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Journal Feed Weekly Wrap-Up

EMDocs

Spoon Feed In adults presenting to EMS after OHCA, those receiving epinephrine prior to advanced airway management (AAM = supraglottic airway, SGA, or endotracheal tube) experienced better outcomes and prehospital ROSC than those receiving AAM before epinephrine. Clay Smith at @spoonfedEM , and sign up for email updates here. #1:

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REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients

RebelEM

The potential for soiled airways, cervical spine injuries, maxillofacial injuries and head injuries combined with agitation/delirium, altered mental status and hypoxemia can make securing a definitive airway both an anatomic and physiologic challenge.

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Acute Esophageal Variceal Bleeding in Children

Pediatric EM Morsels

Maybe injuries to the spleen or kidney come to mind. Perhaps thoughts of pelvic injuries or severe head injury dominate our considerations. Long-term Outcomes and Health Perceptions in Pediatric-onset Portal Hypertension Complicated by Varices. Semin Liver Dis. 2023 Feb;43(1):100-116. doi: 10.1055/s-0042-1759613.

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Ep 159 Geriatric Trauma Part 1: The Under-Triaging Problem, Resuscitation, Airway, Head and C-spine Imaging, Clearing the C-spine

Emergency Medicine Cases

In this Part 1 of our 2-part EM Cases podcast series on Geriatric Trauma, Dr. Barbara Haas, Dr. Camilla Wong and Dr. Bourke Tillman answer questions such as: why are older patients under-triaged to trauma centers and how does that affect outcomes? What is the utility of the Shock Index in older patients? and many more.

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Grand Rounds Recap 11.15.23

Taming the SRU

r4 case follow-up WITH DR. milligan CC: Found down The case: A young F was found down in a snow bank after a GSW to the head. EMS had reported she had coded en route. She presented with a core temp of 30C and her CT scan did not show a devastating head injury as was expected. She regained pulses with warming on arrival.

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SGEM#266: Old Man Take a Look at the Canadian CT Head Rule I’m a Lot Like You Were

The Skeptics' Guide to EM

In an attempt to improve resource utilization, emergency department length of stay, limit cost and improve outcomes, there have been multiple Clinical Decision Rules (CDRs) created to help guide clinicians in their decision-making process. We have covered the CCHR on the SGEM with the EM Swami and Dr. Emily Junck back on SGEM#106.

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Intranasal Fentanyl for Sickle Cell Vaso-Occlusive Pain

ACEP Now

Primary Outcome: Discharged home from the ED Secondary Outcomes: There were several secondary outcomes. Another interesting secondary outcome that could confound the results is that children who received IN fentanyl received higher overall total parenteral opioid morphine equivalents. Am J Hematol.