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 →
The management of traumatic cardiac arrest differs significantly from the management of medical cardiac arrest, however the management is often lumped together. In this weeks Grand Rounds summary Dr. Nicholas Costain takes us through some controversies in the management of these difficult cases. Objectives: Review updated literature regarding indications toRead More →
Journal Club Summary Methodology: 3.5/5 Usefulness: 3/5 Peacock WF, et al. JAMA Cardiol. 2017 Dec 13 EDITORIAL: The Wait for High-Sensitivity Troponin Is Over-Proceed Cautiously Korley FK. JAMA Cardiol. 2017 Dec 13 Question and Methods: This prospective, observational, multicenter study evaluated if a negative hsTnt assay at 0h and 3h post EDRead More →
In this post, we take a deep dive into the ever-present issue of ED crowding, going beyond the basic input-throughput-output model and focusing on institutional and provincial strategies for managing patient flow and overcrowding. We will cover the following objectives: Going beyond input – throughput – output: Understanding ED crowdingRead More →
Methodology Score: 3.5/5 Usefulness Score: 3/5 Semler MW, et al. Chest. 2017 Oct;152(4):712-722. Editorial: Should the Ramped Position Be “Sniffed at” in the ICU? Scott JA, et al. Chest. 2017 Oct;152(4):693-694. Question and Methods: Multicenter, randomized, unblinded, trial of 260 ICU patients comparing the ramped vs sniffing position for intubations performed by criticalRead More →
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3.5/5 Cournoyer A, et al. Acad Emerg Med. 2017 Sep;24(9):1100-1109. Question and Methods: Retrospective observational cohort study to evaluate if the addition ACLS to BLS during EMS management for Out-of-Hospital cardiac arrest – OHCA (and for a predefined subgroup of potential ECMO candidates) improve ratesRead More →
Journal Club Summary Dewey M, et al. BMJ. 2016 Oct 24;355:i5441. Methodology: 2.5/5 Usefulness: 2.5/5 Question and Methods: Prospective single center RCT to determine whether patients with intermediate probability of CAD and atypical chest pain/angina should undergo cardiac CT or coronary angiography. Findings: The study found no difference in major procedural complications withinRead More →
Renal colic is an diagnostic entity emergency providers see almost every shift, often cited as the “worst pain imaginable”. Here, Dr. Landreville takes use through an evidence based update so that we can provide the best possible care to these patients. Introduction Suspected renal colic is a common complaint resultingRead More →
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 3.5/5 Question and Methods: This meta-analysis included prospective studies to assess the ability of a single negative hs-cTnT and non-ischemic ECG to identify patients at low risk for AMI. Findings: The results of 11 studies were pooled, resulting in a pooled sensitivityRead More →
A Code Silver represents the planned response for a person with a weapon within the hospital. The Ontario Hospital Association has recommended the addition of Code Silver to separate the response of a person who is actively killing from that of a hostage situation (previously both under Code Purple). ARead More →