I am not sure which I prescribe more often each shift: analgesics or antiemetics. Despite having medical directives for both, I am still interrupted multiple times every hour with requests to chart one or the other. To be fair, I am never bothered. Nausea and vomiting are horrible symptoms, and […]
Evidence Based Medicine
124 posts
It’s time for another edition of the research round up and BroomeDocs journal club – a collection of the most interesting emergency medicine research I have encountered in the last few months. This time around we have (of course) CRASH 3, some articles on laceration repair, improving the ED experience […]
Since publishing my 5 part series illustrating that stress tests are useless (also available as an EM Cases Journal Jam Episode and on EM:RAP), I have received a number of requests to review coronary CT angiography (CCTA). After all, stress testing is old technology. CCTA is newer and therefore obviously […]
Although the CT scan is a wonderful piece of technology that has undoubtedly improved the practice of emergency medicine, we are clearly over-using this technology in modern practice. For example, one study that looked retrospectively at all head CTs ordered for trauma concluded that more than 1/3 were unnecessary based […]
TXA has been the darling drug of emergency medicine and critical care since the publication of the CRASH 2 trial back in 2010. CRASH 2 demonstrated a 1.5% decrease in mortality when TXA was given to trauma patients with significant bleeding. (CRASH 2 2010) These results led to the widespread […]
You can’t interpret the results of a test without knowing the pretest probability. I am sure we have all heard the same lecture about screening tests. I am sure that we have all been surprised by the strange numbers that result from applying seemingly excellent tests in low risk populations. […]
It’s time for another deep dive into the medical literature, this time looking at the evidence for heparin (or any anticoagulant) in the setting of STEMI and PCI. I have previously outlined the evidence that indicates that heparin shouldn’t be used (is harmful) in unstable angina and NSTEMI. However, that […]
I have addressed the WOMAN trial before on First10EM. (Twice actually). Two mentions of a trial of TXA in postpartum hemorrhage might already seem a bit excessive for an emergency medicine blog. However, this trial has been discussed widely, and there seems to be some persistent confusion about the results […]
I recently wrote a post lamenting our lack of attention to distress in adult patients. There is so much we can do to improve the emergency department experience. I am tempted to say that we should treat our patients as we would want to be treated – a variation on […]