First10EM Journal Club: October 2020

Welcome back tot another COVID-lite journal club for the month of October 2020. As always the free PDF version of all the papers we discuss are available at the links below.

Justin has done a deep dive into a few of these topics and you can go to the write up over at First10EM and read them there if audio is not your thing.


Another negative TXA trial. Life was simpler when this was a miracle drug.

Rowell SE, Meier EN, McKnight B, et al. Effect of Out-of-Hospital Tranexamic Acid vs Placebo on 6-Month Functional Neurologic Outcomes in Patients With Moderate or Severe Traumatic Brain Injury. JAMA. 2020 Sep 8;324(10):961-974. doi: 10.1001/jama.2020.8958. PMID: 32897344.

Read the full post here.

Lawati, K.A., Sharif, S., Maqbali, S.A. et al. Efficacy and safety of tranexamic acid in acute traumatic brain injury: a systematic review and meta-analysis of randomized-controlled trials. Intensive Care Med (2020). [free full text]

Pediatric Inflammatory Multisystem Syndrome

Whittaker E, Bamford A, Kenny J, et al. Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA. 2020;e2010369. doi:10.1001/jama.2020.10369 PMID: 32511692

Delayed antibiotics are dumb

Rowe TA, Linder JA. Delayed Antibiotic Prescriptions in Ambulatory Care: Reconsidering a Problematic Practice. JAMA. 2020;10.1001/jama.2020.2325. doi:10.1001/jama.2020.2325 PMID: 32297898

Justin’s full rant on this issue can be found here.

Door to triage time: the hidden, dirty secret of busy emergency departments

Hansen B, Bonin D, Van Aarsen K, Dreyer J. Door-To-Triage Time in a Canadian Tertiary-Care Center. J Emerg Med. 2020 Sep 8:S0736-4679(20)30697-1. doi: 10.1016/j.jemermed.2020.07.015. PMID: 32917452

Bottom line: At most hospitals, there is a lot of work that needs to be done to unburden our triage nurses and fix this “door to triage” problem. 

At the Intersection of Fear, Grief, and Love

Veal CT. At the Intersection of Fear, Grief, and Love. Ann Intern Med. 2020;10.7326/M20-4113. doi:10.7326/M20-4113 PMID: 32716704

Full text available free here.

Squeezing out cellulitis

Webb E, Neeman T, Bowden FJ, Gaida J, Mumford V, Bissett B. Compression Therapy to Prevent Recurrent Cellulitis of the Leg. N Engl J Med. 2020 Aug 13;383(7):630-639. doi: 10.1056/NEJMoa1917197. PMID: 32786188

Should Evidence Come with an Expiration Date?

Greene P, Prasad V, Cifu A. Should Evidence Come with an Expiration Date?. J Gen Intern Med. 2019;34(7):1356-1357. doi:10.1007/s11606-019-05032-4 PMID: 31062228

Sometimes it isn’t the evidence, but the concept that needs a expiration date

The STAND trial: Jaung R, Nisbet S, Gosselink MP, Di Re A, Keane C, Lin A, Milne T, Su’a B, Rajaratnam S, Ctercteko G, Hsee L, Rowbotham D, Hill A, Bissett I. Antibiotics Do Not Reduce Length of Hospital Stay for Uncomplicated Diverticulitis in a Pragmatic Double-Blind Randomized Trial. Clin Gastroenterol Hepatol. 2020 Mar 30:S1542-3565(20)30426-2. doi: 10.1016/j.cgh.2020.03.049. PMID: 32240832

You can read more here.

Don’t just do something, stand there

Farrow GS, Delate T, McNeil K, et al. Vitamin K versus warfarin interruption alone in patients without bleeding and an international normalized ratio > 10. J Thromb Haemost. 2020;18(5):1133-1140. doi:10.1111/jth.14772 PMID: 32073738

monitoring | Anticoagulation Services

NSAIDs and nonunion

George MD, Baker JF, Leonard CE, Mehta S, Miano TA, Hennessy S. Risk of Nonunion with Nonselective NSAIDs, COX-2 Inhibitors, and Opioids. J Bone Joint Surg Am. 2020;10.2106/JBJS.19.01415. doi:10.2106/JBJS.19.01415 PMID: 32453106

Good Samaritan App

Derkenne C, Jost D, Roquet F, et al. Mobile Smartphone Technology Is Associated With Out-of-hospital Cardiac Arrest Survival Improvement: The First Year “Greater Paris Fire Brigade” Experience. Acad Emerg Med. 2020 May 23. doi: 10.1111/acem.13987 PMID: 32445436

Remember, this is an SGEM HOP paper. Listen to the full critical appraisal on the SGEM, and then leave your comments and questions. The best questions and comments get published in Academic Emergency Medicine. 

Rippey Chicken for the WIN!

Selame LA, Risler Z, Zakaria SJ, Hughes LP, Lewiss RE, Kehm K, Goodsell K, Kalwani R, Mirsch D, Kluger SB, Au A. A comparison of home made vascular access ultrasound phantom models for peripheral intravenous catheter insertion. J Vasc Access. 2020 Oct 6:1129729820961941. doi: 10.1177/1129729820961941. PMID: 33023394.

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