First10EM Journal Club: November 2021

Welcome back to the Journal club with Dr Justin. Morgenstern. Below are the links to the papers that Justin has chosen to discuss this month. You can listen at the link at the bottom or download us on your favourite podcast player app. Plenty of pearls this month and a few things that you probably never wanted to know but cannot escape!

Have a listen, it is free. Please share with all of your nerdy friends and even those who may be just borderline statistically oriented. If you prefer the written version you can pop over to First10EM blog and read Justin’s summary here:

Ketamine for agitation – some RCTs

Lin J, Figuerado Y, Montgomery A, Lee J, Cannis M, Norton VC, Calvo R, Sikand H. Efficacy of ketamine for initial control of acute agitation in the emergency department: A randomized study. Am J Emerg Med. 2021 Jun;44:306-311. doi: 10.1016/j.ajem.2020.04.013. PMID: 32340820

Barbic D, Andolfatto G, Grunau B, Scheuermeyer FX, Macewan B, Qian H, Wong H, Barbic SP, Honer WG. Rapid Agitation Control With Ketamine in the Emergency Department: A Blinded, Randomized Controlled Trial. Ann Emerg Med. 2021 Aug 2:S0196-0644(21)00433-9. doi: 10.1016/j.annemergmed.2021.05.023 PMID: 34353650

Racial Bias in Pulse Oximetry – part 2

Valbuena VSM, Barbaro RP, Claar D, et al. Racial Bias in Pulse Oximetry Measurement Among Patients About to Undergo ECMO in 2019-2020, A Retrospective Cohort Study. Chest. 2021 Sep 27:S0012-3692(21)04065-4. doi: 10.1016/j.chest.2021.09.025. PMID: 34592317

Industry-funded medical education is always promotion

Fugh-Berman A. Industry-funded medical education is always promotion-an essay by Adriane Fugh-Berman. BMJ. 2021 Jun 4;373:n1273. doi: 10.1136/bmj.n1273. PMID: 34088736

Twelve tips for applying the science of learning

Gooding HC, Mann K, Armstrong E. Twelve tips for applying the science of learning to health professions education. Med Teach. 2017 Jan;39(1):26-31. doi: 10.1080/0142159X.2016.1231913. Epub 2016 Sep 25. PMID: 27665669

1. Reduce extraneous load whenever possible (extraneous load is cognitive work not directly related to the complexity of the information itself, such as complicated and hard to interpret slides)
2. Help learners manage intrinsic load and assist learners with germane load (germane load is the cognitive work of organizing new information into schemas)
3. Create opportunities for retrieval practice appropriate for the content to be learned
4. Space retrieval practice over time and interleave content
5. Explicitly prepare learners to transfer knowledge to new settings
6. Engage learners in deliberate practice
7. Help learners to create learning-oriented goals
8. Teach learners to recognize their emotional state and its role in their learning
9. Create learning spaces that are psychologically safe
10. Attend to the social nature of learning
11. Create authentic experiences for workplace learning
12. Promote metacognition in our learners and ourselves

Paracetamol in pregnancy

Bauer AZ, Swan SH, Kriebel D, Liew Z, Taylor HS, Bornehag CG, Andrade AM, Olsen J, Jensen RH, Mitchell RT, Skakkebaek NE, Jégou B, Kristensen DM. Paracetamol use during pregnancy – a call for precautionary action. Nat Rev Endocrinol. 2021 Sep 23. doi: 10.1038/s41574-021-00553-7 PMID: 34556849

Another study that will chill your enthusiasm for hypothermia

Le May M, Osborne C, Russo J, et al. Effect of Moderate vs Mild Therapeutic Hypothermia on Mortality and Neurologic Outcomes in Comatose Survivors of Out-of-Hospital Cardiac Arrest: The CAPITAL CHILL Randomized Clinical Trial. JAMA. 2021 Oct 19;326(15):1494-1503. doi: 10.1001/jama.2021.15703. PMID: 34665203

More details can be found here

COVID is depression?

Reis G, Dos Santos Moreira-Silva EA, Silva DCM, et al. Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. Lancet Glob Health. 2021 Oct 27:S2214-109X(21)00448-4. doi: 10.1016/S2214-109X(21)00448-4. PMID: 34717820

A malaria vaccine!

Datoo MS, Natama MH, Somé A, et al. Efficacy of a low-dose candidate malaria vaccine, R21 in adjuvant Matrix-M, with seasonal administration to children in Burkina Faso: a randomised controlled trial. Lancet. 2021 May 15;397(10287):1809-1818. doi: 10.1016/S0140-6736(21)00943-0. PMID: 33964223

A can’t miss diagnosis: restless anal syndrome

Nakamura I, Itoi T, Inoue T. Case report of restless anal syndrome as restless legs syndrome variant after COVID-19. BMC Infect Dis. 2021 Sep 23;21(1):993. doi: 10.1186/s12879-021-06683-7. PMID: 34556029

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