In this journal club breakdown, we analyze an article examining the relationship between invasive arterial line blood pressure measurements and non-invasive cuff measurements.

Is the Cuff Enough?

In this most recent Journal Club recap podcast, Dr. Cole Davis covers a paper investigating the use of sterile vs clean gloves for laceration repair in the ED.

Sterile v NonSterile

Out of hospital cardiac arrest (OOHCA) represents a great cause of morbidity and mortality. Approximately 350,000 cardiac arrests occur in North America annually and 20% can be attributed to Ventricular tachydysrhythmias (i.e. ventricular tachycardia [v fib] and ventricular tachycardia [v tach]without a pulse). In this journal club recap, Dr Kelly Tillotson recaps an article comparing different ways of defibrillation and their effect on outcomes in OOHCA

Shock Differently - Out of Hospital Cardiac Arrest

In this journal club recap, Dr Sarah Moulds recaps a recent meta-analysis of papers looking at the therapeutic effect of TXA in patients with severe trauma.  Are their higher rates of thromboembolic complications? Is mortality improved? This article by Fouche et al attempts to answer these questions.

TXA in Severe Trauma - A Metanalysis

In patients with cirrhosis and ongoing bleeding, it can be challenging to determine whether or not patients are hyper or hypocoagulable. Traditional markers of coagulation status like INR can be difficult to interpret in patients with abnormal synthetic function and potentially increase consumption of coagulation factors.  Can TEG (thromboelastography) be a helpful too in these situations? In this journal club recap, Dr. Grisoli recaps a recent article by Rout et al that addresses this issue.

TEG for Cirrhotic Bleeding

Sepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well  as the rest of the world. Sepsis as a disease process has been difficult to both clearly define and quickly recognize. Many metrics for recognition and management of sepsis are dependent upon various scoring systems, including SIRS, SOFA, qSOFA, and MEWS, none of which were designed for the acute detection of sepsis within the emergency department. This journal club recap will look at an article by Knack et al looking at physician gestalt vs scoring systems for the detection of sepsis.

Sniffing out Sepsis - Vibes vs Scoring Systems?

097 RUF: A Fellow's Tale

There is a wide variation in practice, particularly in obtaining neuro-imaging in patients presenting with vertigo. Many patients are imaged and subjected to a longer length of stay, and on the other side of the coin, some patients with serious pathology fall through the cracks. The authors of this study set out to create a risk score to apply to patients who present to the ED with vertigo which would identify the patients at risk for serious pathology (which they defined as stroke, TIA, vertebral artery dissection, or brain tumor).

Is Your Head Spinning? The Sudbury Vertigo Risk Score

Current screening tools for pediatric septic shock and sepsis are highly specific but lack sensitivity. This study substituted age adjusted vital sign measures and a pediatric shock index into currently existing pediatric sepsis scoring systems to create the qPS4.When utilizing a cut off of ≧ 2 points, the qPS4 was highly sensitive and specific, and identified pediatric septic shock far sooner into a patient's course. 

Pediatric Septic Score

The sports medicine team visits the studio as we consider common knee injuries in student athletes. We explore the cause, diagnosis, management, and prevention of patellofemoral pain syndrome, Osgood-Schlatter disease, Sinding-Larsen-Johansson syndrome, meniscal tears, patellar dislocation, and your everyday sprains and strains. We hope you can join us!

Common Knee Injuries in Student Athletes - PediaCast CME 102

Drs Roopali Bapat and Berkeley Bennett visit the studio as we consider clinical pathways in pediatric medicine. How are pathways developed, implemented, evaluated, and updated? Where are they useful? What are their benefits… and pitfalls? Tune in to find out!

Clinical Pathways in Pediatric Medicine - PediaCast CME 103

Can a nitro slurry help with food bolus impaction? Glucagon and effervescent beverages have limited evidence for benefit.  Can an old drug used in a new way help these patients?

Oral Nitro for Food Bolus Impaction

We know that the d-dimer can be a helpful test for patients who have a low pre-test probability of pulmonary embolism. But can the test be pushed into use for higher risk patients? Will it still have useful negative predictive value or will we risk missing too many PEs?

Can D-dimer be Used and Useful in High Pre-Test Probability PE Patients?

Severe trauma is the leading cause of death worldwide for adults younger than 50 years of age. Acute traumatic life support (ATLS) guidelines endorse early and aggressive usage of supplemental oxygen in patients with severe trauma, at least until abnormalities of airway or breathing can be safely ruled out. However, unclear target concentration, duration or saturation goals often leads to hyperoxemia. Emerging studies in the intensive care unit (ICU) setting suggest that liberal supplemental oxygen therapy and hyperoxemia is associated with increased mortality. Limited evidence in the trauma population suggests similar outcomes.

Is Hyperoxemia in Trauma Bad?

Pediatrician and podcast pioneer. Answering questions, interviewing experts and explaining evidence since 2006. Join us wherever podcasts are found!

www.tamingthesru.com - Free. Open-Access. Focused on Emergency Medicine, critical care and prehospital medicine, as well as practice algorithms and decreasing knowledge translation in Med Ed.

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