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 →
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 →
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 →
There are a few specific arrhythmias that we encounter often in the ED that deserve a little bit more thought. Dr. Matthew Lipinski takes us through a few updates in the area beyond the routine basics. For other Grand Rounds Summaries please see our archives. Chronic Bundle Branch Block andRead More →
Journal Club Summary Hofmann R, et al. N Engl J Med. 2017 Sep 28;377(13):1240-1249. Methodology Score: 4/5 Usefulness Score: 4/5 Question and Methods: This large, registry-based RCT evaluated the effect of oxygen on patient-centered clinical outcomes for normoxic MI patients. Findings: There were no differences at 365 days or 30Read More →
For other ultrasound focused cases please see our Ultrasound Archives. A woman in her 60’s presents to the emergency department on her 7th post-operative day feeling nauseous, vomiting, weak and dizzy. She has just recently underwent a open left hemi-colectomy, end-colostomy formation for recurrent diverticulitis. . Her past medical historyRead More →
Journal Club Summary Reference: Kirkegaard H, et al. JAMA. 2017 Jul 25;318(4):341-350 EDITORIAL: Targeted Temperature Management After Cardiac Arrest: Finding the Right Dose for Critical Care Interventions. Callaway CW. JAMA. 2017 Jul 25;318(4):334-336. Methodology Score: 3.5/5 Usefulness Score: 2/5 Question and Methods: This pragmatic, multicenter, randomized superiority trial examined whether TTM at 33CRead More →
Many aspects of cardiac arrest care are likely to change in the not-so-distant future. Let’s take a system-level view of cardiac arrest care and see what we can do to conservatively start to move in the direction of more regionalized care. We’ll also take a further evidence based look atRead More →
In order to help evaluate patients who present with chest pain many clinical chest pain scores have been developed. The aim of this post is to: Emergency Department (ED) physicians must assess and risk stratify patients presenting with chest pain nearly every shift. As we all know, acute ischemic coronary syndromeRead More →