These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday’s Spoon Feed:

Combined elevation in two blood biomarkers (GFAP and UCH-L1) showed high sensitivity and negative predictive value (NPV) for positive findings on head CT in anticoagulated patients with mild traumatic brain injury but were not helpful at identifying who would develop post-concussive syndrome.

Thursday’s Spoon Feed:

In this randomized controlled trial, adding 1 liter of IV normal saline to intramuscular diclofenac for acute migraine in the ED did not significantly improve pain relief at 2 hours compared with diclofenac alone.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

Patients presenting with anginal symptoms and a new right bundle branch block (RBBB) on ECG or RBBB-specific high-risk features should prompt emergent evaluation for reperfusion therapy.

Thursday’s Spoon Feed:

Meningococcal disease is a rapidly progressive infection associated with high mortality that often begins with nonspecific symptoms; early recognition, early antibiotics, and aggressive resuscitation are critical to improving outcomes.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

Using Wells-based pretest probability with an age-adjusted D-dimer safely ruled out lower-extremity DVT in ED outpatients with zero 3-month VTE events among patients between the conventional and age-adjusted cutoffs.

Friday’s Spoon Feed:

This evidence-based expert position statement on necrotizing soft tissue infections (NSTIs) provides best practices for assessment, diagnosis, treatment, antimicrobials, adjunctive therapies, and long term management.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday’s Spoon Feed:

When eye exam is limited by trauma, we rely on orbital CT. While specificity is 94%, sensitivity is only 75% for open globe injuries (OGI), making surgical consultation necessary when suspicion remains.

Friday’s Spoon Feed:

This retrospective, propensity-matched study of adult and pediatric patients with severe asthma confirms what we already know clinically: non-invasive positive pressure ventilation (NIPPV) decreases mortality and need for intubation.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday’s Spoon Feed:

A simple 4-factor clinical decision rule accurately distinguished true bacteremia from contaminants in children with positive blood cultures, achieving 99% sensitivity while potentially reducing unnecessary hospitalizations.

Friday’s Spoon Feed:

Point-of-care ultrasound (POCUS) is a powerful adjunct during cardiac arrest that can identify reversible causes, improve pulse checks, optimize chest compressions, and aid prognostication—as long as it does not interrupt high-quality CPR. When utilized correctly, POCUS may meaningfully guide resuscitation without prolonging pauses.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

The modified Valsalva maneuver is the most effective first-line vagal maneuver for stable supraventricular tachycardia, achieving higher conversion rates and reducing the need for intravenous antiarrhythmics without increasing adverse events.

Wednesday’s Spoon Feed:

Approaches to repeat CT scans in traumatic brain injuries (TBIs) are highly variable. This study recommends a risk-stratified approach based upon injury severity, patients’ clinical factors, and timing of initial CT.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday’s Spoon Feed:

In the prehospital setting, universal application of pelvic circumferential compression devices (PCCDs) with suspected pelvic injuries could lead to adverse iatrogenic effects which are further compounded by improper diagnosis and thus misapplication, poor technique when deployed, and a false sense of security, which could lead to bias in recognizing other fatal causes of shock and bleeding.

Friday’s Spoon Feed:

Pigtail catheters had a similar safety profile and rates of catheter failures compared to chest tubes for treatment of hemodynamically stable children with hemothorax or hemopneumothorax.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

This retrospective cohort study found no 24-hour mortality difference when intubating hyperkalemic patients (K > 5.5mmol/L) with succinylcholine versus rocuronium for RSI.

Wednesday’s Spoon Feed:

In a large international cohort of well-appearing febrile infants ≤28 days old, the updated PECARN rule had high sensitivity and negative predictive value for invasive bacterial infection, with no missed cases of bacterial meningitis, supporting selective avoidance of routine lumbar puncture in low-risk neonates.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday’s Spoon Feed:

Older adults discharged from the ED with delirium had almost 3 times the risk of 30-day mortality compared to those discharged without delirium.

Friday’s Spoon Feed:

This RCT of 100 patients with intermediate-high risk PE showed that mechanical thrombectomy plus anticoagulation was superior to anticoagulation alone in reducing RV/LV ratio and earlier normalization of vitals.

Monday’s Spoon Feed:

Implementing Spanish-language discharge instruction videos, interpreter-needed EMR icons, and standardized communication processes in a pediatric ED eliminated a 10% communication equity gap between Spanish- and English-speaking families without increasing length of stay or ED return visits.

Tuesday’s Spoon Feed:

Similar to prior research on the topic, prehospital endotracheal intubation (ETI) is more successful with both sedative and paralytic than with no medications or sedative alone.

Wednesday’s Spoon Feed:

The updated AHA and AAP guidelines on neonatal life support provide the most current, evidence-based recommendations for recognizing and managing newborns who require resuscitation, a time-critical responsibility that has a major impact on survival and neurodevelopmental outcomes.

Thursday’s Spoon Feed:

Here are the top ten most viewed JournalFeed posts in 2025 (from our Google Analytics data). I've dropped a comment on how each article has impacted me this year. Enjoy!

Friday’s Spoon Feed:

Bag valve mask (BVM) ventilations provided by Basic Life Support (BLS) teams during 30:2 cardiopulmonary resuscitation (CPR) in out of hospital cardiac arrest (OHCA) frequently fell well short of the guideline goals for expiratory tidal volume (Vte).

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

Phenobarbital administration for alcohol withdrawal was associated with lower admission rates, shorter ED length of stay (LOS), and fewer IV medication administrations when compared to benzodiazepines.

Friday’s Spoon Feed:

Here's the brief on how to diagnose and treat cyanotic congenital heart disease.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

There was no difference in 28-day mortality in critically ill adult patients with ketamine vs. etomidate for rapid sequence induction (RSI), but ketamine increased the need for peri-intubation vasopressor support.

Tuesday’s Spoon Feed:

The 2025 executive summary shows new developments in the AHA guidelines, integrating science, systems, and education with a unified Chain of Survival across the entire cardiac arrest continuum so that communities can prioritize which changes matter most for their patients, from lay rescuer response to prehospital care to the ED and beyond.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

Personalized hemodynamic resuscitation targeting capillary refill time (PHR-CRT) over a 6 hour intervention period demonstrated less need for organ support in patients with septic shock at 28 days.

Wednesday’s Spoon Feed:

The EVERDAC trial found delayed invasive blood-pressure monitoring is noninferior to early arterial catheterization in patients with shock in terms of 28-day mortality.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday’s Spoon Feed:

When EMS is not immediately available, transporting adult patients with penetrating injuries in urban settings to trauma centers by police or private vehicle leads to improved survival.

Thursday’s Spoon Feed:

Patients with delayed presentation, 4.5 to 24 hours after onset of ischemic stroke, still had significant benefit from tenecteplase (TNK): NNT = 17, NNH = 72.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday’s Spoon Feed:

Younger age and longer tenure at a site increased patients-per-hour (PPH) without increasing 72-hour returns.

Wednesday’s Spoon Feed:

Of 138 infants evaluated with excessive crying, none had facial petechiae. Unexplained petechiae warrant further evaluation for trauma or abuse.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday’s Spoon Feed:

Among children with severe acute malnutrition and gastroenteritis in Africa, IV rehydration was just as safe and effective as oral rehydration, with no increase in mortality or evidence of fluid overload - challenging long-standing WHO guidance to avoid IV fluids in this population.

Friday’s Spoon Feed:

This nationwide database study found that defibrillation within 2 minutes of starting CPR was associated with increased 1 month survival in out of hospital cardiac arrest (OHCA) patients.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday’s Spoon Feed:

After 48 hours of brain rest, moderate recreational screen time may support better psychological recovery post-concussion compared to restrictive or excessive use.

Friday’s Spoon Feed:

Presyncope has a 30-day serious cardiac outcome risk that is identical to patients with true syncope—despite presyncope patients being admitted less often and considered lower risk.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday’s Spoon Feed:

The Safeback SBX device can improve survival in an avalanche, but does not replace the need for appropriate education and knowledge regarding avalanche safety.

Friday’s Spoon Feed:

For anaphylaxis in adults ≥50kg, 0.5mg vs. 0.3mg IM epinephrine is strongly associated with a reduction in escalation of care (repeat epi, epi drip, or intubation).

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

Early fluid resuscitation in sepsis shows a U-shaped relationship between fluid amount and mortality; 30 mL/kg within 3 hours improves survival, supporting current Surviving Sepsis Campaign guidance.

Friday’s Spoon Feed:

Azelastine nasal spray used three times daily for 56 days significantly reduced PCR-confirmed SARS-CoV-2 infections versus placebo.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

Prehospital tranexamic acid (TXA) administration within 3 hours may improve mortality risk in adult trauma patients with hemorrhagic shock and has minimal side effects.

Tuesday’s Spoon Feed:

In patients with an implantable cardioverter-defibrillator (ICD) at risk for ventricular arrhythmias, keeping potassium in the high-normal range (4.5-5.0 mmol/L) reduced shocks, arrhythmia hospitalizations, and deaths, without added harm.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

This secondary analysis found that intubation success correlated with experience, and competency likely is achieved between 35-50 intubations.

Friday’s Spoon Feed:

This summarizes data supporting use of venous blood gas (VBG) screening for hypercarbic respiratory failure and avoiding an arterial blood gas (ABG).

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

Use of resuscitative endovascular balloon occlusion of the aorta (REBOA) increased the odds of mortality in severely injured adult trauma patients with isolated thoracic or abdominal injuries.

Friday’s Spoon Feed:

A transfusion trigger of less than 10g/dL appears to lower 30-day mortality in patients with acute myocardial infarction (AMI).

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday’s Spoon Feed:

Dexamethasone is associated with improved pain control within 60 minutes as an adjunct to ultrasound-guided nerve blocks (UGNBs) when compared to epinephrine, without an increased risk of complications.

Friday’s Spoon Feed:

A new lethal triad performs better than the old one for 28-day mortality in trauma patients. But the "new" is simply a reframing of the classic and doesn't appear that helpful.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

Strap in for a longer-than-normal Spoon Feed to stay updated on the latest ATS guidelines for diagnosing and treating CAP.

Wednesday’s Spoon Feed:

The 2025 AHA/ACC hypertension guidelines recommend a universal BP goal of <130/80 with antihypertensive therapy initiation, guided by hypertension severity, comorbidities, and PREVENT risk score.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

The ACEP subcommittee made policy recommendations on what peri-procedural interventions reduce peri-intubation hypoxia and hypotension.

Wednesday’s Spoon Feed:

Pediatric patients with a positive ultrasound (US) and Pediatric Appendicitis Risk Calculator (pARC) score ≥ 25% are highly likely to have pathology-proven appendicitis.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday’s Spoon Feed:

The National Association of EMS Physicians(NAEMSP)’s comprehensive review of spinal motion restriction in prehospital management of trauma concluded cervical collars and backboards are likely doing more to harm patients than they are to prevent delayed neurological injury(DNI).

Friday’s Spoon Feed:

In ED patients with vertigo, the STANDING algorithm had high diagnostic accuracy and negative predictive value for central causes while reducing CT imaging and length of stay compared to “usual care.” But the main caveat here was that these emergency physicians underwent dedicated training in the algorithm.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

The Queen of Hearts AI (QoH AI) model beat both emergency physicians (EPs) and cardiologists at deciding who needs immediate catheterization for certain STEMI-equivalents and STEMI-mimics—88.9% accuracy vs. ~66%—promising fewer missed occlusion myocardial infarctions (OMIs) and fewer unnecessary activations.

Wednesday Spoon Feed:

Reliance on STEMI criteria alone misses a substantial proportion of LAD occlusions, while expert and AI ECG interpretation achieved earlier and more accurate detection, with 100% sensitivity for LAD occlusion MI in this study.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This meta-analysis found that non-invasive positive pressure ventilation (NIPPV) during preoxygenation of critically ill patients undergoing tracheal intubation led to less hypoxemia compared to a facemask or high-flow nasal cannula (HFNC).

Tuesday Spoon Feed:

Non-targeted hepatitis C screening in the ED (free regardless of risk) identified more new hepatitis C diagnoses than targeted screening; however, while this found more new cases, it did not translate to increases in successful treatment.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

Can I read an ECG better than a computer?

Thursday Spoon Feed:

In this retrospective study of ED-diagnosed UTIs, Cephalexin dosed twice daily was just as effective as four times daily, with no significant difference in treatment failure - suggesting BID dosing may be a practical, adherence-friendly option in some patients.  

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Thoracic trauma is common––and so are pneumothorax and hemothorax. This high-yield review walks through clear, evidence-based ways to recognize, image, and treat these injuries.

Tuesday Spoon Feed:

Both rising and falling patterns in serial high-sensitivity cardiac troponin (hs-cTn) measurement were associated with significantly higher risk of 30-day MACE. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This review updates our knowledge on CPR with highlights being that compression-only bystander CPR improves survival to hospital discharge compared to conventional bystander CPR and that current evidence does not suggest any improved patient outcomes with CPR monitoring tools. 

Thursday Spoon Feed:

In patients with sepsis, new LV dysfunction is associated with in-hospital and ICU mortality. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Duration of prophylactic antibiotic therapy was not found to be associated with likelihood of developing a fracture-related infection after GSW associated with bowel injury in this small retrospective study.

Wednesday Spoon Feed:

Helicopter transport improves survival in trauma patients who meet triage criteria, but only if it saves at least 13–17 minutes over ground transport.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Novel blood-based biomarkers, specifically GFAP, UCH-L1, S100B, and NfL, may be well suited for early classification and triage of patients with acute and subacute minor traumatic brain injury.

Tuesday Spoon Feed:

To reduce hospitalizations of patients with mild to moderate COVID, treat with nirmatrelvir-ritonavir (Paxlovid) or remdesivir. To shorten the duration of COVID symptoms, azithroycin, favipiravir, molnupiravir, umifenovir, or corticosteroids may help, but they are not standard of care. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

A single high-quality CT scan is highly accurate at detecting serious cervical spine injuries in children after trauma and may be enough to clear the spine without further imaging safely in majority of patients.

Thursday Spoon Feed:

For patients with ROSC after OHCA who required vasopressors transported by Finnish helicopter EMS (HEMS), normotension (100-140 mm Hg) was associated with improved 30-day mortality compared to hypo and hypertension.

Friday Spoon Feed:

This study of a trauma database found patients intubated in the emergency department (ED) who required hemorrhage control surgery had worse outcomes than those who were intubated in the operating room (OR). However, a study published just two months ago, from the same database of patients, found no difference in patients based on intubation location. What gives?

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Targeting the 5th percentile mean blood pressure in pediatric septic shock resulted in similar 28-day mortality as targeting the 50th percentile - while reducing vasopressor use, side effects, and complications like ARDS.

Friday Spoon Feed:

This study shows that ketamine alone is a safe choice for pediatric sedation in the ED, with serious adverse events (AE) occurring rarely, primarily in older children or when opioids are coadministered.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Patients with mild asthma who used albuterol-budesonide rescue therapy had about half as many severe exacerbations as those on albuterol alone.

Thursday Spoon Feed:

In ED patients with bone fractures, intranasal ketamine provided pain relief comparable to IV ketamine and morphine, with no significant differences in efficacy or adverse effects across groups.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

Bayesian analysis of the use of EpiDex in bronchiolitis demonstrates a reduced probability of hospitalization for bronchiolitis, although highly skeptical clinicians may require additional evidence.

Friday Spoon Feed:

Over half of transferred patients with facial fractures don’t need treatment or admission. This study proposes smart, evidence-based guidelines – Facial Injury Guidelines, or FIG – to help healthcare systems save money, time, and beds (and maybe a few ambulance rides), pending future validation.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Prolonged central capillary refill time is associated with increased mortality in adult trauma patients—including those with “stable” initial vital signs.

Wednesday Spoon Feed:

This external validation of the Falls decision making tool for older adult patients with head trauma found a high degree of sensitivity and negative predictive value while reducing unnecessary CT scans by almost 32%. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

A retrospective study found that trauma patients who were intubated in the ED had no difference in morality compared to those intubated in the OR on propensity matched analysis. 

Thursday Spoon Feed:

In a large cross-sectional study, cannabis use—particularly daily use—was independently associated with increased risk of myocardial infarction, stroke, and composite cardiovascular outcomes, even among never-tobacco users and younger adults.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

In this retrospective study of 74 peritonsillar abscess (PTA) patients, there were no instances of inadvertent carotid puncture.

Tuesday Spoon Feed:

Ingesting household bleach rarely causes esophageal or gastric injury in children, making routine endoscopy unnecessary in most cases.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

A novel termination of resuscitation (TOR) rule for in-hospital cardiac arrest (IHCA) utilizing information available at the bedside proposed TOR appropriately, often, and rarely misidentified survivable cases.

Friday Spoon Feed Spoon Feed:

Electronic Dance Music Festivals(EDMF) are associated with a higher medical utilization rate (MUR) when compared with other mainstream events. EDMF attendees are also likely to be sicker and present more frequently with drug related concerns. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

The Ten Test is a quick, reliable, no-equipment sensory exam that performed as well as or better than traditional methods in assessing hand and finger injuries – with none of the cost.

Friday Spoon Feed:

In this Bayesian network meta analysis, researchers compared pharmacologic interventions for migraine treatment. There was no clear superior choice for single-agent pain control, but chlorpromazine IV/IM was among the most effective for adequate pain relief at two hours, and IV/IM ketorolac was possibly among the worst.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Short-term ambulatory cardiac monitoring has diagnostic usefulness, although limited, in patients discharged from the emergency department. 

Friday Spoon Feed:

40% of patients undergoing endotracheal intubation (ETI) have a major adverse event. This article gets you up to speed on what tools, techniques, drugs, and interventions give your patient the best shot at a successful intubation without adverse events. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

The use of pre-operative GLP-1 receptor antagonists did not increase rates of post-operative aspiration pneumonia or acute respiratory failure.

Wednesday Spoon Feed:

Computed Tomography (CT) examinations in 2023 alone are projected to result in approximately 103,000 future cancers over the lifetime of exposed patients and could account for 5% of all new cancer diagnoses annually.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

The ALI’s first restatement of medical malpractice law shifts from “customary practice” to “reasonable medical care,” integrating evidence-based medicine, clarifying liability standards, discouraging defensive medicine, and promoting transparency while balancing ethical communication and legal accountability.

Tuesday  Spoon Feed:

In children with moderate to severe TBI, 3% hypertonic saline (HTS) was not associated with improved survival or better functional outcomes compared to 20% mannitol. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

This preplanned subgroup analysis of the TOMAHAWK Trial of patients with ROSC after OHCA found no EKG findings (excluding STEMI) that predicted the presence of coronary artery lesions.

Thursday Spoon Feed:

In this substudy of the Canadian TIA Score cohort, researchers found score utilization with subsequent MRI imaging could improve the outcome of patients suffering from TIA or stroke, particularly in the medium-risk category, scoring between 4-8 points.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday Spoon Feed:

The authors created The Sudbury Vertigo Risk Score for ED patients presenting with vertigo that may better identify those at risk for serious neurologic conditions like stroke. The scoring system has remarkable sensitivity for serious neurolgic pathology, but it has yet to be validated.

Friday Spoon Feed:

The previously derived Sudbury Vertigo Risk Score was validated with a new cohort, and low scores accurately identified patients as low risk and therefore not requiring further investigation or treatment for a serious diagnosis of vertigo.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Lidocaine use during pre-hospital resuscitation from ventricular fibrillation or ventricular tachycardia (VF/VT) resistant to defibrillation, when compared to amiodarone, was associated with higher rates of ROSC, fewer post-drug shocks, and greater odds of survival to discharge in this observational study.

Tuesday Spoon Feed:

People with cannabis use disorder were more likely to die from suicide, trauma, and drug poisoning and had a higher overall risk of death, which challenges the popular belief that it's is a harmless recreational drug.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

For pediatric ED patients, NSAIDs, ketamine, and mid-high potency opioids all reduced pain compared to placebo, with NSAIDs also reducing the need for rescue medication.

Wednesday Spoon Feed:

Antibiotic treatment for acute uncomplicated appendicitis in children has a significantly higher failure rate (34% vs. 7%) compared to appendectomy, but this is limited by differing definitions of failure and the chosen non-inferiority margin.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

A large meta-analysis of ICU RCT subgroups finds decreased mortality in patients with traumatic brain injury treated with normal saline vs. crystalloid and an increase in those without.

Thursday Spoon Feed:

Regardless of anticipated difficulty of placement of peripheral intravenous catheter (PIVC) in a pediatric patient, ultrasound-guided insertion results in improved success.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

In a RCT of 550 patients with intermediate-risk PE, those who received large-bore mechanical thrombectomy (LBMT) were less likely to suffer clinical decompensation than those who received catheter-directed thrombolysis (CDT).

Thursday Spoon Feed:

Patients with potentially difficult airways were oxygenated and ventilated in the operating room via an endotracheal tube in the pharynx, which could be applied to a ‘can’t intubate, can’t oxygenate (CICO)’ scenario.

Download the JournalFeed iPhone app!

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

When time is of the essence, as in ovarian torsion, furosemide plus fluid provides a quick, effective, noninvasive option for bladder filling to expedite ultrasound in pediatric patients.

Friday Spoon Feed:

In this new clinical practice guideline, the American College of Obstetrics and Gynecology (ACOG) recommends foregoing routine Rh screening and RhIg prophylaxis for patients less than 12 weeks gestation undergoing abortion or experiencing pregnancy loss.

The JournalFeed podcast for the week of March 3-7, 2025.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Guidelines recommended low molecular weight heparin (LMWH) for most patients with acute pulmonary embolism (PE), but we often choose unfractionated heparin (UFH). Here's why...

Friday Spoon Feed:

This pre-planned secondary analysis compared OHCA patients who received a single dose of epinephrine to standard ACLS epinephrine dosing and found mixed results in the outcomes of ROSC and survival to hospital discharge. Strap in for this nuanced article summary. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday Spoon Feed:

Nebulized high-dose inhaled corticosteroid use in addition to short acting beta-agonist therapy may reduce emergency department length of stay in adult asthma exacerbation, but additional studies are necessary.

Friday Spoon Feed:

The pace at which your co-attending operates can significantly influence your own productivity and efficiency throughout the shift.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This RCT found that just-in-time coaching increased first pass success prior to infant intubations by inexperienced clinicians in the operating room.

Thursday Spoon Feed:

This review highlights key evidence-based updates for diagnosing and managing sympathetic crashing acute pulmonary edema in emergency settings, emphasizing the role of noninvasive positive pressure ventilation and high-dose nitroglycerin; while cautioning against routine diuretic use and advising alternative therapies like clevidipine or IV enalaprilat when hypertension is refractory.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Giving 1g IV tranexamic acid (TXA) prophylactically after delivering a baby in a high-risk patient prevented severe postpartum hemorrhage.

Friday Spoon Feed:

This systematic review of 13 studies found slightly higher rates of adverse events after administration of diltiazem versus metoprolol, when treating atrial fibrillation (a-fib) with RVR.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

Patients who received as-needed antihypertensive medications while hospitalized had higher risk for acute kidney injury (AKI).

Thursday Spoon Feed:

This trial found no significant difference in long-term neurologic outcomes in anemic patients with aneurysmal subarachnoid hemorrhage (aSAH) with a liberal versus restrictive transfusion strategy.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

There was no difference in patient centered outcomes between trauma patients who received either restrictive or liberal oxygen therapy in this RCT.

Thursday Spoon Feed:

Patients wearing hospital gowns during simulated hospital visits reported increased feelings of vulnerability and disempowerment compared to patients wearing personal clothes.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

Preoperative antibiotics significantly decreased the microbiologic yield of operative cultures (10.9%) in patients with native joint septic arthritis.

Friday Spoon Feed:

The PERC-35 rule was designed to reduce unnecessary testing in individuals ≤35 years old, but had an unacceptably high miss-rate.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed: 

When compared to working solo as an emergency physician (EP), productivity is positively influenced by the presence of senior residents, minimally affected by junior residents, and negatively impacted or neutral with medical students.

Tuesday Spoon Feed:

In a cohort of 1,007 children, longer CPR duration after a cardiac arrest lowered the chances of positive neurologic outcomes, with the likelihood of moderate disability or better dropping below 1% after 64 minutes of CPR.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

Tranexamic acid reduces the risk of life-threatening postpartum bleeding with no measurable increased risk of thrombosis.

Thursday Spoon Feed:

High-velocity nasal insufflation (HVNI) was non-inferior to noninvasive positive pressure ventilation (NiPPV) for treating acute exacerbations of chronic obstructive pulmonary disease (COPD) in the emergency department.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

Workplace violence (WPV) occurs in one out of every 3.7 shifts among healthcare workers (HCWs) in emergency departments, with nurses and younger HCWs being at higher risk.

Wednesday Spoon Feed:

Here are the top ten most viewed JournalFeed articles from 2024. Enjoy! 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

In patients presenting with an abdominal gunshot wound with clear indications for operative intervention, a preoperative CT provides no additional benefit and frequently misses injuries.

Wednesday Spoon Feed:

Quick, grab some dark chocolate this Christmas to protect yourself from developing type 2 diabetes (T2D)!

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed: 

This article breaks down patient selection, setup, special considerations, and step-by step instructions to manage awake intubations, a rarely utilized but essential technique in emergency airway management.

Tuesday Spoon Feed:

This large retrospective database study found a 28% increased risk of mortality in patients intubated with etomidate.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

A post-hoc analysis of 3 studies conducted in Europe (PROPER, MODIGLIANI, TRYSPEED) analyzed patients with a high pretest probability for PE based on Wells’ or revised Geneva score and found that using D-dimer alone would have missed 0 PEs, but this strategy is not ready for primetime.

Tuesday Spoon Feed:

An open-label, multicenter RCT found that patients with severe brain injury who were mechanically ventilated had a worse composite outcome if they were ventilated with a lung protective strategy compared to a conventional strategy. This study was underpowered and stopped early secondary to funding issues. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

This animal model study compared the classic median bar technique for zipper skin entrapment release to a novel approach. There was no upside or downside to using the new technique.

Thursday Spoon Feed:

There is a very low likelihood of missing aneurysmal SAH if CT brain imaging is obtained within 24 hours of symptoms onset, but these results are not enough to change practice.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This secondary analysis of 2 RCTs found no significant difference between rocuronium or succinylcholine on first attempt success or severe complications in critically ill patients undergoing endotracheal intubation. 

Wednesday Spoon Feed:

Acute pericarditis is a common cause of nonischemic chest pain. In North America, it is typically idiopathic, develops after a viral infection, or follows a cardiac procedure. In areas with higher prevalence, tuberculosis can be an underlying cause of pericarditis. For the majority of patients, treatment with NSAIDs and colchicine leads to a favorable prognosis.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Most of the time, targeting a hemoglobin threshold of 7 – 8 g/dL in critically-ill patients is recommended, with acute coronary syndrome as the exception to the rule. Strap in for this longer-than-normal Spoon Feed summary of these guidelines.

Wednesday Spoon Feed:

This study utilized Bayesian analysis and found that when paralytic medications were administered before sedatives during ED intubation, there was an association with decreased first attempt failure rate. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

In this randomized control trial of left versus right ultrasound-guided infraclavicular subclavian central venous access, the left-sided approach was associated with a lower catheter malposition rate.

Friday Spoon Feed:

The American Academy of Pediatrics has released their first clinical practice guideline on opioid prescribing in children and adolescents. The 12 evidence-based key action statements outline safe practices for prescribing opioids for acute pain in the outpatient setting.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

This RCT found high-intensity non-invasive positive pressure ventilation (NPPV) in COPD patients with persistent hypercapnia decreased the need for endotracheal intubation according to prespecified criteria. 

Friday Spoon Feed:

While there was concern for selection bias in a number of included studies, this systematic review and meta-analysis found that small–bore thoracostomy tubes may be appropriate to use in traumatic hemothorax.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

In this NEAR database study, there was an independent association between increasing number of intubation attempts and risk of complications.

Wednesday Spoon Feed:

Dual therapy with both ibuprofen and acetaminophen or in alternating regimens may be superior to monotherapy for treating fever in children. Ibuprofen also appears superior to acetaminophen at 4 hours when both are used as monotherapy but similar at 6 hours. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This article emphasizes the difference between hypertensive emergency and asymptomatic elevated blood pressure (BP). While hypertensive emergency requires prompt treatment to lower BP, treatment of asymptomatic elevated BP in acute care settings may be harmful. 

Tuesday Spoon Feed: 

This was a multi-hospital retrospective study of patients who presented to the emergency department with severe hypertension without end organ damage. The authors found that the 1 year rate of major adverse cardiovascular events (MACE) was 15.5%.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

This prospective study of a new proprietary rapid host-protein test, MeMed BV (MMBV), shows promising results for differentiating viral vs bacterial causes of fever. However, the gold standard for comparison was similar to current common practice, making it difficult to measure the added value of MMBV over usual care.

Friday Spoon Feed: 

This large study in Canada of patients aged 66+ found that all commonly prescribed oral antibiotics were associated with an increased risk of serious cutaneous drug reactions (cADRs) relative to macrolides; however, few of these reactions led to hospitalization and an even smaller amount were true cutaneous emergencies (SJS/TEN).

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

ACEP released a clinical policy that addresses the choice of a second-line agent for adults with refractory seizures after adequate dosing of benzodiazepines.

Friday Spoon Feed:

Cavernous sinus thrombosis (CST) is a rare but serious thrombophlebitic disease that can be easy to miss in the emergency department setting. This article provides an overview of CST as well as some pearls for clinching this diagnosis for emergency medicine physicians.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

In adult patients with sepsis, empiric use of vancomycin and piperacillin/tazobactam compared to vancomycin and cefepime, when anti-anaerobic coverage was not clinically indicated, was associated with a 5% increase in mortality.

Friday Spoon Feed:

Mental practice, a cognitive rehearsal technique from sports psychology, can enhance skill retention and competency in emergency medicine, particularly for high-acuity, low-frequency procedures.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Post-processing techniques completed by ultrasound machines to improve spatial resolution have become so advanced that it can now fool us into thinking a FAST exam is positive.

Tuesday Spoon Feed:

This was a single center retrospective study at a tertiary pediatric ED of patients with suspected pediatric appendicitis. The authors found that combining a low pediatric Appendicitis Risk Calculator (pARC) result with a nondiagnostic ultrasound results in a high negative predictive value for appendicitis.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Due to a multitude of factors, the tick population is increasing leading to a congruent increase in tick borne diseases (TBD), most notably Lyme disease and babesiosis. Clinicians should keep TBD on their differential for fever with flu-like symptoms, even in traditionally non-endemic areas, as range is expanding and travel has increased.

Wednesday Spoon Feed:

This retrospective study suggests that full dose antibiotic challenges for patients with listed beta-lactam antibiotic allergies can be safely accomplished in the ED.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

There are an increasing number of water bead related injuries in children, with the majority occurring in children less than five. While most cases can be treated and released from the ED, water bead injury can be serious and even deadly.

Friday Spoon Feed:

These researchers developed and trained a deep ensemble artificial intelligence (AI) model to classify ECGs as STEMI versus non-STEMI. The AI performed well in both accuracy and in improving sensitivity.

JournalFeed wants your feedback!! Tap here for a brief survey!! (<2 minutes)

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

In a retrospective study of 142 patients with an initial shockable rhythm and 4 to 5 episodes of recurrent/refractory ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT), shorter duration of VF and pVT was associated with higher rates of ROSC. 

Friday Spoon Feed:

In non-traumatic out of hospital cardiac arrest (OHCA), administration of an initial dose of IM epinephrine by EMS prior to an established IV or IO was associated with improved survival outcomes. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

A new PECARN clinical decision rule for cervical spine imaging in children after blunt trauma identifies children at low risk for C-spine injury utilizing nine risk factors.

Friday Spoon Feed:

The MISSION Act Scribes Trial evaluated the implementation of medical scribes in Veterans Health Administration (VHA) EDs. Contrary to expectations, scribes decreased provider productivity and increased patient throughput times.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed: 

Using the aortic dissection detection (ADD) risk score in addition to point-of-care ultrasound (POCUS) and D-dimer, providers can increase their diagnostic accuracy and ensure that the appropriate patients are receiving advanced imaging to make the diagnosis of acute aortic syndrome (AAS).

Friday Spoon Feed:

Back blows outperformed abdominal thrusts and chest compressions in successful clearance of out-of-hospital foreign body airway obstructions (FBAO).

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

This was a large RCT of critically ill adults with suspected infection who were randomized to receive either continuous infusions or intermittent dosages of intravenous antibiotics. 90-day mortality between groups was not statistically significant, while clinical cure rate was higher in the continuous infusion group.

Friday Spoon Feed:

Based on key history and physical examination findings, the Eastern Association for the Surgery of Trauma (EAST) developed an algorithm for the evaluation of blunt trauma patients ≥65 years.

Monday Spoon Feed: 

For acute ischemic stroke patients with recent DOAC ingestion who (1) had their DOAC level measured, (2) had DOAC reversal with idarucizumab, or (3) inadvertently received thrombolytics with DOAC subsequently discovered, there was not evidence of increased significant intracranial hemorrhage associated with off-label thrombolytic therapy.

Friday Spoon Feed:

In patients with large vessel occlusions(LVO) presenting 4.5-24 hours after onset, without access to endovascular thrombectomy (ET), tenecteplase(TNK) administration bested standard medical treatment(SMT) in 90-day disability-free recovery.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday Spoon Feed:

This retrospective study found increased use of unfractionated heparin (UFH) relative to low-molecular weight heparin (LMWH) and direct oral anticoagulants (DOACs) over time, despite guidelines recommending LMWH or DOACs as first-line treatment for most patients with acute pulmonary embolism (PE).

Friday Spoon Feed:

Anticoagulation is the cornerstone of managing acute pulmonary embolism (PE), but initial management strategies in the intensive care unit (ICU) for sicker patients* with acute PE lack consensus guidelines. This reviews the available evidence and provides guidance.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday Spoon Feed:

The first direct comparison of the Clinical Institute Withdrawal Assessment-Alcohol Revised (CIWA-Ar) scale to a slightly modified Richmond Agitation and Sedation Scale (mRASS-AW) in a pre-post quality assurance study found mRASS-AW to not compromise length of stay or safety for the evaluation of alcohol withdrawal syndrome (AWS), while we already know it to be faster and more intuitive.

Friday Spoon Feed:

This RCT of U.S. patients being evaluated for acute MI using a 0/1 hour hs-cTnI protocol, compared to standard care with a 0/3 hour hs-cTnI protocol, didn’t find a difference in the percentage of patients discharged from the ED nor in the rates of 30 day death or MI.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

In a cohort of septic children, delays in antibiotic administration 330 minutes or longer from arrival to the emergency department led to an increase in mortality.

Friday Spoon Feed:

An analysis of the NEAR database demonstrated a lower first-pass success rate of 89.2% for patients with anatomically difficult airways (ADA) compared to 93.7% in the control group. First-pass success for physiologic difficult airways (PDA) was 92.9% and fell to 87.4% for those with both ADA/PDA.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

GRACE-4 is packed with practice-changing recommendations for patients with alcohol withdrawal syndrome (AWS), alcohol use disorder (AUD), and cannabinoid hyperemesis syndrome (CHS).

Friday Spoon Feed:

A “D-dimer only” pathway in patients with suspected pulmonary embolism (PE) was safely used to determine need for imaging without clinical decision rules, but there are some concerns with this approach.

Monday Spoon Feed: 

The only strong recommendation for corticosteroid use was in patients needing to be hospitalized with severe community acquired pneumonia. The panel recommended against high-dose/short duration corticosteroids in patients with septic shock.

Tuesday Spoon Feed: 

In pediatric patients who have an Alvarado score 6 and below, the absence of free fluid or periappendiceal fat inflammation, when the appendix was not visualized on ultrasound, had a negative predictive value of 99.4% for appendicitis.

Tuesday Spoon Feed:

In a cohort of febrile infants, the performance of WBC, ANC, and CRP decreased in patients with less than 2 hours of fever; PCT remained similar.

Thursday Spoon Feed:

Ketamine has been shown to be efficacious in managing acute pain conditions in the emergency department (ED), and this study showed equal efficacy between nebulized and intravenous administration of sub-dissociative ketamine (IV-SDK).

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday Spoon Feed:

This bias-adjusted meta-analysis of randomized controlled trials (RCT) finds a one-month mortality benefit in trauma patients receiving tranexamic acid (TXA) during initial emergency management.

Friday Spoon Feed:

Reliance on landmark guidance for chest tube placement may pose significant safety issues in pediatric patients.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This was a validation study for the recently published American College of Cardiology (ACC) Expert Consensus Decision Pathway for chest pain. Results suggest this pathway is safe and efficacious for use in patients without known CAD; however, performance was not as good for patients with known CAD.

Friday Spoon Feed:

Noninvasive ventilation (NIV) was superior to standard non-rebreather (NRB) oxygen mask for preoxygenation of critically ill, adult ED or ICU patients requiring intubation, with a NNT of 11 to prevent 1 episode of hypoxemia <85%.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

In this RCT, successful intubation on the first attempt in critically ill neonates was much higher in patients when video laryngoscopy (VL) was used compared to direct laryngoscopy (DL).

Tuesday Spoon Feed:

Data supporting pediatric cardiac arrest guidelines are limited. This study found increases in the longest pause in chest compressions (CC) during pediatric in-hospital cardiac arrest (pIHCA) were inversely associated with survival and ROSC.

Wednesday Spoon Feed:

This secondary analysis derives and validates a machine learning model that supports the use of personalized oxygen saturation targets (SpO2) in mechanically ventilated critically ill adults based on individual patient characteristics.

PILOT & ICU-ROX

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

A retrospective study of 60 patients who received a fixed-dose ketamine of 250 mg by EMS observed that 6 were intubated in the ED. There was no association between weight-based dose of ketamine and risk for intubation.

Thursday Spoon Feed:

In a large retrospective review of patients with out-of-hospital-cardiac-arrest (OHCA) there was a very small, and probably clinically insignificant, association with favorable neurological outcome and survival in those who underwent early as opposed to late advanced airway management. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This review article illustrates the evidence-based “no-zone” approach in managing penetrating neck injuries, with a reliance on clinical symptoms as well as multidetector computed tomographic angiography (MDCTA) to mitigate unnecessary invasive tests and negative explorations. 

Friday Spoon Feed:

This multicenter prospective validation study of the PECARN prediction rules for CT imaging of children with blunt abdominal or minor head trauma performed extremely well (all three having NPVs of 100%).

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

Serious bacterial infections were exceedingly rare in this study of recently immunized infants 6-12 weeks presenting to the emergency department with a fever.

Friday Spoon Feed:

This pig cadaver study argues that jam is a reasonable alternative (if honey and sucralfate are unavailable) to give patients while awaiting definitive endoscopic removal after button battery ingestion.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

Utilizing oxygen, rather than room air, for patients with intermediate-risk acute PE may be helpful even if patients are not hypoxemic. We’ll need a study (but not this one), for further information.

Thursday Spoon Feed:

Sodium-glucose cotransporter 2 inhibitor (SGLT2i)-associated ketoacidosis (DKA) had delayed resolution compared to type 1 diabetes (T1D)-associated DKA despite often being “milder”. This could be due to significantly lower insulin doses given in the setting of the lower plasma glucose levels often seen in this population.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

The HOT-COVID RCT found that hypoxemic COVID-19 patients in the ICU benefitted from a lower oxygenation target (PaO2 60 mm Hg) by having more days without life support than those who had a higher oxygenation target (PaO2 goal 90 mm Hg).

Friday Spoon Feed:

A significant minority of code STEMI patients have an initial normal computer ECG interpretation. Consequently, emergency physicians must remain vigilant to identify signs of OMI regardless of the initial computer ECG interpretation.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

In a controlled hypoxemia study, pulse oximetry was falsely elevated in subjects with darker skin pigmentation and low perfusion.

Friday Spoon Feed:

In patients with ACS and concern for STEMI/NSTEMI requiring urgent intervention, randomization to the contrast volume reduction group reduced the rate of acute kidney injury and sustained kidney damage.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

In subgroup analysis, there may be more successful ROSC in patients with upper extremity IO access compared to lower extremity access in OHCA, but these results should be adopted with caution.

Thursday Spoon Feed:

Targeted ETCO2 ≥20 mm Hg during pediatric resuscitation was associated with higher rate of survival in patients with in-hospital cardiac arrest.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

This external validation compared the 2023 Duke-International Society for Cardiovascular Infectious Diseases Diagnostic (ISCVID) Criteria against various other criteria for diagnosing infective endocarditis (IE) and found the 2023 Duke-ISCVID Criteria had the best test characteristics. 

Thursday Spoon Feed:

Yesterday, we covered an article demonstrating the superior diagnostic accuracy of the new Duke-International Society for Cardiovascular Infectious Diseases Diagnostic (Duke-ISCVID) criteria. 

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

This single centre RCT investigated the link between IV cannula diameter and how painful it will be to insert. 18G cannulas were not more painful nor more difficult to place than 20G cannulas across the spectrum of experience levels. Pain and insertion success rates being equal, patients are better off with cannulas that can accommodate higher flow rates.

Friday Spoon Feed:

In this systematic review and meta-analysis to evaluate the use of a bougie versus non-bougie approach (ie. stylet) in intubations of adult patients, a bougie-first approach significantly increased the rate of first-attempt success compared to controls. But what does this say about your intubation strategy?

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Using online telemedicine platforms, the authors found that it was appallingly easy to rapidly obtain inappropriate antibiotic prescriptions for symptoms of viral URIs by paying a nominal fee. This highlights the need for increased education and regulations around inappropriate prescribing of antibiotics to safeguard the public and uphold good medical practices.

Tuesday Spoon Feed:

Clinicians have an important role in advising families on the appropriate evidence-based treatments for upper respiratory tract infections (URTIs) in children.

These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed: 

This Bayesian network meta-analysis of RCTs indirectly compares hydrocortisone + fludrocortisone to hydrocortisone alone or placebo in septic shock and finds superiority with the combination regimen.

Friday Spoon Feed: 

In this retrospective study of ED physicians in one state, researchers found statistically significant differences in admission rates among clinicians but little consistency in admission tendencies across multiple conditions. Clinicians with greater tolerance to risk (as a general attitude) had associated lower rates of admission when compared to projections.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday Spoon Feed:

This updated meta-analysis re-demonstrated a benefit for extracorporeal cardiopulmonary resuscitation (ECPR) in reducing overall in-hospital cardiac arrest (IHCA) mortality and improving neurological outcomes after cardiac arrest but also demonstrated a new significant reduction in out of hospital cardiac arrest (OHCA) mortality with ECPR.

Source:

Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: an updated meta-analysis and trial sequential analysis. Crit Care. 2024 Feb 21;28(1):57. doi: 10.1186/s13054-024-04830-5.

Friday Spoon Feed:

A Bayesian meta-analysis found an 83.2% probability that ketamine lowers mortality compared to etomidate in critically ill patients undergoing intubation.

Source:

Ketamine versus etomidate as an induction agent for tracheal intubation in critically ill adults: a Bayesian meta-analysis. Crit Care. 2024 Feb 17.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

A meta-analysis of 15 randomized trials found that ketamine had a quicker analgesic effect than morphine, but morphine exhibited sustained reduction in pain at 120 minutes.

Source:

Low-dose ketamine versus morphine in the treatment of acute pain in the emergency department: A meta-analysis of 15 randomized controlled trials. Am J Emerg Med. 2024;76:140-149. doi:10.1016/j.ajem.2023.11.056

Wednesday Spoon Feed:

The ACEP consensus seems to indicate that it may be safe for patients with a simple corneal abrasion to go home with 24 hour usage of topical anesthetics for pain relief, but the ophthalmologists are not on board.

Source:

Use of Topical Anesthetics in the Management of Patients With Simple Corneal Abrasions: Consensus Guidelines from the American College of Emergency Physicians. Ann Emerg Med. 2024 Feb 6:S0196-0644(24)00004-0. doi: 10.1016/j.annemergmed.2024.01.004. Epub ahead of print.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This systematic review and meta-analysis concluded, with moderate certainty evidence, that oseltamivir has little to no effect on hospitalization but does increase nausea and vomiting. 

Source:

Evaluation of Oseltamivir Used to Prevent Hospitalization in Outpatients With Influenza. JAMA Intern Med. 2024 Jan 1;184(1):18-27. doi: 10.1001/jamainternmed.2023.0699. Erratum in: JAMA Intern Med. 2023 Nov 20;: PMID: 37306992; PMCID: PMC10262060.

Tuesday Spoon Feed

This survey of US physicians found taking more than 3 weeks of vacation per year was associated with lower rates of burnout, while spending 30 minutes or more per vacation day on patient-related work was associated with increased burnout. 

Source:

Vacation Days Taken, Work During Vacation, and Burnout Among US Physicians. JAMA Netw Open. 2024 Jan 2;7(1):e2351635. doi: 10.1001/jamanetworkopen.2023.51635.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This single-center prospective study found that in 2,275 ECGs with a computerized interpretation of “normal” and “otherwise normal,” there was a negative predictive value (NPV) of 100% for STEMI, with no final diagnoses of ACS or STEMI, and none required cardiac catheterization that visit.

Source:

Validity of Computer-interpreted "Normal" and "Otherwise Normal" ECG in Emergency Department Triage Patients. West J Emerg Med. 2024;25(1):3-8. doi:10.5811/westjem.58464

Tuesday Spoon Feed:

An artificial intelligence (AI) ECG model outperformed standard STEMI criteria in identifying occlusion myocardial infarction (OMI) confirmed by coronary angiography.

Source:

International evaluation of an artificial intelligence–powered electrocardiogram model detecting acute coronary occlusion myocardial infarction, European Heart Journal - Digital Health, 2023. https://doi.org/10.1093/ehjdh/ztad074

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

In out-of-hospital cardiac arrest (OHCA), patients presenting with refractory ventricular fibrillation (RVF), receiving short interval (<75ms) dual sequential external fibrillation (DSED) was linked to a higher probability of termination of ventricular fibrillation (VF) and return of spontaneous circulation (ROSC) when compared to longer DSED intervals.

Tuesday Spoon Feed:

Trauma patients who were resuscitated with whole blood compared to component therapy had improved 24-hour mortality and a decrease in the total amount of blood products needed for resuscitation.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

A prospective study by the PERT Consortium found an in-hospital mortality rate of 20% in patients with high-risk PE. 41.9% of patients with high-risk PE were treated with advanced therapies (systemic thrombolytics, catheter-directed thrombolysis or embolectomy, surgical embolectomy, ECMO).

Wednesday Spoon Feed:

Mortality in patients with high-risk pulmonary embolism (PE) in the United States increased over the last decade. Surprised? Here’s why this might be true, and what we should do about it.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

In patients hospitalized with non-severe community-acquired pneumonia (CAP), beta-lactam (BL) only antibiotic regimens have been shown to have increased mortality as compared to other first-line regimens.

Friday Spoon Feed:

Tidal volume (TV) delivered is hard to control during cardiac arrest, and evidence has shown that over-ventilation can be detrimental in physiological parameters integral to cardiac arrest survival. Small bags were thus integrated into a single EMS system to help combat over-ventilation. Paradoxically, large bags had a greater likelihood of return of spontaneous circulation (ROSC) in out of hospital cardiac arrests (OHCA).

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Chair placement near the bedside is a simple intervention that increased the likelihood of physician sitting during patient encounters and yielded higher patient scores in satisfaction and communication.

Wednesday Spoon Feed:

Overall rates of intracranial hemorrhage (ICH) in patients >65 years of age with either definite or uncertain head trauma were found to be 11.4% and 1.7%, respectively, leading these authors to recommend head CT imaging on all geriatric patients presenting with possible head trauma.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This expert opinion piece recommends consideration of nonoperative antibiotic treatment for select cases of uncomplicated acute appendicitis. 

Friday Spoon Feed:

Ever tried having your patient drink Coca-Cola to relieve an esophageal food bolus? This interesting and well-designed multicenter RCT suggests limited efficacy of this off-label approach. 

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This expert panel from Canada has compiled a list of what they deem to be the most influential POCUS papers with regard to cardiac arrest as well as evaluation of shock. Whether you want to further educate yourself or guide your residents to learn more on the subject, this primer is a great place to start.

Wednesday Spoon Feed:

High-dose nitroglycerin improves outcomes in patients with SCAPE without significant side effects when compared to low-dose nitroglycerin.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday

The best articles of 2023!!

Friday Spoon Feed:

A prospective, observational study demonstrated that giving sodium bicarbonate to patients undergoing mechanical ventilation or CPR resulted in an increase in end-tidal CO2 values in as quickly as 17 seconds and lasted for 7 minutes

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

Treatment of COVID-19 with nirmatrelvir-ritonavir (N-R) was associated with virologic rebound (VR) in a prospective observational trial. Viral loads were high enough to cause transmission, though it remains unclear if certain patients may require longer insolation periods or how to identify those patients without significant retesting.

Friday Spoon Feed:

While removing low risk amoxicillin allergies in the pediatric ED by direct oral challenge (DOC) may be effective, numerous factors play a role in reliable implementation.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

For the majority of out-of-hospital cardiac arrest (OHCA) patients undergoing standard (30:2 compressions:breaths) cardiopulmonary resuscitation (CPR) prior to definitive airway placement, bag-valve mask (BVM) ventilations did not achieve adequate lung volumes most of the time. Receiving adequate BVM ventilations >50% of the time was associated with significantly higher rates of return of spontaneous circulation (ROSC) and survival.

Friday Spoon Feed:

This was a stratified analysis of patients according to vulnerability to complications from COVID-19; it showed clinical benefit in most extremely vulnerable groups, but less benefit for healthier patients, even over age 70.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

This secondary analysis of the STOP CP cohort study found that, in isolation, using a 0/2 hour hs-cTnT rule-out protocol did not achieve a NPV ≥ 99% for 30-day cardiac death or MI (CDMI). When combined with a low risk History, ECG, Age, and Risk factor (HEAR) score, it did - but at the cost of significantly decreased efficacy (ruling out only 30.7% of patients).

Thursday Spoon Feed:

This systematic review and meta-analysis did not show significant improvement in measured patient outcomes for treatment of alcohol withdrawal syndrome with phenobarbital vs benzodiazepines.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This single center RCT found no difference in maximum Sequential Organ Failure Assessment (SOFA) score between critically ill adult ED patients receiving ketamine vs etomidate for rapid sequence intubation (RSI).

Thursday Spoon Feed:

Procalcitonin (PCT) is suppressed in young febrile infants in the presence of confirmed viral infection (CVI), which lowers its sensitivity to detect bacterial infection (BI).  Infants meeting the AAP cutoff of 0.5 ng/mL, even in the presence of CVI, should undergo full diagnostic workup for BI.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

This RCT found no differences between high dose (16 mg) and low dose (4 mg) IV dexamethasone in patients who presented to EDs with migraine headaches. 

Friday Spoon Feed:

A randomized trial of patients in septic shock on norepinephrine found no benefit in those treated with an infusion of landiolol (β1-blocker). The trial was stopped early for concern of potential harm in the intervention group.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday Spoon Feed:

In a randomized control trial of 367 discharged infants with bronchiolitis, enhanced home nasal suctioning with a mechanical device did not lead to reduced unscheduled health care revisits as compared to standard bulb suctioning.

Friday Spoon Feed:

In this multicenter, randomized controlled trial comparing suturing the fingernail back onto the nail bed versus simply covering the nail bed with a non-adherent dressing after repair of a nail bed injury, there was no statistically significant difference in infection rate or cosmetic outcome. 

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

There is a nonlinear inverse dose-response trend between daily step count and all-cause death and cardiovascular disease, with progressive risk reductions starting at as few as 2500 to 2700 steps/day, independent of sex. Walking faster provided additive health benefits.

Friday Spoon Feed

In this large, multi-center retrospective study of academic pediatric emergency departments across the US and Canada, researchers found that children presenting with sickle cell disease vaso-occlusive events had nine times (900%) greater adjusted odds of discharge home if given intranasal fentanyl (INF).

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Wednesday Spoon Feed:

Contact precaution (CP) for patients with MRSA infection or colonization is listed as an "essential practice" for all U.S. hospitals, but should it be?

Thursday Spoon Feed:

Our words during handoff can bias our colleagues against our patients.  Here's how it happens and what we can do to improve.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

After a non-diagnostic screening ultrasound for appendicitis, a rapid-MRI has high clinical accuracy in establishing the appropriate diagnosis (appendicitis or not) in a pediatric patient population.

Friday Spoon Feed:

In this randomized control trial (RCT) of patients receiving cefepime or piperacillin-tazobactam, there was no difference in risk of acute kidney injury (AKI) between the two groups. However, those who received cefepime were more likely to have neurologic side effects.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Emergency physician (EP) advancing age was associated with higher 7-day patient mortality. This is a wake-up call to keep up. Whether with JournalFeed or others, your patients will benefit.

Tuesday Spoon Feed:

Emergency department thoracotomy (EDT) is recommended in pulseless pediatric patients with signs of life* who have penetrating thoracic/abdominopelvic trauma; if pulseless with signs of life* and blunt trauma, a conditional recommendation is made.      

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

Opioids, other than codeine, were found to be more effective when compared to non-opioids for treatment of acute musculoskeletal pain after ED discharge. However, they were also associated with a higher rate of adverse outcomes.

Friday Spoon Feed:

Don’t hang your hat on lactate clearance to assess therapeutic response to resuscitation in sepsis; there are too many confounders, and initial clearance does not necessarily project clinical course.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

Children who viewed a 1-minute firearm safety video* exhibited safer behaviors around inert firearms staged in a playroom. With firearm-related deaths overtaking motor vehicles as the leading cause of US minor deaths, introducing children to firearm safety shows promise in addressing one dimension of this public health crisis.

Wednesday Spoon Feed:

In a small, randomized trial, placing an ultrasound-guided central venous catheter (CVC) using 2 planes simultaneously was more likely to be successful on the first attempt and performed more quickly. Both groups had a 100% procedural success rate.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

This prospective observational cohort study found implementing a protocol for peripheral norepinephrine (NE) decreased median number of central venous catheter (CVC) days per patient by one, and 51.6% avoided a CVC entirely. 

Wednesday Spoon Feed:

Using intubation videos, this group identified 13 key performance errors that occur during laryngoscopy. Read more to see what the proceduralists did wrong.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday Spoon Feed:

This RCT found residents using a pediatric cardiac arrest app better adhered to the pediatric cardiac arrest algorithm when compared to those using a PALS visual aid or no aid at all.

Friday Spoon Feed:

Veterans Affairs (VA) patients with known congestive heart failure (CHF) presenting for shortness of breath as a chief complaint were less likely to receive testing for venous thromboembolism (VTE) when triage reported CHF.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

While it doesn’t have great specificity, the sensitivity of ultrasound makes it a viable first step in making the diagnosis of peritonsillar abscess.

Wednesday Spoon Feed:

This randomized controlled trial demonstrated a clinically significant difference in blood pressure measurements when inappropriately sized BP cuffs were used on patients.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed: 

Children with persistent or worsening rhinosinusitis experienced a modest improvement in symptoms when given amoxicillin-clavulanate vs. placebo.

Friday Spoon Feed:

Priapism is a semi-rare time sensitive emergent disease and this article is a summary of guidelines for diagnosis and management.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

In this video review, information contained in out-of-hospital cardiac arrest (OHCA) patient handoffs was highly variable, which is an area for quality improvement and standardization. Try this checklist!

Wednesday Spoon Feed:

In non-ischemic right bundle branch block (RBBB) ECGs, we expect discordant ST depression and T wave inversions in leads V1-V3. ST segment elevation, or even an isoelectric ST segment, in these leads is abnormal and should make us concerned for ischemia.  See below.

These are summaries from just 3 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Through education and advocacy, we can reduce the risk of global nuclear conflict. You have more power to change the world than you might think.

Tuesday Spoon Feed:

Structured surveillance without anticoagulation of patients with isolated subsegmental pulmonary embolism (ssPE) rarely occurs in community practice. After applying CHEST guidelines, ~5% of patients with isolated subsegmental PE are eligible for surveillance.

Wednesday Spoon Feed:

Is taking a croupy child outdoors in the cold air a myth or evidence-based practice? Turns out, the RCT shows it actually works!

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday Spoon Feed:

This article was a multi-institutional prospective validation of the American Association for Surgery of Trauma (AAST) Brain Injury Guidelines (BIG), which were developed to guide effective resource utilization for traumatic brain injury. The validation study demonstrated that this system was accurate and safe and that its implementation can reduce CT scan utilization and neurosurgical consultation.

Friday Spoon Feed:

ACEP has issued an updated Clinical Policy to provide evidence-based guidelines for management of adult patients presenting to the ED with mild traumatic brain injury based on systematic review of available literature.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

This multi-center, double-blinded, non-inferiority trial found that short-course antimicrobial therapy had relatively low treatment failure rates compared to standard-course in children diagnosed with UTI who showed clinical improvement after 5 days of antibiotics.

Tuesday Spoon Feed:

A reduction in both 24-hour and in-hospital mortality was seen among children who received a transfusion after traumatic injury in the prehospital setting compared to those who were transfused in the emergency department.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.               

Thursday Spoon Feed:

In this prospective observational study of patients undergoing CT imaging of the abdomen/pelvis for blunt trauma, gestalt among Emergency Medicine residents/attendings and General Surgery residents was moderately accurate but not sufficiently sensitive to rule out clinically significant injuries when the acceptable miss rate was set at 2%.

Friday Spoon Feed:

Opioid pain medications offer no benefit compared to placebo for patients with acute back or neck pain.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

In a retrospective study of 331 low risk acute pulmonary embolism patients, concerning CTPA findings were not associated with adverse clinical outcomes.

Thursday Spoon Feed:

In this individual patient data meta-analysis, researchers found that a positive clinician gestalt was associated with a three times higher risk of pulmonary embolism (PE) compared to negative gestalt.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Prehospital administration of tranexamic acid (TXA) did not result in greater functional survival in patients with major trauma and suspected trauma-induced coagulopathy.　  

Wednesday Spoon Feed:

Verified physician answers to patient questions on a public social media forum were compared to Chatbot answers to the same questions by rating the quality and empathy of responses. Guess who won?

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed:

On average, female EM physicians leave clinical practice 12 years younger than their male counterparts, after fewer years of practice, and the amount of time spent in the workforce is decreasing over time. We need to identify and implement systemic fixes to stop this. 

Wednesday Spoon Feed:

PEN-FAST is a clinical decision-making tool that effectively identifies patients with self-reported penicillin allergy who are at negligible risk of hypersensitivity reaction after exposure to these antibiotics.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

Orbital cellulitis is a high-risk and low-prevalence disease characterized by a painful, red eye, usually with eyelid erythema. Red flags include pain with eye movements, photophobia, diplopia, decreased visual acuity, decreased color vision, and proptosis.

Tuesday Spoon Feed:

This retrospective study showed that EM providers are equipped to perform lateral canthotomy and cantholysis (C&C) in cases of orbital compartment syndrome (OCS), with success rates comparable to ophthalmologists.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monday Spoon Feed:

A p-value is the probability that an observed outcome (or more extreme outcome) would occur if, in fact, the null hypothesis was true.  Say what??  It's tricky to explain!  This post explains what a p-value is in simple language.

Tuesday Spoon Feed:

There is no association of doxycycline and tooth staining in children under 8 when used at usual dose and duration.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Tuesday Spoon Feed

Post-concussion return to functional baseline occurs early for symptoms, balance, and mental status along with partial neurocognitive functioning. Visual-memory and reaction-time recovery, however, lag behind the other groups post-concussion.

Wednesday Spoon Feed

Aneurysmal subarachnoid hemorrhage (aSAH) is a deadly condition. Here’s a quick summary of the 40-page AHA/ASA evidence-based guidelines for diagnosis and management.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thursday Spoon Feed:

Among patients in the RIETE database with confirmed PEs, there was a low failure rate when the PERC rule was retroactively applied. PERC negative patients who had PEs were less likely to have proximal or high-risk PEs, and their rates of cardiopulmonary complications were lower when compared to PERC positive patients.

Friday Spoon Feed:

The GRACE-3 group (SAEM) provides us with a guideline based on their review we covered previously of the evidence for evaluating and managing adult patients presenting to emergency departments for acute dizziness. Emergency clinicians need additional training in physical exam techniques related to acute dizziness in order to perform them effectively, which should be a specialty-wide goal for the future.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Swabs vs. Urine Spoon Feed

Vaginal swabs are more accurate than urine samples in diagnosing Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. These results support CDC recommendations that vaginal swabs are the preferred sample modality when testing for STIs in women.

Infants and COVID Spoon Feed

Infants who tested positive for SARS-CoV-2 were less likely to have UTI, bacteremia, and bacterial meningitis. 

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

FFOH Spoon Feed

This systematic review found that the prevalence of cervical spine injuries in patients 65 years or older after a ground level or low-level fall was between 3.8-4.1%.

Kids are Challenging Spoon Feed

In this cross-sectional simulation study of seven EMS agencies in Oregon, researchers found that resuscitation quality was significantly lower in pediatric out of hospital cardiac arrests (OHCA) compared to adult OHCA as measured by defect free resuscitations.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Friends Save Lives Spoon Feed

There was an increased number of patient deaths on ICU shifts with low nurse-to-nurse familiarity.

Testicular Traction Spoon Feed

Pulling traction on a torsed testicle is proposed by these authors to help relieve pressure, identify direction of torsion, and make the detorsing rotation easier to perform.  See figure below for technique.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

How to CPR Spoon Feed

Using a 1-handed technique in infants <1yr and 2-handed technique in children >1yr resulted in deeper compressions, closer to AHA guideline recommendations, but compliance with rate and depth were mediocre regardless of technique.

#1 Shoulder Reduction Spoon Feed

This meta-analysis found Boss-Holzach-Matter/Davos and FARES had the most favorable value for success rates, while both FARES and modified external rotation were more favorable in reduction times. FARES also had the most favorable score for pain during reduction. 

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Under/Over-triage Spoon Feed

The Emergency Severity Index (ESI) mistriaged roughly 1 of every 3 patients who presented to 21 EDs in the Kaiser Permanente health system. 

Abdomens and Opioids Spoon Feed

Patients who are discharged from the emergency department after presenting with abdominal pain and receiving opioids are 57% greater odds of return within 30 days. This population is also at higher risk for adverse effects from these medications.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

PTU vs MMI Spoon Feed

This comparative effectiveness study showed no significant difference in clinical outcomes or adverse effects when comparing use of propylthiouracil (PTU) and methimazole (MMI) for thyroid storm. This suggests both medications may be reasonable first-line treatment options for patients with thyroid storm.

CT Ped C-Spine Spoon Feed

In this large, single-institution retrospective review of pediatric blunt trauma patients, no clinically significant injuries (requiring operative intervention) were missed when using multi-detector CT scan as the imaging modality of choice.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Steroids on Steroids Spoon Feed

Patients with septic shock on norepinephrine who were treated with fludrocortisone and hydrocortisone had an associated reduction of in-hospital death or discharge to hospice compared to those treated with hydrocortisone alone.

DSI > RSI Spoon Feed

When compared to rapid sequence intubation (RSI), this RCT showed decreased peri-intubation hypoxic events and increased first attempt success in agitated and delirious ED patients with major trauma who underwent delayed sequence intubation (DSI).

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

PROCOAG RCT Spoon Feed

This well-designed RCT finds early administration of 4-factor prothrombin complex concentrate (PCC) to patients at risk of receiving massive transfusion protocol (MTP) did not reduce 24-hour blood product consumption or mortality but did increase thrombotic events.

Wells vs. YEARS Spoon Feed

Pregnant patients who present with signs and symptoms concerning for pulmonary embolism (PE) can be safely evaluated using Wells criteria or the YEARS algorithm. 

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Journal of ChatGPT Spoon Feed

ChatGPT is an artificial intelligence software that is being explored for scientific writing. While there is great potential for utilizing this in the medical field, it should not be used in isolation and requires human oversight for both concept proof and personalization.

CAPE COD RCT Spoon Feed

Hydrocortisone treatment for patients with severe community-acquired pneumonia was associated with reduced 28-day mortality and no increase in major adverse events.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Ketamine ICP Safety Spoon Feed

This retrospective study of thirty-three pediatric patients with severe traumatic brain injury (sTBI) demonstrated no increase in intracranial pressure (ICP) after administration of ketamine.

Bougie First Spoon Feed

The use of a bougie for pediatric intubation was not associated with increased first pass success or increased complication rates compared to an endotracheal tube (ETT) with a stylet at an academic emergency department where operators are facile with the bougie.  

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Thoracic Aortic Dissections Spoon Feed

Early identification and treatment of thoracic aortic dissections are paramount to patient survival and good clinical outcomes.  Here's what you need to know.

Flu vs. COVID Spoon Feed

A few notable demographic differences in critically ill influenza and COVID-19 were observed—influenza patients were younger, while COVID patients were more likely to be Black, Hispanic, and were more likely to be obese; a majority of both cohorts had one or more underlying medical condition.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Yes Flu, No Abx Spoon Feed

Patients at two separate urgent care locations—one with rapid influenza diagnostic testing (RIDT) and one without—were compared on several parameters. Importantly, antibiotic prescribing was significantly lower, and antiviral prescribing was significantly higher in the group with RIDT testing.

Robot Assisted Reductions Spoon Feed

The authors describe a novel reduction method for posterior hip dislocations using a hydraulic lift to apply longitudinal traction on the upper leg.  

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Cochrane Anti-Maskers Spoon Feed

In this Cochrane review, hand-hygiene programs reduce the incidence of clinical acute respiratory illness (ARI), while masking probably does not provide additional benefit.

Nonstop CPR Spoon Feed

Routinely pausing chest compressions during cardiac arrest to intubate in the emergency department is not necessary; this is especially true if you have video laryngoscopy and a bougie.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

CPR Fatigue Spoon Feed

In this study of firefighters performing CPR with feedback devices, researchers found that compression depth decreased over the course of a two-minute chest compression cycle while compression rate stayed within goal.

Nitrates for RV-MIs Spoon Feed

New evidence has demonstrated that previous dogma to withhold nitrates from patients with right ventricular myocardial infarction (RVMI) may be incorrect.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Diagnostic Error Spoon Feed

Diagnostic errors in the ED occur at rates similar to those in other clinical settings. Not all errors have human causes, and not all are inevitable – this article suggests systems-level opportunities for improvement.

MDI for Croup Spoon Feed

Epinephrine administration via metered-dose inhaler (MDI) for the treatment of croup in children may be a safe and effective alternative to nebulization.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Fake HyperK, Repeat? Spoon Feed

There is rarely any need to repeat potassium testing when the laboratory reports hyperkalemia on a hemolyzed sample in a child with a normal blood urea nitrogen (BUN) and creatinine (Cr).

Less Fluids RCT! Spoon Feed

This unblinded superiority trial found no significant difference in mortality among patients who were randomized to a restrictive fluid strategy with earlier use of vasopressors or liberal fluid administration for treatment of sepsis-induced hypotension.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Over-Sensitive Trops Spoon Feed 

High sensitivity cardiac troponins (hs-cTn) can be more complex to interpret than our usual diagnostics and are worth a deep dive to understand. This article does an incredible job summarizing existing guidelines and data about how to utilize hs-cTn clinically. 

LP Me Which Way? Spoon Feed

This randomized controlled trial demonstrated that lateral decubitus position was statistically the same as the upright position for lumbar puncture success.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Time IS Muscle Spoon Feed

Patients with STEMI or STEMI equivalent who were treated within goal treatment times had significantly lower in-hospital mortality.

STANDING Vertigo Algorithm Spoon Feed

After a training session, both interns and senior emergency providers (EPs) could accurately distinguish between central and peripheral vertigo using the 4-step STANDING algorithm.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Zinc Vs. COVID Spoon Feed

Zinc supplementation for patients with COVID-19 decreased 30-day ICU admission rate and led to shorter symptom duration. Subgroup analysis showed these effects were especially pronounced for elderly patients and those with comorbid conditions.

Tubing in Angioedema Spoon Feed

In patients presenting with angioedema, history of hypertension, shortness of breath, drooling, and anterior tongue or pharyngeal swelling were risk factors for eventual need for intubation.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

WEST Aorta Guidelines Spoon Feed

The Western Trauma Association Algorithms Committee has released new evaluation and management guidelines and a step-by-step algorithm (see below) surrounding blunt thoracic aortic injury.

Guess The EtOH Spoon Feed

ED clinicians are often inaccurate in their estimations of patients’ blood alcohol content (BAC). Overestimation is common, especially in patients arriving by ambulance compared to walk-ins.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Api US’s Spoon Feed

When performed by an experienced EM physician or radiologist, a conclusive appendix ultrasound is both sensitive and specific when evaluating for acute appendicitis and can be used in place of CT. 

Cost of EM Life Spoon Feed

Emergency physicians (EPs) suffer from poor sleep quality and lower sleep quantity than recommended. EPs were also objectively more fatigued during late afternoon and evening shifts and spend almost a quarter of their shift in a fatigued state. 

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Burr, Cold Baby Spoon Feed

There is no definitive low temperature threshold that predicts severe bacterial infections in hypothermic infants. Clinical judgment and adjunct diagnostics are important considerations.

Miss Less GIBs Spoon Feed

In patients with a gastrointestinal bleed (GIB), CT imaging was more often diagnostic when the specific indication (GIB) was listed within the requisition order and multiphase studies were ordered.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Nitro For SCAPE Spoon Feed

This study suggests that high-dose nitroglycerin infusion may be a safe alternative to intermittent bolus dosing for SCAPE, but prospective trials are needed to determine optimal initial rates and titration strategies, as well as the proper use of other adjunct therapies.Nitro For SCAPE | Merit-Based Incentives | Shark WeEK(G)| Hi-Fid Sim | Lido In Joint

Hi-Fid Sim Spoon Feed

Anesthesia residents with little experience in fiber-optic intubation achieved competency faster when trained with a high-fidelity versus low-fidelity model.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Best of Resus 2022 Spoon Feed

Here are the latest evidence updates on basic, advanced, and pediatric life support - and more - from this expert literature review.

Amio Vs. Lido Spoon Feed

For in-hospital ventricular fibrillation/ventricular tachycardia (VF/VT) arrest (IHCA), lidocaine may have more favorable outcomes compared to amiodarone.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Go Go Pheno Spoon Feed:

Hospital adoption of phenobarbital for severe alcohol withdrawal syndrome (SAWS) was associated with lower rates of invasive mechanical ventilation (IMV).

SAH, No LP! Spoon Feed

Non-contrasted multislice CT (MSCT) is known to be highly sensitive in detecting subarachnoid hemorrhage (SAH) when performed within 6 hours of headache onset. Now, with modern MSCT, it looks like we can safely extend the timeframe even more.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

The Only Vertigo Tx Spoon Feed

Vestibular suppressant medications in peripheral vertigo were not associated with symptom resolution, decrease in repeat ED visits, patient satisfaction, or increased quality of life. The authors suggest that positional maneuvers, such as the Epley maneuver, should be the primary treatment for BPPV.

#1 Shock Methods Spoon Feed

For the treatment of refractory ventricular fibrillation (VF) in out-of-hospital cardiac arrest, survival to hospital discharge was more common among patients who received double sequential external defibrillation (DSED) and vector-change (VC) defibrillation than those who received standard defibrillation.  

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Placing Pacing Pads Spoon Feed

Placing transcutaneous cardiac pacer pads in the anteroposterior position required less energy to successfully capture. 

D(on’t)RE Spoon Feed

Use of the digital rectal exam (DRE) in trauma patients has repeatedly demonstrated poor sensitivity for injuries and has little impact on clinical management, with a high rate of false negative rates in pediatric populations.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Delirium = CT Spoon Feed

Among patients ≥65 years who presented to the ED with delirium, confusion, or altered mental status, 15.6% had an abnormal head CT. Presence of neurologic deficit was a significant predictor for abnormal CT, but anticoagulation was not. 

Pre-Hospital C-spine Clearance Spoon Feed

In this large, single-center prospective cohort implementation study, paramedics were able to apply a modified* Canadian C-spine rule to assess low risk trauma patients and transport a large proportion of them to a higher level of care without spinal precautions.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Bougienage Spoon Feed

Esophageal bougienage is an underutilized bedside technique for managing retained esophageal coins.

Spotting Functional Disorders Spoon Feed

Inconsistency and incongruence are two keys to diagnosing a functional neurological disorder.  The video demonstration really helps sort this out.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

CPR, Push Hard Spoon Feed

With ventilation rate standardized, chest compression (CC) depth explains variations in ETCO2 better than chest compression rate.

Wake Up Strokes Spoon Feed

In patients presenting with ‘wake-up’ strokes, endovascular therapy improves functional outcomes, while intravenous alteplase may also provide a small beneficial impact.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Go Scanner Go Spoon Feed

Newer CT scanners led to faster head CT by about 10 seconds, and this decreased the number of pediatric patients who required sedation.

How PEs Kill Spoon Feed

Decompensated right heart failure (RHF) increases morbidity and mortality, but it can be challenging to diagnose and treat. This review summarizes the unique physiology of RHF and treatment implications.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Cranial EZ-IO Spoon Feed

The EZ-IO may be considered as a temporizing measure for trepanation of an epidural hematoma (EDH) in rural ED settings. This should be considered only under the guidance of a skilled neurosurgeon when immediate transportation to a higher level of care is not possible.

Status: Ketamine Spoon Feed

In children with refractory status epilepticus, around 3/4 of patienats who were started on a ketamine infusion had seizure termination or improvement.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

HypoK ¹ HypoMg Spoon Feed

This retrospective single-center study found that hypokalemic patients who received magnesium within 4 hours of their potassium supplementation had no significant difference in time to serum potassium normalization.

Traumatic Pregnancies Spoon Feed

The primary survey and standard initial interventions are the same. Here is how a viable pregnancy changes the algorithm beyond that.  

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Bell’s Roids Spoon Feed

There was no statistical difference in 1, 3, or 6 month facial recovery with prednisolone vs placebo for children with Bell's palsy in this underpowered RCT. However, with a possible signal of long term benefit, I will keep prescribing steroids in these patients.

WATEFALL RCT Spoon Feed

Conservative fluid administration in patients with acute pancreatitis can achieve similar clinical outcomes compared with aggressive resuscitation, with less risk of volume overload.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Peds MTP Spoon Feed:

A transfusion threshold of 20 ml/kg of any blood product during the first hour of pediatric trauma resuscitation maximizes sensitivity and specificity for in-hospital mortality, need for intervention, and additional bleeding episodes and may identify children in need of massive transfusion.

Tega-don’t Spoon Feed

Using Tegaderm™ during ocular ultrasound was associated with poorer image quality and had no effect on patient comfort. If you’re using ocular ultrasound as a modality, consider if using a Tegaderm™ will get in the way of a good diagnosis.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Pax in the Vaxed Spoon Feed

Nirmatrelvir (Paxlovid) use in a population of largely immune outpatients ≥65 years old, during the omicron variant era, was significantly associated with reduction in hospitalization and death.

29-60 Day LP Spoon Feed

Febrile infants 29-60 days with a positive UA had no cases of bacterial meningitis.  These patients do not need a lumbar puncture (LP). 

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

More Paralysis Spoon Feed

In this single center cohort of 886 patients, 5 patients had definite awareness during paralysis. However, there were 61 patients determined to have possible awareness, meaning upwards of 7.4% of patients could have been aware. 

Burnout = Bad Outcomes Spoon Feed

Physician burnout has extensive negative effects, not just on individuals, but on hospital systems and on patient safety and satisfaction. 

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Neonatal Hyperbili Update Spoon Feed

The American Academy of Pediatrics (AAP) updated clinical guidelines for management of term infants presenting with hyperbilirubinemia. Relevant sections for ED providers include slightly raising phototherapy treatment thresholds, removing race as a consideration, and giving courses of action for infants requiring higher levels of care.

Little Less Sleepy Spoon Feed

This pilot trial showed that an educational initiative focused on reducing deep post-intubation sedation in the Emergency Department was feasible and associated with lower mortality, more ventilator-free and ICU-free days, and no increase in adverse events.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

No Dizzy Answers Spoon Feed

We cannot rely on neuroimaging (CT, CTA, MRI or MRA) alone to effectively rule out stroke in patients presenting to the ED with acute dizziness or vertigo.

Hemoptysis, So What? Spoon Feed

Removing the “hemoptysis” item from PERC1-4, YEARS,5-7 and PEGeD8 clinical decision tools (CDTs) did not significantly increase diagnostic failure in a cohort of patients at low risk for acute pulmonary embolism (PE).

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Infant hypothermia Spoon Feed

There is significant practice pattern variation in the ED management of infants ≤90 days of age with hypothermia.

Non-sterile Lac repair Spoon Feed

This trial suggests that there is unlikely to be a large difference in wound infection rates between non-sterile gloves and dressings and sterile gloves, dressings, and drapes for suturing of traumatic wounds in the ED.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Spoon Feed

Patients with long COVID had a host of symptoms, poorer quality of life, and more anxiety and depression, but they did not have a specific cause identified for symptoms despite a comprehensive exam and battery of tests.

Spoon Feed

Occult hypoxemia occurred more often in Black than White patients.  In other words, if a patient's skin tone is darker, what appears to be an acceptable SpO2 (i.e. 92%) may actually be lower when measured with SaO2.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

INTUBE Study Spoon Feed:

Patients who suffer from peri-intubation cardiovascular instability and collapse have an increased risk of mortality. Propofol was significantly associated with increased risk of peri-intubation instability and collapse.

Paxlovid Rebound Spoon Feed:

Some patients treated with nirmatrelvir-ritonavir (Paxlovid) may develop rebound symptoms or convert to a positive antigen test after completion of treatment and initial clinical improvement. Unfortunately, such patients may continue to shed virus and remain infectious while experiencing rebound symptoms.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Monkey Pox Risk Spoon Feed:

The current monkeypox outbreak is characterized by sexual transmission and presents with a flu-like prodrome followed by characteristic rash.

EpisTXAis Spoon Feed:

This single center, double blinded, randomized control trial of 240 patients demonstrated several positive outcomes with addition of tranexamic acid (TXA) to standard therapy.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Non-Op Stabbings Spoon Feed:

In abdominal stab wound patients without criteria for immediate operative intervention, 24 hours of observation was sufficient to identify a failure of conservative management.

Adult Epiglottitis Spoon Feed

This review article offers pearls for adult epiglottitis, a disease with increasing prevalence and high morbidity.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Awake With Paralysis Spoon Feed:

The proportion of patients that experience awareness with paralysis (AWP) is alarmingly high; 3.4% were aware of their surroundings but paralyzed, which is 3.4% more than what should occur.

POCUS Pulse Checks Spoon Feed:

Point-of-care ultrasound carotid artery compression (POCUS-CAC) was quicker than manual palpation (MP) in determining return of spontaneous circulation (ROSC).

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Face-to-Face Intubation Spoon Feed:

Upright face-to-face intubation had minimal difference in time to intubation or laryngeal views obtained when compared to supine intubation on cadavers, but there were some limitations with this study and further investigation into this technique and its application are needed.

Playing DRESS-up Spoon Feed:

This article reviews the literature regarding drug reaction with eosinophilia and systemic symptoms (DRESS) and focuses on the EM and critical care physician’s perspective, summarizing the presentation, clinical features, and management.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

C-Collar Adherence Spoon Feed:

Many children discharged from the emergency department with minor traumatic cervical spine injury do not adhere to recommendations for cervical immobilization or outpatient follow-up, with no significant clinical consequences observed.

Diagnostic Traps Spoon Feed:

There are two distinct ECG patterns to know for isolated right ventricular myocardial infarctions (IRVMI). 

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Very Sensitive Trops Spoon Feed

A single high sensitivity cardiac troponin T (hs-cTnT) measurement* less than the limit of quantitation (the lowest reportable concentration) appears to be sufficient in ruling out acute MI in a low risk population.

Seaman’s Sign Spoon Feed:

The Seamens’ Sign performs better than commonly used criteria for ruling in left ventricular hypertrophy (LVH) by ECG.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Top Ten Tips Spoon Feed:

Here are the top 10 points for optimizing vasopressor use in critically ill patients.

Back to BaSICS Spoon Feed:

There have been multiple publications since the original SMART and SALT-ED trials, including this Brazilian RCT that initially said fluid choice didn’t matter in critically ill patients. However, a secondary analysis of the BaSICS RCT suggests otherwise.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Is Paxlovid Working Spoon Feed:

In the omicron era, nirmatrelvir/ritonavir (Paxlovid) is highly effective in reducing the risk of severe COVID-19 and mortality.

Peds Droperidol Spoon Feed:

This systematic review suggests that droperidol is both safe and effective for treating agitation in the pediatric population.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Top 10 of PEM Spoon Feed:

This review article highlighted some of the pivotal pediatric emergency medicine literature in 2021. It is a great update on commonly seen pathology in the pediatric population.

Here’s A Placebo Spoon Feed:

Children with functional abdominal pain and irritable bowel syndrome (IBS) taking an open-label placebo (OLP) reported significantly less pain and took fewer rescue pain medications. 

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

1 Or 2 Dex Spoon Feed:

A single dose of dexamethasone was as effective as two in treatment of mild to moderate pediatric asthma exacerbations in the emergency department.

Rx: Paxlovid Spoon Feed:

Paxlovid offers an oral option for treating COVID-19 infection.  Here is what you need to know before prescribing.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Sent Home Abnormal Spoon Feed:

18% of children in this cohort were discharged from a pediatric ED with at least one abnormal vital sign. In all-comers, there was no significant difference in return rate between those discharged with or without abnormal vital signs. Those who, at time of discharge, had two or more abnormal vital signs or were less than 3 years of age were more likely to return.

Guided IVs Spoon Feed:

Ultrasound guided peripheral intravenous cannulation (PIVC) has been shown to be effective in some pediatric populations.

Lessons from Tuskegee Spoon Feed:

We need to understand our recent history.  The syphilis study is a story we must tell, internalize, and learn from so we won't make the same mistakes again.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Vapocoolant Please Spoon Feed:

Vapocoolant spray may improve a patient’s experience of digital blocks for repair of finger injuries.

Mystery ECG Spoon Feed:

Presented is a process to interpret an ECG with negative P waves and pathologic Q waves in leads I and aVL.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

IV APAP = less morphine? Spoon Feed:

A 1g dose of IV acetaminophen (APAP) had no additional effect on pain control or reduction in overall morphine dosage.

Good And Bad of Abx Spoon Feed

Antibiotics have a good and bad side for women with uncomplicated cystitis.  Use of trimethoprim-sulfamethoxazole (TMP-SMX) and other antibiotics, when compared to nitrofurantoin, had higher risk of adverse events.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

PE post-D/C Spoon Feed:

Risk for venous thromboembolism (VTE) was highest during hospitalization but the risk remained elevated 3-fold at 3 months post-discharge.

UTICalc Recalibrates Spoon Feed:

Race was strongly associated with UTI risk, with non-Black children having 2-4 times greater odds of infection.  However, replacement of race with 2 other variables resulted in similar diagnostic accuracy for the UTICalc tool.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

New Hepatitis Spoon Feed:

A new, rare form of acute hepatitis has been seen in children, mostly under age 5 years, that presents with vomiting, diarrhea, and abdominal pain, followed by acute hepatitis with jaundice.  If you see a child with a "stomach virus" who has jaundice - check labs!

HyperCa in Cancer Spoon Feed

Cancer-associated hypercalcemia requires prompt recognition and treatment in the ED, starting with aggressive rehydration +/- loop diuretics as well as coordination of initiation of bone resorption inhibition, which can take up to 48 or longer hours to have a full effect.

Corporate EMerica Spoon Feed:

There is undeniable corporate influence in the practice of emergency medicine, and this is not best for patients or for those of us who care for them.  This topic is a minefield, but let's tiptoe through it together.

These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Don’t POCUS? Spoon Feed:

POCUS in the ED can lead to clinically useful information, although research has not yet demonstrated patient-centered improvements in care. While this modality shouldn’t be used for routine screening in the ED, it performs well with a focused clinical question.

Ramped n’ Tubed Spoon Feed:

This systematic review and meta-analysis does not show any statistical difference in first-pass success rate or adverse intubation-related events between patients intubated in an inclined versus supine position.