Skip to main content

Top 5 Journal Club Articles In Emergency Medicine - 2015-2016 Academic year

Courtesy of klik internet
This is a post summarizing our best-rated JC articles and the ones I find are the most useful from the past academic year. Each of the articles is broken down into one to two lines as to how I have incorporated them in my practice. For a little longer summary just click on the links for the JC summaries.


1) Oral Prednisolone in the Treatment of Acute Gout: A Pragmatic, Multicenter, Double-Blind, Randomized Trial.

Rainer TH, et al. 
Ann Intern Med. 2016 Feb 23. doi: 10.7326/M14-2070.
47 yo male with stable CKD presenting with gout of his first MTP joint. I’m concerned about using colchicine or NSAIDs, instead I prescribe Prednisone 30mg/day for 5 days. 


2) Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Neumar RW, Shuster M, Callaway CW, et al.
Circulation. 2015 Nov 3;132(18 Suppl 2):S315-67

For all those unfortunate patients with in and out of hospital arrest. Too many changes to mention but there is a great summary from CanadiEM Summary of 2015 AHA Top 5 changes to guidelines on CPR .


3) Trial of Continuous or Interrupted Chest Compressions during CPR.

Nichol G, et al.
N Engl J Med. 2015 Dec 3;373(23):2203-14

For our of EMS colleagues in out of hospital arrest asynchronous positive-pressure ventilation does not make a difference compared to stopping compressions for ventilation.


4) Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial.

Appelboam A, Reuben A, Mann C, et al.
Lancet. 2015 Aug 24. pii: S0140-6736(15)61485-4.


32 yo with a heart rate of 200 bpm. I perform the modified Valsalva and have him out the door within 30 minutes of arrival. Everyone is happy (patient, me, nurses, admin)!


5) Randomized assessment of rapid endovascular treatment of ischemic stroke

Goyal M, Demchuk AM, Menon BK, et al.
N Engl J Med. 2015 Mar 12;372(11):1019-30


72 yo with acute ischemic stroke, in a proximal artery and there is a small infarct core I’m calling the stroke team to assess you for endovascular therapy.

Comments

Popular posts from this blog

Tips for Success in your Emergency Medicine Rotation

Our wonderful medical students are preparing to start their first clinical rotations. With this in mind here are some of the top tips for success in your EM rotation
1)Be On Time – show up to your shifts on time, better yet 5 minutes early.That first impression is immensely important.
2)Introduce yourself to the team - “Hi my name is John Doe, I am the medical student on shift today” introduce yourself to the attending, residents, nurses, etc.You will be called on a lot more to help when there is something interesting going on if they know your name.
3)Be goal-oriented – have a goal for each shift, whether it’s a procedure or a type of presentation to see.
4)Don’t just stand there, do something – whenever there is a trauma or code, come to the bedside.Get gowned up for traumas and pay attention.Help with things that are within your scope of practice: chest compressions, moving patient, cardioversion
5)Don’t just stand there, do nothing – there are times in medicine when the best thing to d…

2014 Canadian Guidelines for AF Management: Part 1: Introduction and CCS “CHADS-65” Algorithm

by Ian Stiell MD @EMO_Daddy














In this and subsequent postings we will discuss the latest recommendations for ED management of atrial fibrillation (AF) as presented in the newly published 2014 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation. The Guidelines PDF can be downloaded from the CCS website at 2014 Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation
The 2014 Focused Update uses the GRADE system of evidence evaluation as was the case in the comprehensive 2010 AF Guidelines and the 2012 Update. The CCS AF Guidelines Panel is comprised of Canadian cardiologists plus physicians from internal medicine, family medicine, neurology, and emergency medicine. This 2014 Update provides evidence review and recommendations for 8 aspects of AF care, including ED Management (written by myself and Dr. Laurent Macle of the Montreal Heart Institute). The 2014 Update focuses on advances in oral anticoagulant (O…

You CAN reverse that! Reversal of NOAC's and more..

We have seen a large surge of the utilization of New Oral Anticoagulants (NOAC's) in the past few years, as such, it has been a novel challenge when these patients present to the Emergency Department (ED) with life threatening bleeding. Dr. Michael Ho looks to discuss treatment options, and future options in these patients. 
NOACs vs WarfarinDabigatran, Rivaroxaban and Apixaban have seen a dramatic increase in use since their approval in Canada. Dabigatran is a direct thrombin (Factor II) inhibitor, while the latter two are direct Xa inhibitors. These drugs are collectively referred to as novel oral anticoagulants (NOACs). They have also been called direct, or target-specific oral anticoagulants (DOACs or TSOACs) [1]. 
The NOACs have many practical advantages over warfarin: Rapid onset of actionShorter half-lifeLess food and drug interferencePredictable pharmacokineticsEase of use and no requirement for monitoringThe downsides to NOACs are the higher cost to the patient, the inabilit…