December 2016 Journal Club with First10EM

Welcome back the the last journal club with Dr Justin Morgenstern for 2016. [Yes, it is now 2017… but that’s life.]  Another batch of 10 delicious articles to satisfy your post-Christmas cravings for academic nerdiness.  There a bit of something for every taste this month.  Below are the articles with links to the full text PDFs:

You can read Justin’s written synopsis over at the First10EM blog here.


Here are the papers:

Seiger N, Maconochie I, Oostenbrink R, Moll HA. Validity of different pediatric early warning scores in the emergency department. Pediatrics. 132(4):e841-50. 2013.

Bottom line: According to this cohort, none of the available PEWS are good enough for clinical practice.

Motov S, Yasavolian M, Likourezos A. Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. Annals of emergency medicine. 2016. PMID: 27993418

Bottom line: It is time to stop using any dose of ketorolac higher than 10mg.

DePeter KC, Blumberg SM, Dienstag Becker S, Meltzer JA. Does the Use of Ibuprofen in Children with Extremity Fractures Increase their Risk for Bone Healing Complications? The Journal of emergency medicine. 2016. PMID: 27751698

Bottom line: This is another piece of evidence that NSAIDs don’t cause bone healing complications, and that we should just treat children’s pain

Beach ML et al. Major Adverse Events and Relationship to Nil per Os Status in Pediatric Sedation/Anesthesia Outside the Operating Room: A Report of the Pediatric Sedation Research Consortium. Anesthesiology. 124(1):80-8. 2016. PMID: 26551974

Bottom line: Emergency department patients don’t need to be strictly NPO before sedation.

Simpkin AL, Schwartzstein RM. Tolerating Uncertainty – The Next Medical Revolution? The New England journal of medicine. 375(18):1713-1715. 2016. PMID: 27806221

Bottom line: A quote: “Key elements for survival in the medical profession would seem, intuitively, to be a tolerance for uncertainty and a curiosity about the unknown.”

Kawano T, Scheuermeyer FX, Gibo K. H1-antihistamines reduce progression to anaphylaxis among emergency department patients with allergic reactions. Academic emergency medicine. 2016. PMID: 27976492

Bottom line: Antihistamines probably don’t prevent anaphylaxis, but this retrospective data can’t tell you either way

Sutherland S. Late-night breastfeeding advice. Canadian family physician. 62(7):579. 2016. PMID: 27412213

Bottom line: Not all medical advice needs to involve medicine. We treat people, not diseases. Sometimes, you just need a warm bath.

Bexkens R, Washburn FJ, Eygendaal D, van den Bekerom MP, Oh LS. Effectiveness of reduction maneuvers in the treatment of nursemaid’s elbow: A systematic review and meta-analysis. The American journal of emergency medicine. 35(1):159-163. 2017. PMID: 27836316

Bottom line: Hyperpronation works for pulled elbows (but so does pronation-supination, or almost anything in my experience).

Clinical Case 112: looked at this same question

Akimau PI et al. Symptomatic treatment or cast immobilisation for avulsion fractures of the base of the fifth metatarsal: a prospective, randomised, single-blinded non-inferiority controlled trial. The Bone & Joint Journal. 98-B(6):806-11. 2016. PMID: 27235524

Bottom line: Tensor bandage may be as good as walking cast for fifth metatarsal avulsion fractures, but this study is too small to promote wholesale practice changes.

Osterberg EC, Gaither TW, Awad MA. Correlation between pubic hair grooming and STIs: results from a nationally representative probability sample. Sexually transmitted infections. 2016. PMID: 27920223

Bottom line: Keep this data in mind the next time a medical conference brings you to Las Vegas

Ok, thats a wrap for 2016…  we hope you have enjoyed the journal club over the past 6 months.  As always we are striving to make your life easier – if you have any thoughts, tips, comments or corrections please hit us below on the blog.

Catchya in 2017,

Casey & Justin

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