First10EM Journal Club: October 2025

The latest podcast with Dr. Justin Morgenstern. We look at all the latest evidence and a few older pieces from the world of Emergency care. This month we tackle: AI bots for OMIs, paracentesis plumbing, antiplatelet pharma, facial fractures and a sublingual anaphylaxis agent!  Its a lot!  #FOAMed

Physicians vs Queen of Hearts AI Bot

Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs. AI (Queen of Hearts by PMcardio). Am J Emerg Med. 2025 Jul 30;97:193-199. doi: 10.1016/j.ajem.2025.07.061. Epub ahead of print. PMID: 40763602

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Saving toes, thawing digits: sous vide to the rescue?

Daniel NJ, Storn JM, Weinberg NE, Galvin WA, Irons HR, Barksdale AN, Rischall ML, Bilodeau SM, Gale JY, Willet KG, Wilson A, Keiper K, Chevalier J. Assessment of sous vide water baths in the acute rewarming of frostbitten extremities: A multicenter study. Acad Emerg Med. 2025 May;32(5):574-577. doi: 10.1111/acem.15061.PMID: 39654121

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Paracentesis Plumbing Practice

Konerman MA, Price J, Torres D, Li Z. Randomized, controlled pilot study comparing large-volume paracentesis using wall suction and traditional glass vacuum bottle methods. Therap Adv Gastroenterol. 2014 Sep;7(5):184-92. doi: 10.1177/1756283X14532704. PMID: 25177365

 This post from Maimonides goes into a little more detail. 

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Ticagrelor vs Clopidogrel… and the winner is…

Kutcher SA, Dendu

kuri N, Dandona S, Nadeau L, Brophy JM. Ticagrelor Compared to Clopidogrel in Acute Coronary Syndromes trial (TC4): a Bayesian pragmatic cluster randomized controlled trial. CMAJ. 2025 Mar 30;197(12):E309-E318. doi: 10.1503/cmaj.241862. PMID: 40164463

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Trigger point injections: once a fad, now just bad?

Lajeunesse MD, Olivera TR, April MD, Benesch HA, Castaneda P, Couperus KS, Dang VN, Park MS, Deboer RS, Dougherty CA, Downing NC, Gray MW, Hull AM, Jimenez BL, Klausner MJ, Sakai JHM, McLean TJ, Nepal N, Patten HW, Schwartz BT, Walther ND, Wolterstorff CS, Oliver JJ. Trigger Point Injection for Myofascial Pain Syndrome of the Low Back: A Partially Blinded Three-Arm Randomized Controlled Trial. Ann Emerg Med. 2025 Jun 17:S0196-0644(25)00298-7. doi: 10.1016/j.annemergmed.2025.05.008. PMID: 40531073

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Anti-amyloid agents for Alzheimers – what we need to know

Rech MA, Carpenter CR, Aggarwal NT, Hwang U. Anti-Amyloid Therapies for Alzheimer’s Disease and Amyloid-Related Imaging Abnormalities: Implications for the Emergency Medicine Clinician. Ann Emerg Med. 2025 Jun;85(6):526-536. doi: 10.1016/j.annemergmed.2024.12.002. Epub 2025 Jan 17. PMID: 39818674

More details here.

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Facial Fracture Referrals –

Castillo Diaz F, Anand T, Khurshid MH, Kunac A, Al Ma’ani M, Colosimo C, Hejazi O, Ditillo M, Magnotti LJ, Joseph B. Look me in the face and tell me that I needed to be transferred: Defining the criteria for transferring patients with isolated facial injuries. J Trauma Acute Care Surg. 2025 May 9. doi: 10.1097/TA.0000000000004651. Epub ahead of print. PMID: 40341445

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An oral anaphylxis agent… on the horizon

Kraus CN, Wargacki S, Golden D, Lieberman J, Greenhawt M, Camargo CA Jr. Integrated phase I pharmacokinetics and pharmacodynamics of epinephrine administered through sublingual film, autoinjector, or manual injection. Ann Allergy Asthma Immunol. 2025 May;134(5):580-586. doi: 10.1016/j.anai.2025.01.006. Epub 2025 Jan 16. PMID: 39826899

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