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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
Normal White Blood Cell Count Does Not Rule Out BacteremiaFree
- May 11, 2012
- Daniel J. Pallin, MD, MPH
Of 289 patients with bacteremia, 52% had normal WBC count and 17% had neither WBC elevation nor fever.
- Reviewing:
- Seigel TA et al. J Emerg Med 2012 Mar; 42:254
Recent Emergency Medicine Articles
SUMMARY AND COMMENT
Antibiotics Are Overprescribed for Acute Bronchitis
- May 11, 2012
- Daniel J. Pallin, MD, MPH
Antibiotics were prescribed to too many patients and bronchodilators to too few at two emergency departments in San Diego.
- Reviewing:
- Kroening-Roche JC et al. J Emerg Med 2012 Feb 16
SUMMARY AND COMMENT
Testing for and Treating Influenza
- May 11, 2012
- J. Stephen Bohan, MD, MS, FACP, FACEP
Positive rapid influenza test results are helpful, negative results are not; antiviral treatments have modest effects.
- Reviewing:
- Hsu J et al. Ann Intern Med 2012 Apr 3; 156:512
SUMMARY AND COMMENT
Thrombolysis in the Prehospital Setting for Acute Stroke
- May 11, 2012
- Kristi L. Koenig, MD, FACEP
In a small urban study, use of a mobile stroke unit reduced time to thrombolysis but did not affect outcomes.
- Reviewing:
- Walter S et al. Lancet Neurol 2012 May; 11:397
SUMMARY AND COMMENT
Treatment Initiation by Physicians Improves Process Measures
- May 11, 2012
- Daniel J. Pallin, MD, MPH
Although time to disposition decreased minimally, time to other interventions decreased substantially.
- Reviewing:
- Soremekun OA et al. J Emerg Med 2012 Mar 23
SUMMARY AND COMMENT
Placing Art in the Waiting Room Mellows Patients and Visitors
- May 11, 2012
- Daniel J. Pallin, MD, MPH
A simple study shows that installing images of nature in the waiting room can reduce restless behavior.
- Reviewing:
- Nanda U et al. J Emerg Med 2012 Feb 9
SUMMARY AND COMMENT
Low-Risk Chest Pain Patients Can Be Monitored and Discharged Without Provocative TestingFree
- May 4, 2012
- Daniel J. Pallin, MD, MPH
This single-center study suggests that deferring provocative testing to the outpatient setting is safe.
- Reviewing:
- Scheuermeyer FX et al. Ann Emerg Med 2012 Apr; 59:256
SUMMARY AND COMMENT
Mild Therapeutic Hypothermia May Benefit Patients in Cardiogenic Shock
- May 4, 2012
- Kristi L. Koenig, MD, FACEP
Mild hypothermia reduced need for vasopressors and inotropes in patients with cardiogenic shock after out-of-hospital cardiac arrest.
- Reviewing:
- Zobel C et al. Crit Care Med 2012 Apr 6; 40:1
SUMMARY AND COMMENT
Eradication of Staphylococcus aureus Colonization Is Effective in Only Half of Cases
- May 4, 2012
- Diane M. Birnbaumer, MD, FACEP
But a larger reduction in subsequent skin and soft-tissue infections was seen when the entire household was treated.
- Reviewing:
- Fritz SA et al. Clin Infect Dis 2012 Mar 15; 54:743
SUMMARY AND COMMENT
New Decision Rule for Syncope Safely Reduces Hospitalizations
- May 4, 2012
- Daniel J. Pallin, MD, MPH
At a single emergency department, implementation of the Boston Syncope Criteria reduced admissions by 11% and identified all patients with adverse outcomes.
- Reviewing:
- Grossman SA et al. J Emerg Med 2012 Mar; 42:345
SUMMARY AND COMMENT
Ground vs. Air Transport for Severely Injured Patients
- April 27, 2012
- J. Stephen Bohan, MD, MS, FACP, FACEP
Helicopter transport is associated with a small but real benefit, but it comes at a high cost.
- Reviewing:
- Galvagno SM Jr et al. JAMA 2012 Apr 18; 307:1602
Editor's Picks from across Journal Watch
SUMMARY AND COMMENT
Epidural Steroids, Etanercept, or Saline Injections for Subacute Sciatica?
- May 8, 2012
- By Jamaluddin Moloo, MD, MPH
- General Medicine
No significant benefit was found for drug treatment relative to saline.
- Reviewing:
- Ann Intern Med 2012 Apr 17; 156:551
SUMMARY AND COMMENT
What's the Incidence of Venous Thromboembolism After Knee Arthroscopy?
- April 24, 2012
- By Allan S. Brett, MD
- General Medicine
Incidence was 0.40% in this large cohort study.
- Reviewing:
- J Bone Joint Surg Am 2012 Apr 18; 94:714
SUMMARY AND COMMENT
Anticoagulation for Pregnant Women with Mechanical Prosthetic Heart Valves
- April 19, 2012
- By Kirsten E. Fleischmann, MD, MPH
- Women's Health
Encouraging results with low-dose warfarin throughout pregnancy, but the approach must be validated.
- Reviewing:
- J Am Coll Cardiol 2012 Mar 20; 59:1110
SUMMARY AND COMMENT
Infective Endocarditis Involving Implantable Cardiac DevicesFree
- April 25, 2012
- By Larry M. Baddour, MD
- Infectious Diseases
Both in-hospital and 1-year mortality rates were high in this multinational survey.
- Reviewing:
- JAMA 2012 Apr 25; 307:1727
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.
