Securing definitive control of a threatened airway is a fundamental skill in the care of critically ill patients and remains an ever-popular topic of discussion in Emergency Medicine. As Emergency Medicine providers, we find few procedures as satisfying or potentially difficult as airway management; we continually seek to hone ourRead More →
Sudden cardiac arrest represents a significant cause of morbidity and mortality worldwide. Over 356,000 out-of-hospital cardiac arrests (OHCA) occur annually in the United States, with resuscitative efforts extending into the Emergency Department (ED) for many of these patients. Prognosis remains dismal, with death occurring in 92%. Background WhileRead More →
Journal Club Summary Methodology: 2.5/5 Usefulness: 2/5 Connolly SJ, et al. N Engl J Med. 2019 Feb 7. Question and Methods: This was the first trial looking at clinical outcomes for reversal of factor Xa inhibitor anticoagulation in major bleeding episodes using the specific reversal agent, Andexanet alfa. It wasRead More →
This article discusses the patient perspective of early pregnancy loss in the ED. We will define the quality gap as it pertains to ED care for patients with early pregnancy loss. We will then look at patient-centered communication strategies for counseling and discharge of patients with early pregnancy loss inRead More →
IV fluid is a drug Intravenous fluid administration is the second most common medical intervention next to supplemental oxygen.1 Over 200 million liters of normal saline (NS) is used in the United States annually.2 Intravenous fluids, like any other drug, should be given with thought and knowledge about the effectsRead More →
Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 2/5 Gaspari RJ, et al. Ann Emerg Med. 2019 Jan;73(1):1-7 Question and Methods: Unblinded single-centre RCT comparing POCUS vs. physical exam guided I&D of abscesses in systemically well patients, comparing treatment failure at 10d defined by repeat I&D producing purulence. Findings: InRead More →
A checklist is a physical, cognitive aid that lists essential actions required for a task to compensate for limitations in human memory. While checklists have been around forever, the concept of checklists in medicine is much newer. Medical checklists have been gaining popularity and appearing on social media, but isRead More →
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3/5 Shaikh N, Hoberman A, Hum SW, Alberty A, Muniz G, Kurs-Lasky M, Landsittel D, Shope T. JAMA Pediatr. 2018 Jun 1;172(6):550-556. Question and Methods: The objective was to develop a risk-tool (UTICalc) to aid physicians in deciding when to perform urinanalysis and when toRead More →
In the second part of this two-part series, Dr. Michael Wong discusses the process for obtaining consent for incapable persons in the Emergency Department. For a review of a rational and patient-centered approach to difficult discussions in the Emergency Department around goals of care and resuscitation, please see the firstRead More →
Journal Club Summary Methodology: 3/5 Usefulness: 3.5/5 Annane D, et al. N Engl J Med. 2018 Mar 1;378(9):809-818. Editorial: A Role for Hydrocortisone Therapy in Septic Shock? Question and Methods: Large multi-center, double-blinded, randomized-controlled trial comparing effects of steroids (fludrocortisone + hydrocortisone) to placebo on 90-day mortality of ICU patientsRead More →