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In: Chronic Pain, Journal Club

Methodology: 2/5 Usefulness: 2.5 /5 Lumanauw DD, et al. Acad Emerg Med. 2019 Sep;26(9):1044-1051. doi: 10.1111/acem.13755. Epub 2019 Apr 29. Question and Methods: A randomized placebo-controlled trial to determine if sub-dissociative dose Ketamine (SDDK) is effective for treating acute exacerbations of chronic Pain in the emergency department. Findings: Ketamine infusions atRead More →

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In: Infectious Disease, Journal Club, Respirology

Methodology: 4/5 Usefulness: 2/5 Alexander E., et al. JAMA. 2019 Sep 27. doi: 10.1001/jama.2019.15468. Editorial: Lefamulin-A New Antibiotic for Community-Acquired Pneumonia. Question and Methods: LEAP-2 was a phase 3, double-blinded RCT to determine non-inferiority of early clinical response of an oral lefamulin to oral moxifloxacin in Community Acquired Bacterial Pneumonia (CABP). Findings: Early clinical response rates were 90.8%Read More →

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In: Journal Club, Thrombosis

Methodology Score: 4/5 Usefulness Score: 4.5/5 Kearon C, et al. N Engl J Med. 2019 Nov 28;381(22):2125-2134 Question and Methods: the authors sought to demonstrate safety using a d-dimer cut-off of 1000ng/mL for low pre-test probability patients & a cut-off of 500ng/mL for moderate pre-test probability patients. Findings: Of 1325Read More →

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In: Full Article, Journal Club, Trauma

Methodology: 4/5 Usefulness: 2/5 Sims CA, et al. JAMA Surg. 2019 Aug 28. Question and Methods: Single-centre, double-blind, randomized control trial to determine whether low-dose vasopressin decreases the need for blood product transfusion in trauma patients with hemorrhagic shock. Findings: A total of 100 adult trauma patients were enrolled. VasopressinRead More →

RAFF2

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In: Cardiology, Featured, Infographics, Journal Club

RAFF2 Ian Stiell and colleagues are back at it with atrial fibrillation; The RAFF2 trial (Electrical versus Chemical cardioversion for Emergency Department patients with Atrial Fibrillation (RAFF2); A partial factorial randomized trial) was published in The Lancet this week. Acute atrial fibrillation is an irregular dysrhythmia that should be treatedRead More →

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In: Full Article, Journal Club, Neurology, Pediatrics

Methodology: 4/5 Usefulness: 4/5 Lyttle MD, et al. Lancet. 2019 May 25;393(10186):2125-2134. Question and Methods: Eclipse was an open label RCT that evaluated time to seizure cessation in pediatric SE between Keppra and Dilantin Findings: They found that Keppra was not superior (HR 1.2, 95%CI 0.91-1.60, p= 0.20) to DilantinRead More →

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In: Full Article, Journal Club, Neurosurgery, Resuscitation, Trauma

Methodology Score: 3/5 Usefulness Score: 3/5 Cooper DJ, et al. JAMA. 2018;320(21):2211-2220. doi:10.1001/jama.2018.17075 Question/Methods: This study was done to determine the effectiveness of early prophylactic hypothermia compared with normothermic management of patients after severe traumatic brain injury (TBI). Findings:  No statistically significant difference in favorable neurologic outcomes at 6 months wasRead More →

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In: Journal Club, Orthopedics, Orthopedics, Trauma

Methodology: 4/5 Usefulness: 3.5/5 Kortekangas T, et al. BMJ. 2019 Jan 23;364:k5432 Question and Methods: This is a pragmatic, randomized, controlled trial to determine if 3 weeks of immobilization (in cast or orthosis) is non-inferior to usual treatment (6 weeks cast immobilization) for stable Weber B ankle fractures Findings: ImmobilizationRead More →

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In: ENT, Journal Club

Methodology Score: 2.5/5 Usefulness Score: 2.5/5 Akkan S, et al. Ann Emerg Med. 2019 Jul;74(1):72-78 Question and Methods: Prospective RCT comparing compression with saline, compression with tranexamic acid, and nasal packing with merocel for anterior epistaxis. Findings: No difference in 15-minute bleeding cessation for TXA (91.1%) or packing (93.3%), v/s saline (71.1%).  Lower 24hRead More →