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This is a quick summary of the most important articles we covered this week on the JournalFeed blog. It’s the audio spoon-feed!
Help you to read less, learn more, and save lives!
Help you to read less, learn more, and save lives!
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The JournalFeed podcast for the week of Sept 16-20, 2024.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.
The JournalFeed podcast for the week of Sept 9-13, 2024.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.
The JournalFeed podcast for the week of Sept 2-6, 2024.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.
The JournalFeed podcast for the week of August 26-30, 2024.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.
The JournalFeed podcast for the week of Aug 19-23, 2024.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).
The JournalFeed podcast for the week of Aug 12-16, 2024.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.
The JournalFeed podcast for the week of August 5-9, 2024.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.
The JournalFeed podcast for the week of July 29 – August 2, 2024.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.
The JournalFeed podcast for the week of July 22-26, 2024.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.
The JournalFeed podcast for the week of July 15-19, 2024.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.
The JournalFeed podcast for the week of July 8-12, 2024.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.
The JournalFeed podcast for the week of July 1-5th , 2024.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.
The JournalFeed podcast for the week of July 24-29, 2024.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).
The JournalFeed podcast for the week of June 17-21, 2024.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.
The JournalFeed podcast for the week of June 10-14, 2024.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%.
The JournalFeed podcast for the week of June 3-7, 2024.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
The JournalFeed podcast for the week of May 27-31, 2024.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.
The JournalFeed podcast for the week of May 20-24, 2024.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%).
The JournalFeed podcast for the week of May 13-17, 2024.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.
The JournalFeed podcast for the week of May 6-10, 2024.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.
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