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Emergency Medicine
Journal Watch condenses summaries of key research across specialties from more than 250 medical journals into concise yet comprehensive articles, incorporating clinical commentary from prominent physician-editors in the field.
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Featured Article
SUMMARY AND COMMENT
New and Established Troponin Assays Are Highly Sensitive and Specific for AMIFree
- January 20, 2012
- John A. Marx, MD, FAAEM
Use of either type of assay can safely exclude or confirm AMI within 3 hours of emergency department admission.
- Reviewing:
- Keller T et al. JAMA 2011 Dec 28; 306:2684
Recent Emergency Medicine Articles
SUMMARY AND COMMENT
Helium-Oxygen Therapy Improves Bronchiolitis Scores in Infants Receiving Nebulized Epinephrine
- January 20, 2012
- Katherine Bakes, MD
Improvement was noted on each of two validated severity scores.
- Reviewing:
- Kim IK et al. Arch Pediatr Adolesc Med 2011 Dec; 165:1115
SUMMARY AND COMMENT
GlideScope Provides Better Glottic Views Than Direct Laryngoscopy
- January 20, 2012
- Cheryl Lynn Horton, MD, and Ron M. Walls, MD, FRCPC, FAAEM
In this meta-analysis, the GlideScope also was associated with faster intubation times and higher first-attempt success rates among nonexpert operators.
- Reviewing:
- Griesdale DEG et al. Can J Anaesth 2012 Jan; 59:41
SUMMARY AND COMMENT
Airtraq Outperforms Other Devices for Face-to-Face Intubation
- January 20, 2012
- Cheryl Lynn Horton, MD, and Ron M. Walls, MD, FRCPC, FAAEM
In a manikin study, the Airtraq laryngoscope was faster, more successful, and easier to use than the GlideScope or LMA Fastrach for face-to-face intubation.
- Reviewing:
- Amathieu R et al. Br J Anaesth 2012 Jan; 108:140
SUMMARY AND COMMENT
Inappropriate Ventilation in Intubated Prehospital Patients on Arrival at the ED
- January 20, 2012
- Kristi L. Koenig, MD, FACEP
In a study at a single emergency department, end-tidal CO2 values revealed inappropriate ventilation in nearly half the patients.
- Reviewing:
- Holmes J et al. Prehosp Emerg Care 2012 Jan 4
SUMMARY AND COMMENT
QTc Intervals in Youth Are Often Shorter at Follow-Up Than in the ED
- January 20, 2012
- Katherine Bakes, MD
But this study's methodology was so weak that we can't draw any meaningful interpretation.
- Reviewing:
- Van Dorn CS et al. Pediatrics 2011 Dec; 128:e1395
SUMMARY AND COMMENT
Corticosteroids Impart No Benefit After Single-Dose Etomidate for IntubationFree
- January 13, 2012
- Kristi L. Koenig, MD, FACEP
Moderate-dose hydrocortisone infusion did not affect outcomes in intubated patients without septic shock who had etomidate-related adrenal insufficiency.
- Reviewing:
- Payen JF et al. Crit Care Med 2012 Jan; 40:29
SUMMARY AND COMMENT
Nebulized Naloxone Is Safe and Effective for Management of Opioid Overdose
- January 13, 2012
- Kristi L. Koenig, MD, FACEP
But some patients will still require injected naloxone.
- Reviewing:
- Weber JM et al. Prehosp Emerg Care 2011 Dec 22
SUMMARY AND COMMENT
Intubation Requires Less Force with GlideScope Than with the Macintosh Laryngoscope
- January 13, 2012
- Cheryl Lynn Horton, MD, and Ron M. Walls, MD, FRCPC, FAAEM
In a manikin study of normal and difficult airways, higher forces were applied with the Macintosh laryngoscope, particularly for difficult airways.
- Reviewing:
- Carassiti M et al. Br J Anaesth 2012 Jan; 108:146
SUMMARY AND COMMENT
Propofol Saves Time for Orthopedic Procedures
- January 13, 2012
- Kristi L. Koenig, MD, FACEP
And, it is as effective as midazolam/ketamine for procedural sedation in adults.
- Reviewing:
- Uri O et al. J Bone Joint Surg Am 2011 Dec 21; 93:2255
SUMMARY AND COMMENT
TIA Clinics Might Be More Cost-Effective Than Hospitalization
- January 13, 2012
- Richard D. Zane, MD, FAAEM
However, developing such clinics for patients with transient ischemic attacks might not be feasible.
- Reviewing:
- Joshi JK et al. Neurology 2011 Dec 13; 77:2082
Editor's Picks from across Journal Watch
SUMMARY AND COMMENT
Complications from Rebleeding in Aneurysmal Subarachnoid Hemorrhage
- January 10, 2012
- By Alejandro A. Rabinstein, MD
- Neurology
After SAH, rebleeding increases mortality and the risk for cerebral and systemic complications but does not change the course or severity of delayed cerebral ischemia.
- Reviewing:
- Neurology 2012 Jan 3; 78:31
SUMMARY AND COMMENT
A Single-Sampling Blood Culture Strategy?
- January 4, 2012
- By Thomas Glück, MD
- Infectious Diseases
An uncommon approach involving six bottles drawn during a single venipuncture, together with pathogen-specific interpretation, showed high positive predictive values for major pathogens.
- Reviewing:
- Eur J Clin Microbiol Infect Dis 2011 Dec; 30:1537
SUMMARY AND COMMENT
Another Perspective on SepsisFree
- January 4, 2012
- By Richard T. Ellison III, MD
- Infectious Diseases
Postmortem studies of patients who died of sepsis show evidence of profound immunosuppression.
- Reviewing:
- JAMA 2011 Dec 21; 306:2594
SUMMARY AND COMMENT
Even Subclinical AF Is Associated with Stroke
- January 18, 2012
- By Mark S. Link, MD
- Cardiology
In patients with pacemakers, asymptomatic AF is common and warrants increased vigilance.
- Reviewing:
- N Engl J Med 2012 Jan 12; 366:120
Journal Watch Emergency Medicine summarizes important medical journal articles about a wide variety of subjects relevant to the practice of emergency medicine including acute coronary syndrome, airway management, asthma, cardiac arrest, chest pain, endotracheal intubation, head trauma, pulmonary embolism, sedation, and stroke.
