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BCM Emergency Medicine Journal Club

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9 papers 0 to 25 followers Baylor College of Medicine Emergency Medicine residency program journal club articles
By Cedric Dark MD, MPH, FACEP, FAAEM
https://www.readbyqxmd.com/read/27371185/immediate-total-body-ct-scanning-versus-conventional-imaging-and-selective-ct-scanning-in-patients-with-severe-trauma-react-2-a-randomised-controlled-trial
#1
RANDOMIZED CONTROLLED TRIAL
Joanne C Sierink, Kaij Treskes, Michael J R Edwards, Benn J A Beuker, Dennis den Hartog, Joachim Hohmann, Marcel G W Dijkgraaf, Jan S K Luitse, Ludo F M Beenen, Markus W Hollmann, J Carel Goslings
BACKGROUND: Published work suggests a survival benefit for patients with trauma who undergo total-body CT scanning during the initial trauma assessment; however, level 1 evidence is absent. We aimed to assess the effect of total-body CT scanning compared with the standard work-up on in-hospital mortality in patients with trauma. METHODS: We undertook an international, multicentre, randomised controlled trial at four hospitals in the Netherlands and one in Switzerland...
August 13, 2016: Lancet
https://www.readbyqxmd.com/read/25913166/diltiazem-vs-metoprolol-in-the-management-of-atrial-fibrillation-or-flutter-with-rapid-ventricular-rate-in-the-emergency-department
#2
RANDOMIZED CONTROLLED TRIAL
Christian Fromm, Salvador J Suau, Victor Cohen, Antonios Likourezos, Samantha Jellinek-Cohen, Jonathan Rose, John Marshall
BACKGROUND: Diltiazem (calcium channel blocker) and metoprolol (beta-blocker) are both commonly used to treat atrial fibrillation/flutter (AFF) in the emergency department (ED). However, there is considerable regional variability in emergency physician practice patterns and debate among physicians as to which agent is more effective. To date, only one small prospective, randomized trial has compared the effectiveness of diltiazem and metoprolol for rate control of AFF in the ED and concluded no difference in effectiveness between the two agents...
August 2015: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26129992/impact-of-a-telepsychiatry-program-at-emergency-departments-statewide-on-the-quality-utilization-and-costs-of-mental-health-services
#3
MULTICENTER STUDY
Meera Narasimhan, Benjamin G Druss, Jason M Hockenberry, Julie Royer, Paul Weiss, Gretl Glick, Steven C Marcus, John Magill
OBJECTIVE: This study estimated the impact of a statewide, centralized telepsychiatry service provided in nonpsychiatric emergency departments (EDs) on use of mental health services. METHODS: Individuals treated via telepsychiatry were compared with a matched control group of individuals with mental health diagnoses who were treated in nonparticipating hospitals. Bivariate and two-part and generalized linear regression models were used to assess differences between the two groups in outpatient follow-up, hospital admission following the ED visit, length of hospital stay if admitted, and inpatient and total costs...
November 2015: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/26962903/trimethoprim-sulfamethoxazole-versus-placebo-for-uncomplicated-skin-abscess
#4
RANDOMIZED CONTROLLED TRIAL
David A Talan, William R Mower, Anusha Krishnadasan, Fredrick M Abrahamian, Frank Lovecchio, David J Karras, Mark T Steele, Richard E Rothman, Rebecca Hoagland, Gregory J Moran
BACKGROUND: U.S. emergency department visits for cutaneous abscess have increased with the emergence of methicillin-resistant Staphylococcus aureus (MRSA). The role of antibiotics for patients with a drained abscess is unclear. METHODS: We conducted a randomized trial at five U.S. emergency departments to determine whether trimethoprim-sulfamethoxazole (at doses of 320 mg and 1600 mg, respectively, twice daily, for 7 days) would be superior to placebo in outpatients older than 12 years of age who had an uncomplicated abscess that was being treated with drainage...
March 3, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/23425733/a-prospective-multicenter-comparison-of-levetiracetam-versus-phenytoin-for-early-posttraumatic-seizure-prophylaxis
#5
RANDOMIZED CONTROLLED TRIAL
Kenji Inaba, Jay Menaker, Bernardino C Branco, Jonathan Gooch, Obi T Okoye, Joe Herrold, Thomas M Scalea, Joseph Dubose, Demetrios Demetriades
BACKGROUND: Brain Trauma Foundation guidelines recommend seizure prophylaxis for preventing early posttraumatic seizure (PTS). Phenytoin (PHE) is commonly used. Despite a paucity of data in traumatic brain injury, levetiracetam (LEV) has been introduced as a potential replacement, which is more costly but does not require serum monitoring. The purpose of this study was to compare the efficacy of PHE with that of LEV for preventing early PTS. METHODS: Consecutive blunt traumatic brain injury patients undergoing seizure prophylaxis were prospectively enrolled at two Level 1 trauma centers during a 33-month period...
March 2013: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/23911630/incidence-and-factors-associated-with-cardiac-arrest-complicating-emergency-airway-management
#6
Alan C Heffner, Douglas S Swords, Marcy N Neale, Alan E Jones
OBJECTIVE: Cardiac arrest (CA) is a rare but recognized complication of emergency airway management. Our aim was to measure the incidence of peri-intubation CA during emergency intubation and identify factors associated with this complication. METHODS: Retrospective cohort study of emergency endotracheal intubations performed in a large, urban emergency department over a one-year period. Patients were included if they were >18 years old and not in CA prior to intubation...
November 2013: Resuscitation
https://www.readbyqxmd.com/read/8411577/users-guides-to-the-medical-literature-i-how-to-get-started-the-evidence-based-medicine-working-group
#7
A D Oxman, D L Sackett, G H Guyatt
No abstract text is available yet for this article.
November 3, 1993: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/25272316/goal-directed-resuscitation-for-patients-with-early-septic-shock
#8
RANDOMIZED CONTROLLED TRIAL
Sandra L Peake, Anthony Delaney, Michael Bailey, Rinaldo Bellomo, Peter A Cameron, D James Cooper, Alisa M Higgins, Anna Holdgate, Belinda D Howe, Steven A R Webb, Patricia Williams
BACKGROUND: Early goal-directed therapy (EGDT) has been endorsed in the guidelines of the Surviving Sepsis Campaign as a key strategy to decrease mortality among patients presenting to the emergency department with septic shock. However, its effectiveness is uncertain. METHODS: In this trial conducted at 51 centers (mostly in Australia or New Zealand), we randomly assigned patients presenting to the emergency department with early septic shock to receive either EGDT or usual care...
October 16, 2014: New England Journal of Medicine
https://www.readbyqxmd.com/read/20554319/effects-of-tranexamic-acid-on-death-vascular-occlusive-events-and-blood-transfusion-in-trauma-patients-with-significant-haemorrhage-crash-2-a-randomised-placebo-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Haleema Shakur, Ian Roberts, Raúl Bautista, José Caballero, Tim Coats, Yashbir Dewan, Hesham El-Sayed, Tamar Gogichaishvili, Sanjay Gupta, Jorge Herrera, Beverley Hunt, Pius Iribhogbe, Mario Izurieta, Hussein Khamis, Edward Komolafe, María-Acelia Marrero, Jorge Mejía-Mantilla, Jaime Miranda, Carlos Morales, Oluwole Olaomi, Fatos Olldashi, Pablo Perel, Richard Peto, P V Ramana, R R Ravi, Surakrant Yutthakasemsunt
BACKGROUND: Tranexamic acid can reduce bleeding in patients undergoing elective surgery. We assessed the effects of early administration of a short course of tranexamic acid on death, vascular occlusive events, and the receipt of blood transfusion in trauma patients. METHODS: This randomised controlled trial was undertaken in 274 hospitals in 40 countries. 20 211 adult trauma patients with, or at risk of, significant bleeding were randomly assigned within 8 h of injury to either tranexamic acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h) or matching placebo...
July 3, 2010: Lancet
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