Video Laryngoscopy Compared to Augmented Direct Laryngoscopy in Adult Emergency Department Tracheal Intubations: A National Emergency Airway Registry (NEAR) Study

Methodology: 2/5 Usefulness: 4/5 Brown CA 3rd, et al. Acad Emerg Med. 2020 Feb;27(2):100-108. Question and Methods: This was one the largest prospective, observational, ED-only airway studies to date comparing first-pass success (FPS) rates in “augmented” DL (A-DL) intubations with unaided VL intubations. Findings: FPS for unaided VL: 90.9% (95%CI 88.7-93.1%) vs. A-DL: 81.1%(78.7-83.5%). Multivariable AOR was 2.8 (2.4-3.3) in favour of […]

Does N-Terminal Pro-B-Type Natriuretic Peptide Improve the Risk Stratification of Emergency Department Patients With Syncope?

Methodology: 4/5 Usefulness: 3/5 Thiruganasambandamoorthy V, et al. Ann Intern Med. 2020 May 19;172(10):648-655. Methods: Prospective cohort study to evaluate whether adding NT-proBNP to the CSRS improves prediction of 30-day SAEs. Findings: Adding NT-proBNP provided no additional benefit to the model and would result in 10% of patients being correctly reclassified and 8.7% of patients being incorrectly reclassified in terms […]

Multicenter Emergency Department Validation of the Canadian Syncope Risk Score

Methodology: 4.5/5 Usefulness: 4.5/5 Thiruganasambandamoorthy V, et al. JAMA Intern Med. 2020 Mar 23;180(5):1-8.  Question and Methods: Prospective cohort validation to predict 30-day serious outcomes among ED patients with syncope Findings: 3819 patients had an overall 3.6% serious event rate at 30-days. At a score of -1, the CSRS had a Sn/Sp/NPV of 97.8%/44.3%/100% Limitations: Overlap in recruitment sites and […]

Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease: A Review

Methodology: 1/5 Usefulness: 2/5 Riley CM, et al. JAMA. 2019 Feb 26;321(8):786-797. Question: Aimed to review and provide practical information regarding the diagnosis and long-term management of patients with COPD in the outpatient setting. Methods: This was a systematic assessment where authors searched multiple sources and simply reviewed articles. Findings: They suggested the treatment of COPD should be done on a step-wise […]

Electrical versus pharmacological cardioversion for emergency department patients with acute atrial fibrillation (RAFF2): a partial factorial randomised trial.

Methodology: 4.5/5 Usefulness: 4/5 Stiell IG, et al. Lancet. 2020 Feb 1;395(10221):339-349 Editorial: Atrial fibrillation cardioversion in the emergency department.  Question and Methods: This partial factorial randomized trial aimed to determine which rhythm control strategy was superior; procainamide followed by electrical cardioversion if needed compared with electrical cardioversion alone. It also sought to determine whether anterolateral or antero-posterior pad placement […]

Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs

Methodology: 2.5/5           Usefulness: 3/5 Daley JI, et al. Acad Emerg Med 26 (11), 1211-1220 Nov 2019 Questions and methods: In patients with abnormal vital signs, what is the sensitivity of FOCUS for the diagnosis of PE? Prospective, multicenter, observational study. Findings: 136 patients with pending CTPE, subdivided in (1) HR≥100 BPM and/or sBP <90 mmHg, […]

Use of a Rapid Diagnostic for Chlamydia Trachomatis and Neisseria Gonorrhoeae for Women in the Emergency Department Can Improve Clinical Management: Report of a Randomized Clinical Trial

Methodology: 3/5           Usefulness: 2.5/5 Gaydos CA et al. Ann Emerg Med. 2019 Jul;74(1):36-44. doi: 10.1016/j.annemergmed.2018.09.012. Epub 2018 Nov 2. Question and Methods: RCT of women receiving pelvic testing for CT/NG comparing standard of care test (NAAT) vs. POC test (GeneXpert). Treatment was at the discretion of the clinician Findings: CT undertreatment rate difference –46.2%; 95% CI […]

Outcome of Applying the ESC 0/1-hour Algorithm in Patients With Suspected Myocardial Infarction.

Methodology: 3/5           Usefulness: 3/5 Twerenbold R, et al. J Am Coll Cardiol. 2019 Jul 30;74(4):483-494. Editorial: Evaluating Suspected Acute MI in the Emergency Department: What Is and What Should Never Be. Question and Methods: Prospective international study of the impact on management and patient safety using the ESC 0/1hr high-sensitivity troponin algorithm in the ED for patients […]