First10EM Journal Club: October 2024

Welcome to a special edition of the Journal Club with Justin. This month we recorded live with a bunch of fantastic Broome junior doctors. Justin gate-crashed our local journal club to share his approach to “reading a paper” ( Video version here) and then we dived into a bunch of new papers… and one really old one. Thanks to Drs Emily Wishart, Josh Briotti and Will Arnott who were brave enough to join the chaos and unscripted nerd fest that we put on every month or two.

So follow along with the papers below and read to make up your own mind about the evidence presented.

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Too much ‘aint enough blood?

Turgeon AF, Fergusson DA, Clayton L,et al. Liberal or Restrictive Transfusion Strategy in Patients with Traumatic Brain Injury. N Engl J Med. 2024 Jun 13. doi: 10.1056/NEJMoa2404360. PMID: 38869931

Bottom line: This large multi-center RCT comparing liberal and restrictive transfusion triggers in patients with traumatic brain injury was statistically negative, but may actually support more liberal transfusion. 

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Can patients predict the future?

Mols EM, Haak H, Holland M, Schouten B, Ibsen S, Merten H, Christensen EF, Nanayakkara PWB, Nickel CH, Weichert I, Kellett J, Subbe CP, Kremers MNT; Safer@Home Research Consortium. Can acutely ill patients predict their outcomes? A scoping review. Emerg Med J. 2024 May 28;41(6):342-349. doi: 10.1136/emermed-2022-213000. PMID: 38238065

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Oral vs IV ABs… another negative trial

Nielsen AB, Holm M, Lindhard MS, et al. Oral versus intravenous empirical antibiotics in children and adolescents with uncomplicated bone and joint infections: a nationwide, randomised, controlled, non-inferiority trial in Denmark. Lancet Child Adolesc Health. 2024 Jul 15:S2352-4642(24)00133-0. doi: 10.1016/S2352-4642(24)00133-0. Epub ahead of print. PMID: 39025092

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Is early CT actually 100% sensitivity for SAH (Of course not)

Roberts et al, Subarachnoid haemorrhage in the emergency department (SHED): a prospective, observational, multicentre cohort study. Emergency Medicine Journal Published Online First: 12 September 2024. doi: 10.1136/emermed-2024-214068

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MagA: Making Airways Great Again?

Zouche I, Guermazi W, Grati F, Omrane M, Ketata S, Cheikhrouhou H. Intravenous magnesium sulfate improves orotracheal intubation conditions: A randomized clinical trial. Trends in Anaesthesia and Critical Care. 2024; 57:101371-.

You can read more on BroomeDocs: MagA: Making Airways Great Again?

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Yes, this paper is more than 100 years old

The Relationship Between Herpes Zoster, Syphilis and Chickenpox. JAMA. 2019 Nov 5;322(17):1722. doi: 10.1001/jama.2018.15583. PMID: 31688874

How will we look with the retrospectoscope in 100 years? Probably not that bright!

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