisRead More →
Mass gathering medicine (MGM) is an exciting niche field of emergency medicine focused on providing emergency medical care at large events. Mass gatherings, as the name implies, are events in which “large numbers of people assemble in public or private spaces to celebrate or participate in musical, sporting, cultural, religious,Read More →
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5 /5 Sperry JL, et al. N Engl J Med. 2018 Jul 26;379(4):315-326. Question and Methods: Determine the efficacy of prehospital plasma compared with standard-care resuscitation in injured patients at risk for hemorrhagic shock during air medical transport to level 1 traumaRead More →
We’re familiar with sodium bicarbonate as a simple buffer solution, which has been utilized for a myriad of medical indications backed up by physiologic rationale and occasional moderate-quality evidence. It comes in two forms; vials (typically for infusions) and pre-filled syringes (pushed in cardiac arrest). There have been on-an-off shortagesRead More →
Journal Club Summary Methodology: 4/5 Usefulness: 3.5/5 Wang HE, et al. JAMA. 2018 Aug 28;320(8):769-778. Editorial: Pragmatic Airway Management in Out-of-Hospital Cardiac Arrest. Question and Methods: This multicenter pragmatic cluster-crossover randomized trial compared initial advanced airway strategy effectiveness between laryngeal tube (LT) and endotracheal intubation (ETI) in adults with OHCA. Findings: The LTRead More →
In this post, we will aim to review the literature looking at identifying clinical and historical features that can help differentiate stroke mimics from strokes. We will also discuss the safety of the administration of IV tPA to misdiagnosed stroke mimics. This post will not focus on the recent developmentsRead More →
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Jabre P, et al. JAMA. 2018 Feb 27;319(8):779-787. Question and Methods: This was a multicenter randomized trial comparing bag valve mask ventilation with endotracheal intubation performed by emergency physicians in 2043 patients with out-of-hospital cardiac arrest in France and Belgium Findings: Their primary outcome ofRead More →