As we were preparing for our “Critical Care Week” here at the EM Ottawa Blog, I was thinking I should definitely tap into the knowledge of an ICU physician whom I know very well. That physician is also my awesome wife, Dr. Erin Rosenberg. She’s been a staff intensivist atRead More →
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3/5 Driver BE, et al. JAMA. 2018 May 16. doi: 10.1001/jama.2018.6496. Question/Methods: This single-centre, randomized clinical trial enrolled 757 patients to compare first-attempt intubation success facilitated by the bougie to ETT plus stylet, in an ED where use of the bougie wasRead More →
Methodology Score: 3.5/5 Usefulness Score: 4/5 Babl FE, et al. Lancet. 2017 Jun 17;389(10087):2393-2402. Question and Methods: This prospective observational study sought to externally validate and subsequently compare the relative performance of the PECARN, CATCH, and CHALICE paediatric head injury CDRs. Findings: The validation cohort demonstrated a sensitivity of 100%Read More →
Journal Club Summary Methodology: 4/5 Usefulness: 4/5 Chu DK, et al. Lancet. 2018 Apr 28;391(10131):1693-1705. Question & Methods: The authors wanted to summarize the best available evidence of RCTs to guide rational use of O2 therapy. Findings: Their review of over 16 000 patients provides high-quality evidence that liberal supplemental O2 increasesRead More →
Methodology: 3.5/5 Usefulness: 2.5/5 Heidari K. et al. J Shoulder Elbow Surg. 2014 Jun;23(6):759-66. Journal Club Bottom Line Question & Methods: Can abduction and external rotation (AbER) immobilization after primary anterior shoulder dislocation reduce rates of recurrence compared to conventional immobilization in adduction and internal rotation (AdIR). A randomized trial. Findings: AfterRead More →
Methodology Score: 3/5 Usefulness Score: 3/5 Nazerian P, et al. Circulation. 2018 Jan 16;137(3):250-258. Editorial – Biomarker-Assisted Diagnosis of Acute Aortic Dissection. Question: The ADvISED trial was an International Multicenter prospective observational study of a novel diagnostic strategy that integrated the Aortic Dissection Detection Risk Score (ADD-RS) and D-Dimer in an ED population to rule outRead More →
Methodology Score: 4/5 Usefulness Score: 3/5 Venkatesh B, et al. N Engl J Med. 2018 Jan 19. Journal Club Bottom Line Question/Methods: This was a international, pragmatic, double-blind, randomized, controlled trial comparing hydrocortisone as continuous infusion to placebo in patients with septic shock on mechanical ventilation and at least 4-hoursRead More →
Methodology: 3.5/5 Usefulness: 4/5 Albers GW, et al. N Engl J Med. 2018 Jan 24. Journal Club Bottom Line Question/Methods: This was a multicentre, prospective, randomized, open label, blinded outcome trial comparing thrombectomy + medical therapy vs medical therapy alone in patients with delayed presentation (6-16 hours) of proximal MCARead More →
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 4/5 Stagg A, et al. BMJ Qual Saf. 2018 Feb;27(2):140-147. Question and Methods: This QI time-series analysis assessed the efficacy, safety and costs of a 2-step urine culture (UC) collection system. Findings: There was a decrease in UC processing (5.9%-4.6%), positive UCsRead More →
Journal Club Summary Alam N, et al. Lancet Respir Med. 2018 Jan;6(1):40-50. Question and Methods: The authors of this nation-wide open-label RCT studied the mortality effect of pre-hospital antibiotics on febrile patients with one other non-laboratory SIRS criteria by comparing pre-hospital usual care with IV fluids and oxygen to theRead More →