Nebulized hypertonic saline for bronchiolitis in the emergency department: a randomized clinical trial

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2.5/5   Florin TA, Shaw KN, Kittick M, Yakscoe S, Zorc JJ. JAMA Pediatr. 2014Jul;168(7):664-70. Full Article   This single-centre triple-blinded study compared nebulized 3% saline (hypertonic) to 0.9% (normal) saline in infants with bronchiolitis and found infants treated with a single dose of hypertonic saline had less improvement than those receiving […]

Prehospital ticagrelor in ST-segment elevation myocardial infarction

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3/5   Montalescot G, van ‘t Hof AW, Lapostolle F, et al. for the ATLANTIC Investigators. N Engl J Med. 2014 Sep 11;371(11):1016-27. Full Article   This corporate-sponsored international, multicenter, RCT randomized 1,862 STEMI patients to receive ticagrelor prehospital vs in-hospital and found no difference in outcomes (70% or greater reduction of […]

Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings

Journal Club Summary Methodology Score: 3.5/5                 Usefulness Score: 4/5   Orr SL, et al. Cephalalgia. 2014 May 29. http://www.ncbi.nlm.nih.gov/pubmed/24875925   This Canadian Headache Society guideline for ED management of acute migraine gave a strong recommendation for 5 treatments: ketorolac, metoclopramide, sumatriptan (if presenting within 2 hours), prochlorperazine and lysine-ASA (the latter 2 are unavailable in Canada). Despite some concerns about lack of […]

Epi Lessons – Part 5 – PROGNOSIS AND OTHER ARTICLES

As part of our Journal Club summaries our JC Chairs (Drs. Lisa Calder and Ian Stiell @EMO_Daddy) have been tasked with explaining Epidemiological concepts so that everyone in our department can analyze the literature and appraise articles on their own. For this Blog post we have all the “Epi Lesson” as they relate to “Prognosis and Miscellaneous Articles”. That completes our 5 part series […]

Effect of Provider Experience on Clinician-Performed Ultrasonography for Hydronephrosis in Patients With Suspected Renal Colic

Journal Club Summary Methodology Score: 3/5                    Usefulness Score: 3.5/5   Herbst MK, Rosenberg G, Daniels B, Gross CP, Singh D, Molinaro AM, Luty S, Moore CL. Ann Emerg Med. 2014 Sep;64(3):269-76. Abstract Link   This prospective study of ED patients undergoing CT scan for renal colic found that bedside ultrasound performed by the emergency provider had excellent test characteristics for diagnosing hydronephrosis […]

Epi Lessons – Part 4 – DECISION RULE ARTICLES

As part of our Journal Club summaries our JC Chairs (Drs. Lisa Calder and Ian Stiell @EMO_Daddy) have been tasked with explaining Epidemiological concepts so that everyone in our department can analyze the literature and appraise articles on their own. For this Blog post we have all the “Epi Lessons” as they relate to “Decision Rules Articles”. More to follow in the coming weeks. […]

Ondansetron compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial.

Journal Club Summary Methodology Score: 3/5                    Usefulness Score: 2/5   Abas MN, Tan PC, Azmi N, Omar SZ. Obstet Gynecol. 2014 Jun;123(6):1272-9. Abstract Link    This small RCT found that ondansetron was not superior in efficacy to metaclopramide for patients with hyperemesis gravidarum. Although ondansetron seemed better tolerated by patients, the clinical significance of the documented adverse effects of metoclopramide were questioned by […]

Epi Lessons – Part 3 – OVERVIEW ARTICLES

As part of our Journal Club summaries our JC Chairs (Drs. Lisa Calder and Ian Stiell @EMO_Daddy) have been tasked with explaining Epidemiological concepts so that everyone in our department can analyze the literature and appraise articles on their own. For this Blog post we have all the “Epi Lesson” as they relate to “Overview Articles”. More to follow in the coming weeks. Clinical […]

Epi Lessons – Part 2 – THERAPY ARTICLES

As part of our Journal Club summaries our JC Chairs (Drs. Lisa Calder and Ian Stiell @EMO_Daddy) have been tasked with explaining Epidemiological concepts so that everyone in our department can analyze the literature and appraise articles on their own. For this Blog post we have all the “Epi Lesson” as they relate to “Therapy Articles”. More to follow in the coming weeks. Absolute […]

Effect of Prehospital Induction of Mild Hypothermia on Survival and Neurological Status Among Adults With Cardiac Arrest A Randomized Clinical Trial

Journal Club Summary Methodology Score: 3/5                    Usefulness Score: 2/5   Kim F, et al. JAMA. 2014 Jan 1;311(1):45-52. Full Article   Editorial: Randomized Clinical Trial Progress to Inform Care for Out-of-Hospital Cardiac Arrest Granger CB, Becker LB JAMA. 2014;311(1):31-32   Article Link   This randomized clinical trial found that early pre-hospital cooling with 2 litres of IV Normal Saline at 4 degrees […]