tag:blogger.com,1999:blog-76759265991641497752023-06-20T05:53:01.986-07:00UF Emergency Medicine JC Blog / Game ChangersBe aware of RESTRICTED INFORMATION when posting comments: • PROTECTED HEALTH INFORMATION (PHI) -Health information combined with name, or med record #, or address, or key dates, or family members, or any other information that would link a person to their health condition. • PERSONAL INDENTIFICATION INFORMATION (PII) - Names combined with SSN, ID Numbers, or any information that could be used to commit identity fraud.Unknownnoreply@blogger.comBlogger43125tag:blogger.com,1999:blog-7675926599164149775.post-89447678687611973612013-08-12T07:43:00.001-07:002013-08-12T07:51:01.741-07:00Nontraumatic Subarachnoid Hemorrhage in the Setting of Negative Cranial Computed Tomography Results: External Validation of a Clinical and Imaging Prediction Rule<a href="http://www.annemergmed.com/article/S0196-0644%2812%2901508-9/abstract?source=aemf" target="_blank"><span style="color: blue;">Nontraumatic Subarachnoid Hemorrhage in the Setting of Negative Cranial Computed Tomography Results: External Validation of a Clinical and Imaging Prediction Rule</span></a><br />
<br />
<strong>Study objective</strong><br />
Clinical variables can reliably exclude a diagnosis of nontraumatic subarachnoid hemorrhage in patients with negative cranial computed tomography (CT) results. We externally validated 2 decision rules with 100% reported sensitivity for a diagnosis of subarachnoid hemorrhage, among patients undergoing lumbar puncture after a negative cranial CT result: (1) clinical rule: presence of any combination of age 40 years and older, neck pain or stiffness, loss of consciousness, or headache onset during exertion; and (2) imaging rule: cranial CT performed within 6 hours of headache onset.<br />
<br />
<strong>Methods</strong><br />
This was a matched case-control study of patients presenting to 21 emergency departments between 2000 and 2011. Patients with a diagnosis of subarachnoid hemorrhage as determined by lumbar puncture after a negative cranial CT result were screened for inclusion. A matched control cohort was selected among patients with a diagnosis of headache after negative cranial CT and lumbar puncture results.<br />
<br />
<strong>Results</strong><br />
Fifty-five cases of subarachnoid hemorrhage meeting inclusion criteria were identified, 34 (62%) of which were attributed to cerebral aneurysms. External validation of the clinical rule demonstrated a sensitivity of 97.1% (95% confidence interval [CI] 88.6% to 99.7%), a specificity of 22.7% (95% CI 16.6% to 29.8%), and a negative likelihood ratio of 0.13 (95% CI 0.03 to 0.61) for a diagnosis of subarachnoid hemorrhage. External validation of the imaging rule revealed that 11 of 55 subarachnoid hemorrhage cases (20%) had negative cranial CT results for tests performed within 6 hours of headache onset.<br />
<br />
<strong>Conclusion</strong><br />
The clinical rule demonstrated useful Bayesian test characteristics when retrospectively validated against this patient cohort. The imaging rule, however, failed to identify 20% of subarachnoid hemorrhage patients with a negative cranial CT result.<br /><br />
<h3>
</h3>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-29242276984768442742013-05-10T08:54:00.000-07:002013-05-10T08:55:42.057-07:002-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker <div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-Pxelc48lVDk/UY0X4hmDRHI/AAAAAAAAAFs/maVjgHvndUY/s1600/thumbs+up.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-Pxelc48lVDk/UY0X4hmDRHI/AAAAAAAAAFs/maVjgHvndUY/s1600/thumbs+up.jpg" /></a></div>
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=J+Am+Coll+Cardiol.+2012+Jun+5%3B59(23)%3A2091-%C2%AD%E2%80%908" target="_blank"><span style="color: blue;">2-Hour Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins as the Only Biomarker : The ADAPT Trial. Than, M, Cullen, L, et. al. Am Coll Cardiol. 2012 Jun 5;59(23):2091-‐8.</span></a><br />
<br />
In the ADAPT trial patients were enrolled between 2007 – 2011. Inclusion and exclusion criteria appear appropriate and relevant to our population with the exception one: the inability to contact the patient after follow-up. This exclusion could potentially apply to a large number of our patients. In addition the exclusion criteria included “staff considered recruitment to be inappropriate”, which could introduce bias into the study. Of those recruited not a single person was lost to follow-up. Of those deemed low-risk only one had a MACE, which on further review had a rising trop, making it very unlikely that this patient would have been discharged from our ED. The negative likelihood ratio for the ADAPT trial was 0.01, which is very strong. Additionally it was noted that the negative likelihood ratio for TIMI 0 and non-ischemic ECG was 0.07, also very strong. This data is similar that found in other studies evaluating TIMI and low-risk ECG. While this data needs to be reproduced in additional studies a 2 hours protocol using TIMI, ECG, and high sensitivity troponin may be safe option in low-risk patients.<br />
<br />
Overall the article was well received. It was felt that although the study was done in Australia, as we are currently using high-sensitivity troponin in our ED, this study could be applied to our patient population. In general the study receives a thumbs-up. Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-57116424856837814502013-04-26T08:36:00.004-07:002013-04-26T08:45:49.952-07:00Zinc for the Common Cold<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-1nEUXAards8/UXqgufVjFWI/AAAAAAAAAFY/MgeVlmm1mtU/s1600/thumbs+up.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-1nEUXAards8/UXqgufVjFWI/AAAAAAAAAFY/MgeVlmm1mtU/s1600/thumbs+up.jpg" /></a></div>
<v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f"><span style="font-family: Calibri;"><v:stroke joinstyle="miter"><v:formulas><v:f eqn="if lineDrawn pixelLineWidth 0"><v:f eqn="sum @0 1 0"><v:f eqn="sum 0 0 @1"><v:f eqn="prod @2 1 2"><v:f eqn="prod @3 21600 pixelWidth"><v:f eqn="prod @3 21600 pixelHeight"><v:f eqn="sum @0 0 1"><v:f eqn="prod @6 1 2"><v:f eqn="prod @7 21600 pixelWidth"><v:f eqn="sum @8 21600 0"><v:f eqn="prod @7 21600 pixelHeight"><v:f eqn="sum @10 21600 0"><span style="font-size: large;"><span style="font-family: Times New Roman;"></span></span></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas></v:stroke></span></v:shapetype><br />
<o:p>
</o:p><span style="font-family: "Times New Roman","serif"; font-size: 16pt; line-height: 115%;">Zinc
for the Common Cold<o:p></o:p></span><br />
<span style="font-family: "Times New Roman","serif";">Singh,
M., Das, R.R.<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Zinc for the common cold.</i><span style="mso-spacerun: yes;">
</span>Cochrane Database Syst Rev. 2011 Feb 16;(2):CD001364. doi:
10.1002/14651858.CD001364.pub3</span><br />
<span style="font-family: "Times New Roman","serif";"><o:p>
<a href="http://www.ncbi.nlm.nih.gov/pubmed/21328251"><span style="font-family: "Times New Roman","serif";"><span style="color: blue;">http://www.ncbi.nlm.nih.gov/pubmed/21328251</span></span></a></o:p></span><br />
<span style="font-family: "Times New Roman","serif";"><o:p><span style="font-family: "Times New Roman","serif";"><o:p></o:p></span></o:p></span><br />
<span style="font-family: "Times New Roman","serif";">
</span><span style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">1)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span>The
common cold is one of the most common causes for illness, doctor visits, and
missing school/work.<span style="mso-spacerun: yes;"> </span>The average child
gets eight colds per year and the average adult gets three colds per year.<span style="mso-spacerun: yes;"> </span>This study proposed assessing zinc
supplementation as beneficial for the common cold.<span style="mso-spacerun: yes;"> </span>This was a Cochrane review that included
randomized, double-blind placebo-controlled trials with zinc; both the
treatment and prevention of colds were assessed.<span style="mso-spacerun: yes;"> </span>Nine hundred sixty-six participants in 13 trials
were assessed and findings showed that there was a significant reduction in the
duration and severity of the colds with zinc.<span style="mso-spacerun: yes;">
</span>In two preventative trials with 394 participants, there was decreased
incidence of colds, less antibiotic use, and fewer school absences in the zinc
group.<span style="mso-spacerun: yes;"> </span>However, there was also a higher
rate of nausea and bad taste in the zinc group.<span style="mso-spacerun: yes;">
</span>Results showed that zinc should be administered within one day of
symptoms at the onset of the cold to be effective and should continue for at
least five days.<o:p></o:p><br />
<span style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;"></span></span><br />
<span style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">2)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span>The
patients were randomized and they only included placebo-controlled trials.<span style="mso-spacerun: yes;"> </span>This review used a total of 15 different
studies that were very heterogeneous in the outcomes they measured and the type
and amount of zinc that was used.<span style="mso-spacerun: yes;"> </span>They
included the best studies available to date with the best methodology, but
given the variety in studies, it is hard to make clear statements on exact
recommendations. <span style="mso-spacerun: yes;"> </span>Patients may have also
known what group they were in based solely on the taste of zinc and nausea
associated with its use.<span style="mso-spacerun: yes;"> </span>Treatment
effects were clearly shown in some studies and not clear in others. However,
overall the results showed that if zinc is taken within one day of symptoms, the
patient had a two-day earlier resolution of their cold as well as decreased
severity.<span style="mso-spacerun: yes;"> </span>The patients in these studies
tended to be outpatients and not ED patients.<span style="mso-spacerun: yes;">
</span>Given that side effects are minimal and not life threatening, the benefits
are worth the potential risk.<o:p></o:p><br />
<span style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;"></span></span><br />
<span style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman";"><span style="mso-list: Ignore;">3)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span>Although
this is not a lifesaving treatment, it is something that is safe and can
provide patients with an additional way to fight off viral infections in lieu
of only purchasing over- the-counter cold relievers. It has also been shown
that patients who take zinc end up being prescribed fewer antibiotics, which is
highly beneficial to both patients and healthcare at the national level.<o:p></o:p><br />
<br />
Coben
Thorn<o:p></o:p>Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-477696623719864972013-04-18T12:44:00.000-07:002013-04-23T12:46:39.197-07:00A Phase 2 Randomized, Double-Blind, Placebo– Controlled Study of the Safety and Efficacy of Talactoferrin in Patients With Severe Sepsis*, <a href="http://intensivo.sochipe.cl/subidos/catalogo3/Talactoferrina%20en%20sepsis%20severa%20Crit%20Care%20Med%202013.pdf" target="_blank"><span style="color: blue;">A Phase 2 Randomized, Double-Blind, Placebo–Controlled Study of the Safety and Efficacy ofTalactoferrin in Patients With Severe Sepsis*</span></a><br />
<br />
<span style="color: red;">Objectives:</span><br />
Lactoferrin is a glycoprotein with anti-infective and antiinflammatory<br />
properties found in secretions and immune cells. Talactoferrin<br />
alfa, a recombinant form of human lactoferrin, has similar<br />
properties and plays an important role in maintaining the gastrointestinal<br />
mucosal barrier integrity. In experimental animal models, administration<br />
of talactoferrin reduces translocation of bacteria from the gut<br />
into the systemic circulation and mortality from sepsis. Our objective<br />
was to determine if talactoferrin could reduce 28-day all-cause mortality<br />
in patients with severe sepsis and to assess its safety.Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-30489174648160041142012-11-15T12:31:00.000-08:002013-04-23T12:39:28.416-07:00Management of Minor Head Injury in Patients Receiving Oral Anticoagulant Therapy: A Prospective Study of a 24-Hour Observation Protocol<span style="background-color: #fff2cc;"><u></u></span><br />
<a href="http://www.sciencedirect.com/science/article/pii/S0196064411018877" target="_blank"><span style="background-color: #fff2cc; color: blue;">Management of Minor Head Injury in Patients Receiving OralAnticoagulant Therapy: A Prospective Study of a 24-HourObservation Protocol</span></a><br />
<br />
<span style="color: red;">Background</span><br />
The indications for computed tomography (CT) scanning in<br />
the setting of minor head injury have been the focus of<br />
substantial research. Long-term oral anticoagulation has been<br />
identified as a significant risk factor for intracranial injury,<br />
and CT scanning is generally recommended for such patients<br />
regardless of clinical presentation. However, it remains<br />
unclear whether such patients should then be hospitalized for<br />
observation or undergo a later second CT scan. Oral<br />
anticoagulant therapy is prescribed to prevent thromboembolic<br />
complications of atrial fibrillation, deep venous thrombosis, and<br />
surgically placed cardiac valves.Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-72082705140248168732012-10-18T12:26:00.000-07:002013-04-23T12:28:31.691-07:00Prospective Evaluation of a Clinical Practice Guideline for Diagnosis of Appendicitis in Children<span style="font-family: AdvVersal-R; font-size: small;"><span style="font-family: AdvVersal-R; font-size: small;"></span></span><a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2012.01402.x/abstract" target="_blank"><span style="color: blue;">Prospective Evaluation of a Clinical Practice Guideline for Diagnosis of Appendicitis in Children</span></a><br />
<span style="color: red;"></span><br />
<span style="color: red;">Objectives:</span> <br />
The objective was to assess the performance of a clinical practice guideline for evaluation of possible appendicitis in children. The guideline incorporated risk stratification, staged imaging, and early surgical involvement in high-risk cases.Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-36467017268291788402012-09-06T12:18:00.000-07:002013-04-23T12:20:15.969-07:00Patients With Rib Fractures Do Not Develop Delayed Pneumonia: A Prospective, Multicenter Cohort Study of Minor Thoracic Injury<a href="http://www.sciencedirect.com/science/article/pii/S0196064412002909" target="_blank"><span style="color: blue;">Patients With Rib Fractures Do Not Develop Delayed Pneumonia: A Prospective, Multicenter Cohort Study of Minor Thoracic Injury</span></a><br />
<span style="color: red;"></span><br />
<span style="color: red;">Background</span><br />
In 2006, there were 119.2 million visits to hospital<br />
emergency departments (EDs) in the United States, and<br />
more than one third of them were injury-related. Thoracic<br />
trauma frequency is estimated at 12 people per million per<br />
day, representing more than 796,000 ED visits annually.<br />
In the case of thoracic trauma, injuries of moderate<br />
severity are most often sustained to the chest wall and thus<br />
rarely require surgical intervention. Ziegler and Agarwal<br />
reported a 10% incidence of rib fractures in trauma patients<br />
treated at their site. In 2003, Liman et al observed that 2 of<br />
3 patients could be safely discharged from EDs. As financial<br />
pressures create more ambulatory care situations, minor<br />
thoracic injury patients are rapidly discharged from EDs<br />
without appropriate follow-up.Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-33173777482004085342012-02-09T12:48:00.000-08:002013-04-23T12:50:20.019-07:00Treating primary headaches in the ED: can droperidol regain its role?<span style="color: blue;"><a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Treating+primary+headaches+in+the+ED%3A+can+droperidol+regain+its+role%3F%22" target="_blank"><span class="highlight">Treating</span> <span class="highlight">primary</span> <span class="highlight">headaches</span> in the <span class="highlight">ED</span>: can <span class="highlight">droperidol</span> <span class="highlight">regain</span> its <span class="highlight">role</span>?</a></span><br />
<br />
<span style="color: red;">OBJECTIVE:</span> <br />The aim of this study was to describe the use and efficacy of low-dose (≤2 mg) droperidol for the treatment of primary headaches (ie, migraine, cluster, tension-type headache and trigeminal autonomic cephalalgias, and other primary headaches) in the emergency department (ED).Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-67492387055989237012011-09-01T12:13:00.000-07:002013-04-19T12:30:30.627-07:00Ketamine With and Without Midazolam for Emergency Department Sedation in Adults: A Randomized Controlled Trial<strong><a href="http://download.journals.elsevierhealth.com/pdfs/journals/0196-0644/PIIS0196064410015362.pdf"><span style="background-color: #fff2cc; color: blue;">Ketamine With and Without Midazolam for Emergency Department Sedation in Adults: A Randomized Controlled Trial</span></a></strong><br />
<strong></strong><strong></strong><br />
<strong><span style="color: red;">Background</span></strong><br />
Procedural sedation and analgesia is a technique of administering<br />
sedatives (midazolam, propofol, etomidate) or dissociative agents<br />
(ketamine) with or without opioid analgesics (fentanyl, morphine,<br />
meperidine) to induce a state that allows the patient to tolerate<br />
unpleasant procedures while maintaining cardiorespiratory function.<br />
Ketamine, first described in 1965, has been administered extensively for procedural sedation and analgesia in children and is a safe and effective sedative analgesic for painful procedures not only in the emergency department (ED) but also in the out-of-hospital setting.<br />
The widespread acceptance of ketamine as an agent for procedural<br />
sedation and analgesia in adult ED patients may be limited by<br />
physician apprehension about dreaming and hallucinations during<br />
recovery, and unpleasant reactions and nightmares, collectively referred to as recovery agitation.<br />
<br />
<br />Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-73424899441895241052011-06-14T08:57:00.000-07:002011-06-14T09:14:22.647-07:00Vasopression / Epinephrine / Dabigatran / Warfarin and CardiopulmonaryUF EM Journal Club 06/14/2011<br /><br />*<span style="color:#3333ff;"> </span><a href="http://intranet.emergency.med.ufl.edu/journal_club/061411/Christie_vasopressin.pdf"><span style="color:#3333ff;">Vasopressin and Epinephrine vs. Epinephrine Alone in Cardiopulmonary Resuscitation<br /></span></a><span style="color:#ff0000;">BACKGROUND: </span>During the administration of advanced cardiac life support for resuscitation from cardiac arrest, a combination of vasopressin and epinephrine may be more effective<br />than epinephrine or vasopressin alone, but evidence is insufficient to make clinical<br />recommendations.<br /><br />*<span style="color:#3333ff;"> </span><a href="http://intranet.emergency.med.ufl.edu/journal_club/061411/Coben_NEJMoa0905561.pdf"><span style="color:#3333ff;">Dabigatran versus Warfarin in Patients with Atrial Fibrillation<br /></span></a><span style="color:#ff0000;">BACKGROUND: </span>Warfarin reduces the risk of stroke in patients with atrial fibrillation but increases the risk of hemorrhage and is difficult to use. Dabigatran is a new oral direct thrombin<br />inhibitor.Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-3117062491031473512011-01-18T06:33:00.000-08:002013-04-24T05:03:01.764-07:00Do Emergency Department Blood Cultures Change Practice in Patients With Pneumonia?<strong><span style="font-size: 130%;">UF EM Journal Club - 01/20/2011</span></strong><br />
<a href="http://intranet.emergency.med.ufl.edu/journal_club/012011/Do_Emergency_Department_Blood_Cultures_Change_Practice_in_Patients_With_Pneumonia.pdf"><span style="color: blue;">Do Emergency Department Blood Cultures Change Practice in Patients With Pneumonia?</span></a><br />
<br />
<strong>Study objective:</strong> Although it is considered standard of care to obtain blood cultures on patients hospitalized for pneumonia, several studies have questioned the utility and cost-effectiveness of this practice. The objective of this study is to determine the impact of emergency department (ED) blood cultures on antimicrobial therapy for patients with pneumonia.<br />
<br />
Please print and have this article ready for conference.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-14915208068466810962011-01-11T06:30:00.000-08:002013-04-24T05:04:57.910-07:00Traumatic Pedatric Lacerations Repair / Gut vs Nylon Sutures<span style="color: black;">UF EM Journal Club - 01/25/11</span><br />
<span style="color: black;"></span><br />
<span style="color: black;">Hi all<br />This is my article for our journal club on Jan 25th:</span><br />
<span style="color: #3333ff;"></span><br />
<strong><span style="background-color: #fff2cc; color: blue;"><a href="http://intranet.emergency.med.ufl.edu/journal_club/012511/JC012511Nealon.pdf">CLINICAL INVESTIGATIONS ARTICLE - LINK</a></span></strong><br />
<span style="color: black;">A Randomized, Controlled Trial Comparing Long-term<br />Cosmetic Outcomes of Traumatic Pediatric<br />Lacerations Repaired with Absorbable Plain Gut<br />versus Nonabsorbable Nylon Sutures</span><br />
<span style="color: #3333ff;"></span><br />
<span style="color: #3333ff;"><strong><span style="color: red;">Abstract</span></strong></span><span style="color: black;">Objectives: To show that the use of absorbable sutures in<br />pediatric traumatic lacerations affords good long-term<br />cosmesis and no increase in complications (infection, dehiscence<br />rates, and need for surgical scar revision) when<br />compared with wounds sutured with nonabsorbable sutures.</span><br />
<span style="color: black;"></span><br />
<span style="color: black;">Please print article, and have on hand at meeting.</span>Unknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-67161471458521035262010-10-06T12:29:00.000-07:002010-10-06T12:42:52.654-07:00The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysisThe link below is for the EM Journal Club meeting on 10/19/2010.<br /><br /><a href="http://intranet.emergency.med.ufl.edu/journal_club/101910/steroids_versus_steroids_plus_antivirals.pdf"><span style="color:#000099;"><strong>The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis</strong></span></a><span style="color:#000099;"><br /></span><br />ABSTRACT:<br />Objective To determine whether steroids plus antivirals<br />provide a better degree of facial muscle recovery in<br />patients with Bell’s palsy than steroids alone.<br />Design Meta-analysis<br /><br /><a href="http://intranet.emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><span style="color:#000099;"><strong>Journal Club Assessment Form</strong></span><br /></a><br />Please be prepared, and have all materials printed for Journal Club.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-83285090018807449762010-07-08T06:26:00.000-07:002010-08-13T09:35:00.772-07:00Implementation of the Canadian C-Spine RuleThe link below is assigned reading for EM Journal Club on July 29,2010.<br /><br /><a href="http://emergency.sites.medinfo.ufl.edu/files/2010/07/Canadian-C-spine.pdf"><strong><span style="color:#000099;">Implementation of the Canadian C-Spine Rule</span></strong></a><strong><span style="color:#000099;"> </span></strong><br /><p><strong><span style="color:#000099;"><a href="http://intranet.emergency.med.ufl.edu/journal_club/072910/CRASH-2.pdf"><span style="color:#000099;">Effects of tranexamic acid</span></a><span style="color:#000099;"><br /></span><br /></span></strong><a href="http://emergency.sites.medinfo.ufl.edu/files/2010/07/journal_club_assessment_form.doc"><strong><span style="color:#000099;">EM Journal Club Assessment Form </span></strong></a><br /><br />Please print, and have ready for EM Journal Club</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-16146613551592308382010-06-14T06:35:00.000-07:002010-06-17T07:21:39.393-07:00Management of suspected pulmonary embolism (PE) by D-dimerManagement of suspected pulmonary embolism (PE) by D-dimer<br />Attached are the articles for Journal Club.<br /><br /><a href="http://emergency.med.ufl.edu/journal_club/061710/ddimer1.pdf"><strong><span style="color:#3333ff;">Management of suspected pulmonary embolism (PE) by<br />D-dimer and multi-slice computed tomography in outpatients:<br />an outcome study</span></strong></a><br /><br /><a href="http://emergency.med.ufl.edu/journal_club/061710/ddimerstaliatest.pdf"><strong><span style="color:#3333ff;">The performance of STA-Liatest D-dimer assay in out-patients<br />with suspected pulmonary embolism</span></strong></a><strong><span style="color:#3333ff;"><br /></span></strong><br /><a href="http://emergency.med.ufl.edu/journal_club/061710/5ddimertest.pdf"><strong><span style="color:#3333ff;">The usefulness of five D-dimer assays in the exclusion of deep<br />venous thrombosis</span></strong></a><br /><br /><a href="http://emergency.med.ufl.edu/journal_club/061710/Pulm%20Embo%20-%20JC%20Lecture.pdf"><strong><span style="color:#3333ff;">Clinical Features From the History and Physical Examination<br />That Predict the Presence or Absence of Pulmonary Embolism in<br />Symptomatic Emergency Department Patients: Results of a<br />Prospective, Multicenter Study</span></strong></a><br /><br /><a href="http://emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><strong><span style="color:#3333ff;">Journal Club Assessment Form</span></strong></a><strong><span style="color:#3333ff;"><br /></span></strong>There will be no paper copies distributed.<br />Please print these out if you wish to have a hard copy.<br />All residents should be prepared to discuss all of the articlesUnknownnoreply@blogger.comtag:blogger.com,1999:blog-7675926599164149775.post-77116405739229201442009-12-08T11:59:00.000-08:002009-12-08T16:07:11.949-08:00Dexamethasone as Add-On Therapy in ChildrenDexamethasone as Add-On Therapy in Children<br />Attached are the articles for Journal Club for 12/15.<br /><br /><a href="http://emergency.med.ufl.edu/journal_club/121509/1%20vs%203%20days%20of%20dex%20in%20kids%20with%20strept%20throat.pdf"><span style="color:#000099;">1 versus 3 Days of Dexamethasone Add-On Therapy in Children With Streptococcal Pharyngitis</span></a><span style="color:#000099;"><br /><br /></span><a href="http://emergency.med.ufl.edu/journal_club/121509/Clinical%20efficacy%20of%20dexamethasone%20for%20acute%20exudative%20pharyngitis.pdf"><span style="color:#000099;">CLINICAL EFFICACY OF DEXAMETHASONE FOR ACUTE EXUDATIVE PHARYNGITIS</span></a><span style="color:#000099;"><br /></span><br /><p><span style="color:#000099;">Dr. Kaplan asks, "Do you think the benefits of pain reduction for pharyngitis outweigh potential risks associated with steroid use on the general population?"</span></p><p><span style="color:#000099;"><br /></span><a href="http://emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><span style="color:#000099;">Journal Club Assessment Form</span></a><span style="color:#000099;"><br /></span>There will be no paper copies distributed.<br />Please print these out if you wish to have a hard copy.<br />All residents should be prepared to discuss all of the articles</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-74601887069266398752009-11-19T08:21:00.000-08:002009-11-19T05:25:48.744-08:00Pregnancy Risks and Birth Defects<strong><span style="font-size:130%;">Attached are the articles for EM Conference 11/19/09<br /></span><br /></strong><a href="http://emergency.med.ufl.edu/journal_club/111909/antimicrobials_pregnancy.pdf"><span style="color:#000099;">Antibacterial Medication Use During Pregnancy and Risk of Birth Defects.</span></a><span style="color:#000099;"><br /><br /></span><a href="http://emergency.med.ufl.edu/journal_club/111909/NEJM_and_pneumococcal_vaccine.pdf"><span style="color:#000099;">Effects of Pneumococcal Conjugate Vaccine on Pneumococcal Meningitis.</span></a>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-58501160471056392392009-10-12T06:06:00.000-07:002009-10-12T07:29:23.366-07:00ED Throughput : Examining hospital and other significant factors.<strong><a href="http://emergency.med.ufl.edu/journal_club/101509/HospitalBedOccupancy.pdf">The Effect of Hospital Bed Occupancy on Throughput in the Pediatric Emergency Department</a></strong><br /><strong>Objective:</strong> Although it has been suggested that high hospital occupancy leads to emergency department (ED) overcrowding and impedes ED throughput, there are limited data defining this relationship. The objective of this study is to examine whether high inpatient hospital occupancy negatively affects throughput in a pediatric ED.<br /><br /><strong><a href="http://emergency.med.ufl.edu/journal_club/101509/EDExpansionOvercrowding.pdf">The Effect of Emergency Department Expansion on Emergency Department Overcrowding<br /></a>Objective:</strong> To examine the effects of emergency department (ED) expansion on ambulance diversion at an urban, academic Level 1 trauma center.<br /><br /><a href="http://emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><strong>Journal Club Assessment Form</strong></a><br />There will be no paper copies distributed.<br />Please print these out if you wish to have a hard copy.<br />All residents should be prepared to discuss all of the articles.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-34273118930222003912009-09-11T07:45:00.000-07:002009-09-14T05:47:08.759-07:00Medical Treatment for Small Stones in the Lower Ureter<strong>Tamsulosin for Ureteral Stones in the Emergency Department: </strong><br /><strong>A Randomized, Controlled Trial</strong><br /><strong></strong><br /><strong>Study objective:</strong> The adrenergic antagonist tamsulosin hydrochloride has become an increasingly common adjunct in the treatment of ureteral calculi; however, its efficacy in a general emergency department (ED) population has not been investigated.<br /><br />Attached are the articles for Journal Club which will be held on 09/15/09.<br /><br /><a href="http://emergency.med.ufl.edu/journal_club/091509/Medical_Treatment_for_Small_Stones_in_the_Lower_Ureter.pdf"><strong><span style="color:#000099;">Medical Treatment for Small Stones in the Lower Ureter</span></strong></a><br /><strong><span style="color:#000099;"></span></strong><br /><a href="http://emergency.med.ufl.edu/journal_club/091509/Tamsulosin_for_Ureteral_Stones_in_the_Emergency_Department.pdf"><strong><span style="color:#000099;">Tamsulosin for Ureteral Stones in the Emergency Department</span></strong><strong><span style="color:#000099;"> </span></strong><br /><strong><span style="color:#000099;"></span></strong></a><br /><br /><a href="http://emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><strong><span style="color:#000099;">Journal Club Assessment Form</span></strong></a><br />There will be no paper copies distributed.<br />Please print these out if you wish to have a hard copy.<br />All residents should be prepared to discuss all of the articles.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-2818703248850927472009-07-31T10:45:00.000-07:002009-11-12T08:18:00.099-08:00Respiratory Disease and Failure with (H1N1)<span style="font-size:130%;"><strong>Respiratory Disease and Failure with (H1N1)</strong></span><br />Attached are the articles for Journal Club which will be held on 08/20/09.<br /><br /><a href="http://emergency.med.ufl.edu/journal_club/082009/Severe%20Respiratory%20Disease%20Concurrent%20(H1N1).pdf"><strong><span style="color:#000099;">Severe Respiratory Disease Concurrent with the Circulation of H1N1 Influenza</span></strong></a><span style="color:#000099;"><br /><br /></span><a href="http://emergency.med.ufl.edu/journal_club/082009/Pneumonia%20and%20Respiratory%20Failure%20from%20(H1N1).pdf"><strong><span style="color:#000099;">Pneumonia and Respiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico</span></strong></a><span style="color:#000099;"> </span><br /><p><span style="color:#ff0000;"><strong>The question to you is: </strong></span><strong>"How will the Infuenza Pandemic affect the ED?"</strong></p><span style="color:#000099;"><span style="color:#000000;">What do you think? </span></span><br /><span style="color:#000099;"><span style="color:#000000;">Please leave a comment on this blog after reading the articles.</span></span><br /><span style="color:#000099;"><strong><span style="color:#000000;"></span></strong><br /></span><a href="http://emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><strong><span style="color:#000099;">Journal Club Assessment Form</span></strong></a><span style="color:#000099;"><br /></span>There will be no paper copies distributed.<br />Please print these out if you wish to have a hard copy.<br />All residents should be prepared to discuss all of the articles.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-23497777952148868532009-07-10T09:47:00.000-07:002009-07-10T09:59:43.906-07:00Acute Abdominal Pain and Opiates<span style="font-size:180%;"><strong>Acute Abdominal Pain and Opiates</strong></span><br /><br />Attached is the article for Journal Club which will be held on 07/16/09.<br /><br /><a href="http://emergency.med.ufl.edu/journal_club/071609/fulltext_ID=119827225&PLACEBO=IE.pdf"><span style="color:#000099;"><strong>Adverse Outcomes and Opioid Analgesic Administration in Acute Abdominal Pain.</strong></span></a><br /><br /><a href="http://emergency.med.ufl.edu/journal_club/071609/Ranji_Narcotics_Abdo_Pain.pdf"><span style="color:#000099;"><strong>Do Opiates Affect the Clinical Evaluation of Patients With Acute Abdominal Pain?</strong></span></a><br /><br /><br /><a href="http://emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><span style="color:#000099;"><strong>Journal Club Assessment Form</strong></span></a><br /><br />There will be no paper copies distributed.<br />Please print these out if you wish to have a hard copy.<br />All residents should be prepared to discuss all of the articles.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-26375343498179185772009-06-15T07:28:00.000-07:002009-06-15T07:46:19.587-07:00Hypothermia and Cardiac Arrest<p><strong><span style="font-size:180%;">Hypothermia and Cardiac Arrest.</span></strong></p><p>Attached is the article for Journal Club which will be held on 06/18/09. </p><p><a href="http://emergency.med.ufl.edu/journal_club/061809/hypothermia1.pdf"><strong><span style="color:#000099;">TREATMENT OF COMATOSE SURVIVORS OF OUT-OF-HOSPITAL CARDIAC ARREST WITH INDUCED HYPOTHERMIA</span></strong></a></p><p><strong><a href="http://emergency.med.ufl.edu/journal_club/061809/hypothermia2.pdf"><span style="color:#000099;">MILD THERAPEUTIC HYPOTHERMIA TO IMPROVE THE NEUROLOGIC<br />OUTCOME AFTER CARDIAC ARREST</span></a></strong><br /><br /><strong><span style="color:#ff0000;">SORRY FOR THE DELAY IN POSTING THE ARTICLES DR. NESSELROADE.</span></strong> </p><p><a href="http://emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><span style="color:#000099;"><strong>Journal Club Assessment Form</strong></span></a><br />There will be no paper copies distributed.<br />Please print these out if you wish to have a hard copy.<br />All residents should be prepared to discuss all of the articles. </p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-28622917735020826902009-05-07T13:10:00.000-07:002009-05-08T11:36:01.474-07:00Acetylcysteine and Whole Body CT<strong><span style="font-size:130%;">Acetylcysteine and Whole Body CT</span></strong><br />Attached is the article for Journal Club which will be held on 05/12/09 at Napolitanos.<br /><br /><a href="http://emergency.med.ufl.edu/journal_club/051209/Acetylcysteine.pdf"><span style="color:#000099;"><strong>Acetylcysteine for prevention of contrast-induced nephropathy after intravascular angiography: A systematic review and meta-analysis</strong></span></a><span style="color:#000099;"><strong><br /><br /></strong></span><a href="http://emergency.med.ufl.edu/journal_club/051209/lancettrauma.pdf"><span style="color:#000099;"><strong>Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study</strong></span></a><span style="color:#000099;"><strong><br /><br /></strong></span><a href="http://emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><span style="color:#000099;"><strong>Journal Club Assessment Form</strong></span></a><br />There will be no paper copies distributed.<br />Please print these out if you wish to have a hard copy.<br />All residents should be prepared to discuss all of the articles.Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-76485902756079990272009-04-07T06:44:00.000-07:002009-04-08T06:36:13.626-07:00Novel treatment strategies for common Emergency Department problems<strong><span style="font-size:130%;">Novel treatment strategies for common Emergency Department problems</span></strong><br />Attached is the article for Journal Club which will be held on 04/16/09.<br /><br /><a href="http://emergency.med.ufl.edu/journal_club/040909/A_prospective,_Randomized_Trial_of_an_ED_Observation_Unit_for_Acute_Onset_Atrial_Fib.doc"><strong><span style="color:#000099;">A Prospective, Randomized Trial of an ED Observation Unit for Acute Onset Atrial Fibrillation.</span></strong></a><strong><span style="color:#000099;"> </span></strong><br /><strong><span style="color:#000099;"><p><br /><a href="http://emergency.med.ufl.edu/journal_club/040909/Sensitivity%20of%20Noncontrast%20Cranial%20Computed%20Tomography.pdf"><span style="color:#000099;">Sensitivity of Noncontrast Cranial Computed Tomography for the Emergency Department Diagnosis of Subarachnoid Hemorrhage</span></a></p><p><br /></span></strong><a href="http://emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><strong><span style="color:#000099;">Journal Club Assessment Form</span></strong></a><br />There will be no paper copies distributed.<br />Please print these out if you wish to have a hard copy.<br />All residents should be prepared to discuss all of the articles.</p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-7675926599164149775.post-68747116390551964612009-03-11T06:50:00.000-07:002009-03-11T07:07:10.422-07:00Influenza and Vaccination in the ED<span style="font-size:130%;"><strong>Influenza and Vaccination in the ED.</strong></span><br /><br />Attached are two articles for Journal Club which will be held on 03/12/09.<br /><br /><a href="http://emergency.med.ufl.edu/journal_club/031209/Impact%20of%20the%20Rapid%20Diagnosis%20of%20Influenza%20on%20Physician%20Decision.pdf"><span style="color:#000099;"><strong>Impact of the Rapid Diagnosis of Influenza on Physician Decision-Making an Patient Management in the Pediatric ED.</strong></span></a><span style="color:#000099;"><strong><br /><br /></strong></span><a href="http://emergency.med.ufl.edu/journal_club/031209/An%20Emergency%20Department%20Based%20Vaccination%20Program.pdf"><span style="color:#000099;"><strong>An Emergency Department–based Vaccination Program: Overcoming the Barriers for Adults at High Risk for Vaccine-preventable Diseases</strong></span></a><span style="color:#000099;"><strong><br /><br /></strong></span><a href="http://emergency.med.ufl.edu/journal_club/journal_club_assessment_form.doc"><span style="color:#000099;"><strong>Journal Club Assessment Form</strong></span></a><br /><br />There will be no paper copies distributed.<br />Please print these out if you wish to have a hard copy.<br />All residents should be prepared to discuss all of the articles.Unknownnoreply@blogger.com0