First10EM Journal Club: November 2024


Welcome back to the podcast and this is a special one – we have created the first Video podcast in which you can gaze lovingly at Justin as he rants, drops pearls and shares all the latest nerdy EBM from the desk. Papers below with link and video at the bottom on Youtube


Palatinus HN, Johnson MA, Wang HE, Hoareau GL, Youngquist ST. Early intramuscular adrenaline administration is associated with improved survival from out-of-hospital cardiac arrest. Resuscitation. 2024 Aug;201:110266. doi: 10.1016/j.resuscitation.2024.110266. Epub 2024 Jun 9. PMID: 38857847

Bottom line: This before and after study demonstrates an association between early IM epinephrine and survival from cardiac arrest. However, there are simply too many confounders in a before and after study design to trust the results. This is hypothesis generating, and warrants a follow-up RCT. 


Leonard JC, Harding M, Cook LJ, Leonard JR, Adelgais KM, Ahmad FA, Browne LR, Burger RK, Chaudhari PP, Corwin DJ, Glomb NW, Lee LK, Owusu-Ansah S, Riney LC, Rogers AJ, Rubalcava DM, Sapien RE, Szadkowski MA, Tzimenatos L, Ward CE, Yen K, Kuppermann N. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. 2024 Jul;8(7):482-490. doi: 10.1016/S2352-4642(24)00104-4. Epub 2024 Jun 4. PMID: 38843852


Soucy Z, Cheng D, Vilke GM, Childers R. Systematic Review: The Role of Intravenous and Oral Contrast in the Computed Tomography Evaluation of Acute Appendicitis. J Emerg Med. 2020 Jan;58(1):162-166. doi: 10.1016/j.jemermed.2019.10.034. Epub 2019 Dec 13. PMID: 31843324

Bottom line: This information is not new. I was taught this in residency. However, it might be new to your radiology group, so if they are still using oral contrast (with all of its many problems) it might be worth starting a conversation.


Chiarlitti N, Graves Z, Lavoie C, Reid RER. Does Examination Table Paper Use Mitigate the Risk of Disease Transmission in a Family Medicine Clinic? Ann Fam Med. 2024 May-Jun;22(3):230-232. doi: 10.1370/afm.3092. PMID: 38806257


Barnicle RN, Bracey A, Weingart SD. Managing Emergency Endotracheal Intubation Utilizing a Bougie. Ann Emerg Med. 2024 Jun 22:S0196-0644(24)00232-4. doi: 10.1016/j.annemergmed.2024.04.021. PMID: 38912998


Luo Z, Li Y, Li W, Li Y, Nie Q, Shi Y, Wang J, Ji Q, Han X, Liu S, Li D, Wang S, Li Z, Jia D, Ge H, Xu P, Feng Z, Li F, An F, Tai N, Yue L, Xie H, Jin X, Liu H, Dang Q, Z hang Y, Sun L, Wang J, Huang H, Chen L, Ma Y, Cao Z, Wang C; HAPPEN Investigators. Effect of High-Intensity vs Low-Intensity Noninvasive Positive Pressure Ventilation on the Need for Endotracheal Intubation in Patients With an Acute Exacerbation of Chronic Obstructive Pulmonary Disease: The HAPPEN Randomized Clinical Trial. JAMA. 2024 Sep 16:e2415815. doi: 10.1001/jama.2024.15815. Epub ahead of print. PMID: 39283649


Coyle C, Shi J, Leonard JC. Antibiotic prophylaxis in pediatric dog bite injuries: Infection rates and prescribing practices. J Am Coll Emerg Physicians Open. 2024 Jun 4;5(3):e13210. doi: 10.1002/emp2.13210. PMID: 38841297

IBottom line: A lot of people are still using prophylactic antibiotics in dog bites, but the logic behind that strategy (treat 100 patients to avoid the same treatment in 5) makes absolutely no sense.


Too tall, got cancer

Wang F, Xu X, Yang J, Min L, Liang S, Chen Y. Height and lung cancer risk: A meta-analysis of observational studies. PLoS One. 2017 Sep 26;12(9):e0185316. doi: 10.1371/journal.pone.0185316. PMID: 28949980


Are we on the verge of a paradigm change in medicine?

Cuker A, Kavakli K, Frenzel L, Wang JD, Astermark J, Cerqueira MH, Iorio A, Katsarou-Fasouli O, Klamroth R, Shapiro AD, Hermans C, Ishiguro A, Leavitt AD, Oldenburg JB, Ozelo MC, Teitel J, Biondo F, Fang A, Fuiman J, McKay J, Sun P, Rasko JEJ, Rupon J; BENEGENE-2 Trial Investigators. Gene Therapy with Fidanacogene Elaparvovec in Adults with Hemophilia B. N Engl J Med. 2024 Sep 26;391(12):1108-1118. doi: 10.1056/NEJMoa2302982. PMID: 39321362


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