Prospective validation of the ABCD2 score for patients in the emergency department with transient ischemic attack

  Journal Club Summary Landmark Series Methodology Score: 4/5                       Usefulness Score: 4/5    Perry JJ, Sharma M, Sivilotti ML, Sutherland J, Symington C, Worster A, Émond M, Stotts G, Jin AY, Oczkowski WJ, Sahlas DJ, Murray HE, MacKey A, Verreault S, Wells GA, Stiell IG. CMAJ. 2011 Jul 12;183(10):1137-45. Article Link   This prospective validation of the ABCD2 clinical decision […]

Apneic oxygenation during prolonged laryngoscopy in obese patients: a randomized, controlled trial of nasal oxygen administration

Journal Club Summary  Methodology: 3.5/5                  Usefulness: 4/5   Ramachandran SK, Cosnowski A, Shanks A, Turner CR. J Clin Anesth. 2010 May;22(3):164-8. PubMed Link   This RCT of 30 obese adult male patients receiving either 5L of O2 via NP or no O2 during simulated difficult intubation prior to elective surgery found the time to desaturation below an SpO2 of 95% as […]

One-Hour Rule-out and Rule-in of Acute Myocardial Infarction Using High-Sensitivity Cardiac Troponin T.

Journal Club Summary Methodology: 2.5/5                    Usefulness:    3.5/5 Reichlin T, Schindler C, Drexler B, et al. Arch Intern Med. 2012 Sep 10;172(16):1211-8. Abstract Link   This study was a prospective, multicenter derivation and internal validation of a rapid AMI rule-in and rule-out algorithm that involved 872 patients using high-sensitivity cardiac troponin T (hsctnT). The rule-out identified 60% of patients with acute MI […]

Emergency Cricothyroidotomy: A Randomized Crossover Trial Comparing Percutaneous Techniques: Classic Needle First Versus “Incision First”

Journal Club Summary  Methodology Score: 3/5                       Usefulness Score: 2/5 Kanji H, Thirsk W, Dong S, Szava-Kovats M, Villa-Roel C, Singh M, Rowe BH. Acad Emerg Med. 2012 Sep;19(9):E1061-E1067.   Article Link   This was a randomized crossover trial comparing needle (seldinger) Cricothyroidotomy (NF) with a new technique that utilizes the initial surgical vertical incision to find the cricothyroid membrane before […]

Accuracy of single-pass whole-body computed tomography for detection of injuries in patients with major blunt trauma

Journal Club Summary  Methodology: 3/5                       Usefulness: 3/5   Stengel D, Ottersbach C, Matthes G, Weigeldt M, Grundei S, Rademacher G, Tittel A, Mutze S, Ekkernkamp A, Frank M, Schmucker U, Seifert J. CMAJ. 2012 May 15;184(8):869-76. Article Link   In this study by Stengel et al., the initial pan-scan findings of 1000 consecutive blunt trauma patients were evaluated and compared […]

Dopamine versus norepinephrine in the treatment of septic shock: a meta-analysis

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 4/5 De Backer D, Aldecoa C, Njimi H, Vincent JL. Crit Care Med. 2012 Mar;40(3):725-30. Article Link This meta-analysis of 6 trials found that in patients with septic shock, dopamine administration was associated with greater mortality (RR 1.12, 95% CI 1.01-1.20; P=0.035) and a higher incidence of arrhythmic events (RR 2.34) compared to […]

Electrocardiographic differentiation of early repolarization from subtle anterior ST-segment elevation myocardial infarction

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Smith SW, Khalil A, Henry TD, Rosas M, Chang RJ, Heller K, Scharrer E, Ghorashi M, Pearce LA. Ann Emerg Med. 2012 Jul;60(1):45-56.e2. Epub 2012 Apr 19. Pub Med Link   This retrospective cohort study of anterior STEMI and Benign Early Repolarization (BER) patients derived and validated a mathematical combination of 3 ECG criteria (R-wave […]

Performance of 4 clinical decision rules in the diagnostic management of acute pulmonary embolism: a prospective cohort study

Journal Club Summary  Methodology Score: 3/5  Usefulness Score: 3/5 Douma RA, Mos IC, et al. Prometheus Study Group. Article Link This European study directly compared four clinical decision rules in combination with d-dimer testing to exclude PE without the need for CT and found similar performance with very high sensitivity for all four; the authors concluded that simplified Wells or […]

Association Between helicopter vs Ground Emergency Medical Services and Survival for Adult with Major Trauma

  Journal Club Summary Methodology Score: 3/5           Usefulness Score: 2.5/5   Galvagno SM Jr, Haut ER, Zafar SN, Millin MG, Efron DT, Koenig GJ Jr, Baker SP, Bowman SM, Pronovost PJ, Haider AH. JAMA 2012 Apr 18;307(15):1602-10. Article Link   This retrospective cohort study of 223,475 patients in the U.S. National Trauma Data Bank used multivariate statistical analyses including propensity scoring […]

The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis.

Journal Club Summary Landmark Series Quant EC, et. al 2009;339:b3354. Methods: 4/5  Usefulness: 4/5  Article Link This high quality meta-analysis demonstrated that the addition of antivirals to steroids did not result in any additional benefit in achieving at least partial facial muscle recovery for Bell’s palsy when compared to steroids alone. JC attendees noted that these conclusions were in contrast to […]