Journal Club Summary

Methodology Score: 3/5
Usefulness Score: 2/5

Atkinson PR, et al. Ann Emerg Med. 2018 Oct;72(4):478-489

Question and Methods: This was the first multicenter, prospective, RCT examining the effect of POCUS on 30-day survival of undifferentiated hypotensive patients presenting to ED.

Findings: There was no important survival benefit with the use of POCUS, including no important differences in IV fluids, inotropes, advanced imaging, or admission/LOS rates.

Limitations: Study was underpowered and stopped early due to slow enrolment and presumed futility. Both inclusion and exclusion criteria likely diluted the beneficial effect of POCUS.

Interpretation: This study is pragmatic and attempts to answer an important clinical question, however, is not conclusive evidence that POCUS should be withheld in undifferentiated hypotensive patients.

By: Dr. Adam Parks 

Epi lesson

Binomial Distribution

“Normal distribution” represents the probability of observing a given value for a continuous variable. “Binomial distribution” is used when observing dichotomous variables which can only take one of two values. It represents the probability of observing one value or the other among n attempts/trials, given a probability p for each attempt. Similarly to the “smooth” normal distribution bell curve, binomial distribution is represented with a series of stepped columns.

Dr. Christian Vaillancourt

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.