Abscess Incision and Drainage With or Without Ultrasonography: A Randomized Controlled Trial

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: In 107 patients who achieved follow-up, the POCUS group had a […]

Airway Checklists in the ED

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 is there actually any evidence to suggest we should be using […]

Development and Validation of a Calculator for Estimating the Probability of Urinary Tract Infection in Young Febrile Children

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 to empirically treat febrile children 2 to 23 months of age. […]

Consent for resuscitation of incapable patients in the Emergency Department

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 first installment of this series. Ontario’s Health Care Consent Act allows […]

Hydrocortisone plus Fludrocortisone for Adults with Septic Shock

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 patients in septic shock on vasopressors for at least 6 hours. Findings: […]

A How-to Guide to Goals of Care Discussions in the Emergency Department

In this two-part series, Dr. Michael Wong begins by reviewing a rational and patient-centered approach to difficult discussions in the Emergency Department around goals of care and resuscitation. In part two, we discuss the process for obtaining consent for incapable persons in the Emergency Department. Common pitfalls with the current paradigm Heyland et al.1 interviewed 1439 patients and family members […]

Tactical Combat Casualty Care (TCCC) – Recent Updates

The Tactical Combat Casualty Care (TCCC) Guidelines are the standard of care for the modern battlefield. TCCC offers operational guidelines for a range of combat personnel – from recommendations for all combatants to combat paramedics and SOF medics. Though these guidelines represent years of cumulative civilian and battlefield experience and literature, the Committee on Tactical Combat Casualty Care (CoTCCC) still […]