Blast injuries resulting from explosions have the capacity to cause life-threatening multisystem injuries in multiple victims simultaneously. The biggest potential challenge in managing blast injuries is the creation of large numbers of simultaneous critically ill casualties. Once notified of a possible bombing or explosion, Emergency Physicians should immediately consider activatingRead More →
Journal Club Summary Methodology Score: 4.5/5 Usefulness Score: 4.5 /5 van der Pol LM, et al. N Engl J Med. 2019 Mar 21;380(12):1139-1149 Question and Methods: Using a prospective cohort study of 510 pregnant women, the authors were trying to see whether an algorithm could safely diagnose PEs and avoidRead More →
Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 3/5 Prins HJ, et al. Eur Respir J. 2019 May 23;53(5). Question and Methods: The CATCH Study was a multicentre, randomised, controlled open intervention clinical trial comparing CRP guided antibiotics for COPDE vs the Gold Strategy Findings: The study had a 14.5%Read More →
Emergency Resuscitative Thoracotomy (ERT) is a potentially lifesaving intervention. It is a true salvage procedure, without which survival is essentially zero, even in indicated scenarios. After reading this post, you’ll be slightly more comfortable should you ever find yourself in a situation where you need to “crack the chest” (i.e.Read More →
Journal Club Summary Methodology: 3.5/5 Usefulness: 2.5/5 Ma H, et al N Engl J Med. 2019 May 9;380(19):1795-1803 Editorial: Image-Guided Intravenous Alteplase for Stroke – Shattering a Time Window. Question and Methods: This was an international, multicenter, randomized, placebo-controlled trial of intravenous tPA in patients with stroke who presented 4.5-9 hours afterRead More →
There was a significant amount of pre-hospital research published in 2018; many trials were that will no doubt inform future guidelines and change practice. This post seeks to look at some of the historical features of prehospital research and give us a road map for how we got here. Pre-HospitalRead More →
Journal Club Summary Pellatt R, et al. Ann Emerg Med. 2019 Mar 7. pii: S0196-0644(19)30059-9. Methodology Score: 3/5 Usefulness Score: 3.5/5 Question and Methods: Randomized control trial of 97 adult emergency department patients comparing buddy taping vs. ulnar gutter splinting, in acute, uncomplicated neck of 5th metacarpal (Boxer) fractures. Findings: At 12 weeksRead More →
In the final post of this 3-part series on concussions, Dr. Erica Lee discusses how to recognize and manage post-concussion complications, and hopes to raise awareness on the legislation and public health burden around concussions. If you haven’t already, please refer to our previous posts for an up-to-date definition ofRead More →
Journal Club Summary Casey JD, et al. N Engl J Med. 2019 Feb 28;380(9):811-821. Methodology Score: 3.5/5 Usefulness Score: 3.5/5 Question and Methods: Multicenter, unblinded RCT in 7 ICUs comparing rates of hypoxia in patients undergoing BVM vs no ventilation during the period between induction and laryngoscopy. Findings: Compared to no ventilationRead More →
Welcome to Part 2 of our series on concussions. In this post, Dr. Erica Lee reviews how to make the diagnosis of concussion and manage these patients in the ED. You can review Part 1 of the series for an up-to-date definition of a concussion and Part 3 for aRead More →