Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 4/5 Johnston SC, et al. N Engl J Med. 2018 Jul 19;379(3):215-225 Editorial: Antiplatelet Therapy after Ischemic Stroke or TIA. Question and Methods: This randomized, double-blind trial evaluated ASA + Clopidogrel (DAPT) against ASA alone for preventing ischemic events after a minor stroke/high-risk TIA.Read More →
Why Should You Care About Health Journalism? Patients receive health information from many sources—and it’s often not from you, their doctor. The accuracy of the health information available varies widely. Critical health journalism can help set records straight, as was the case with the now-debunked measles-mumps-rubella (MMR) vaccine safety controversy.Read More →
Journal Club Summary Methodology: 4/5 Usefulness: 4/5 Kuppermann N, et al. N Engl J Med. 2018 Jun 14;378(24):2275-2287. Editorial: Fluid Composition, Infusion Rate, and Brain Injury in Diabetic Ketoacidosis. Question and Methods: 13 centre RCT with four arms to determine the impact of fluid resuscitation rate and type on development ofRead More →
For other POCUS focused cases please see our ultrasound archives Case The next chart you pick up is for an 87 year-old female brought in by EMS from her nursing home for agitation and vomiting. She is afebrile and her vital signs are normal. She has a past medical historyRead More →
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 5/5 Nath S, et al. Lancet. 2018 Mar 24;391(10126):1197-1204 Question and Methods: This meta-analysis sought to determine, in lumbar punctures, whether atraumatic or conventional (traumatic) spinal needles were superior in terms of their complication rates. Findings: Atraumatic spinal needles were superior to conventional needlesRead More →
In this two part series, we are delving into a few of the many controversies regarding procedural sedation and explore how to reduce resource utilization and ED length of stay. In PART 1, we discussed preprocedural fasting and concluded that adherence to fasting guidelines is unnecessary in healthy patients undergoing proceduralRead More →
Journal Club Summary: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest Methodology Score: 4/5 Usefulness Score: 3.5/5 Perkins GD, et al N Engl J Med. 2018 Jul 18. Editorial: Testing Epinephrine for Out-of-Hospital Cardiac Arrest. Callaway CW, et al. N Engl J Med. 2018 Jul 18. Question and Methods: Multicenter, randomized,Read More →
When we are caring for a septic patient in the ED, we know that aggressive care with early antibiotics and ensuring adequate preload saves lives. But what do we do when we aren’t sure if more fluid will help any longer? How can we finesse our fluid management in theRead More →
Journal Club Summary Methodology: 3.5/5 Usefulness: 3.5/5 Moore HB, et al. Lancet. 2018 Jul 28;392(10144):283-291. Editorial: No gains with plasma-first resuscitation in urban settings? Question and Methods: Use of prehospital plasma in patients with hemorrhagic shock before arrival at an urban level 1 trauma center.Read More →
Procedural sedation is commonly performed in the Emergency Department. It is a critical tool that helps facilitate unpleasant but often necessary procedures that our patients would otherwise not tolerate. However, procedural sedation is also an extraordinarily resource-intensive endeavor. Most often, it requires cardiac monitoring and many interprofessional personnel. Also, despiteRead More →