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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.


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