Classic EM Journal Reviews

Tags: , September 18th, 2018 Leave a Comment

New Orleans Head CT Criteria

CT scans are frequently done after minor head injury to evaluate for intracranial hemorrhage. While CT scans are an excellent tool for diagnosing or ruling out this disorder, they are not without harms including radiation exposure, cost and department delays. Much of the time, CTs are negative, or find injuries for which no intervention is ever done and do not clinically affect the patient.
Read More

Wells’ Score + D-dimer to Rule Out PE

In the US, pulmonary embolism (PE) kills 100,000 people each year and over 360,000 new cases of PE are diagnosed each year (Horlander 2003). Currently, the gold standard for diagnosing PE is the computed tomographic pulmonary angiography (CTPA). Patients with PE present with varying symptoms, from anxiety and tachycardia, to shortness of breath and syncope.
Read More

Tags: , , , , August 2nd, 2018 Leave a Comment

Focused Echocardiographic Evaluation in Life Support and Peri-Resuscitation (FEEL Study)

Focused use of ultrasound in resuscitation of patients with shock and cardiac arrest has become increasingly embraced in both the emergency department (ED) as well as in the prehospital setting. Application of ultrasound, particularly of echocardiography, has the potential to identify treatable causes of shock and arrest, identify shockable rhythms and identify the presence of mechanical activity.
Read More

Prospective Validation of the HEART Score

Chest pain representing acute coronary syndrome (ACS) is the most common reason patients presenting to the emergency department (ED) are admitted to the hospital. The treatment for ACS is early targeted therapy and missed cases results in increased morbidity and mortality. As a result many clinicians choose to admit patients for further evaluation, resulting in further testing and higher medical costs.
Read More

Tags: , December 8th, 2016 Leave a Comment

Canadian Head CT Decision Tool

CT scans are frequently done after minor head injury to evaluate for intracranial hemorrhage. While CT scans are an excellent tool for diagnosing or ruling out this disorder, they are not without harms including radiation exposure, cost and department delays. Much of the time, CTs are negative, or find injuries for which no intervention is ever done and do not clinically affect the patient.
Read More

Ottawa Ankle Clinical Decision Instrument Derivation Study

Prior to the creation of the Ottawa Ankle Decision Instrument, most patients presenting to the Emergency room with a complaint of acute ankle injury had ankle and or foot radiographs ordered to evaluate for fracture, even though the incidence of fracture among this population is relatively low (~ 15%). While ankle radiographs do not expose the patient to large amounts of radiation,
Read More

Tags: , , August 25th, 2016 2 Comments

NEXUS C-Spine Decision Instrument

Neck pain after blunt trauma is common but significant cervical spine injuries are not. An unrecognized cervical spine injury can be catastrophic as it can lead to serious neurologic disability or even death. As a result, we as clinicians are fairly liberal about performing imaging of the cervical spine after trauma. Prior to the creation of the NEXUS C-spine criteria and the Canadian C-spine criteria,
Read More

Tags: , , August 18th, 2016 Leave a Comment

NINDS – tPA in Ischemic Stroke

Each year, 22 million people worldwide will experience a stroke. 50% of these are ischemic strokes. For years, there were no effective treatments for these patients. As a result, the burden of ischemic stroke was enormous. Patients often experience debilitating strokes requiring round-the-clock care. Acute ischemic strokes represent the leading cause of disability in our society and the third most common cause of death.
Read More