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First10EM Journal Club: August 2024

Broome Docs

2024 Mar 25:S0196-0644(24)00099-4. 2024 Jun;26(6):381-385. Epub 2024 Apr 9. 2024 Jul;81:75-81. Epub 2024 Apr 23. 2024 Mar;27(1):26-29. 2024 Apr;165(4):847-857. For the most part, central lines can be left to the ICU team during day time hours (and a good percentage of patients will never need one).

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SGEM#438: Bone, Bone, Bone, Tell Me What Ya Gonna Do ā€“ for IO Access Location?

The Skeptics' Guide to EM

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. February 2024. Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation.

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SGEM#452: Iā€™m Still Standing ā€“ After the Allergy Challenge

The Skeptics' Guide to EM

Date: September 12, 2024 Reference: Anderson et al. AEM August 2024. A pivotal study by Raja et al. The use of direct oral challenges has been tried in the intensive care unit (ICU) setting to de-label patients. Full dose challenge of moderate, severe and unknown beta-lactam allergies in the emergency department.

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SGEM#448: More than A Feeling ā€“ Gestalt vs CDT for Predicting Sepsis

The Skeptics' Guide to EM

Reference: Knack et al. All of the secondary outcomes (mortality at 90 days, misdiagnoses, hospital length of stay, ICU admission rate, ICU length of stay, and quality of life) also did not show a statistical difference between the intervention group and the control group (SGEM#207).

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SGEM#440: Iā€™m Gonna Need Someone To Help Me ā€“ GRACE4 AUD and CHS Management in the ED

The Skeptics' Guide to EM

Reference: Borgundvaag et al. AEM May 2024 Date: May 22, 2024 Dr. Bjug Borgundvaag Guest Skeptic: Dr. Bjug Borgundvaag is the Founding Director of the Schwartz/Reisman Emergency Medicine Institute (SREMI), at Sinai Health System.

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Updates in High dose Insulin and Euglycemia Therapy (HIET) for the treatment of Beta-adrenergic Receptor and Calcium Channel Antagonists Overdose

Core EM

Disposition to ICU. References: Yuan TH, Kerns WP, Tomaszewski CA, et al. von Lewinski D, Bruns S, Walther S, et al. Cole JB, Corcoran JN, Engebretsen KM, et al. Holger JS, Engebretsen KM, Fritzlar SJ, et al. Kerns W, Schroeder D, Williams C, et al. Kline JA, Tomaszewski CA, Schroeder JD, et al.

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The Current Status of Continuous-Seizure Management

ACEP Now

Neurology consultation should be initiated, and the patient should be admitted to the ICU. References Brophy GM, Bell R, Claassen J, et al. Zehtabchi S, Abdel Baki SG, Omurtag A, et al. Towne AR, Waterhouse EJ, Boggs JG, et al. Huff JS, Melnick ER, Tomaszewski CA, et al. Paliwal P, Wakerley BR, Yeo LLL, et al.