December 1,2020: This post was based on the best available evidence at the beginning of the pandemic (March-April 2020). The information contained is still very relevant, but there is also now an updated/companion review specifically looking at the transmission of COVID-19 (and concluding aerosols play a very important role in […]
ebm reviews EBM reviews
The treatment of viral pneumonia is supportive care. The arrival of COVID-19 has not changed that basic principle. Due to the scope of the crisis, there is massive interest in finding other possible treatments. I will review the evidence for those various treatments, starting today with chloroquine and hydroxychloroquine, but […]
For a long time, we have been planning an episode of the EMCases Journal Jam series that will look at the evidence for or against TXA in almost all clinical settings. (It has been in the planning stages for a long time, because it is un-surprisingly hard to coordinate the […]
A new paper was published this month that is likely to change the way that a lot of people manage spontaneous pneumothorax (although I don’t think it will significantly change my practice)…
Sucrose is not a pain medication. That rant already exists on this blog. It was also the subject of my talk at the final SMACC conference, which is now online. Another blog post is probably unnecessary, but neither resource included the references from my literature review, so for those who […]
Superstitions are sort of fun. They represent a lack of scientific understanding and critical thinking that I obviously hate, but they also offer us interesting and relatively harm free insights into the many failings of human cognition. I say “quiet” a lot. I like the word. Although it occasionally upsets […]
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 […]
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 […]
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 […]