HyperK! | Unreliable Exams For CAP

The JournalFeed podcastThese are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday’s Spoon Feed:The effectiveness of 4 commercially available ring-cutter devices in removal of tungsten, titanium, and stainless steel rings was compared. The Dolphin Ring Cutter won by a landslide, with a 100% success rate, beating out the M5118 Stainless Steel Ring Cutter that failed every attempt, Raptors that broke multiple times, and the Gem II Ring Cutter that came in a distant second with moderate success.Thursday’s Spoon Feed:This systematic review and meta-analysis argues that the Brain Injury Guidelines (BIG) can be used to discharge appropriate patients from the ED.

The JournalFeed podcastThese are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Wednesday’s Spoon Feed:This retrospective study found that the AHA PE risk classifications were more sensitive for mortality compared with the ESC definitions.Thursday’s Spoon Feed:In vasopressor-dependent patients with metabolic acidosis, sodium bicarbonate administration corrected acidemia but did not reduce mortality, need for renal-replacement therapy, or renal dysfunction by 30 days.

The JournalFeed podcastThese are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday’s Spoon Feed:When parenteral anticoagulation is needed for acute venous thromboembolism (VTE), low-molecular-weight heparin (LMWH) is the preferred choice over unfractionated heparin (UFH) due to ease of use and superior efficacy.Wednesday’s Spoon Feed:In a nationwide prospective study of nearly 12,700 children, a cervical spine CT was highly sensitive for clinically significant injury after blunt trauma—supporting pediatric c-spine clearance on CT alone, without routine follow-up MRI, even in obtunded kids.

The JournalFeed podcastThese are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Tuesday’s Spoon Feed:In pediatric testicular torsion, manual detorsion by pediatric emergency medicine physicians was associated with restoration of testicular blood flow an average of 105 minutes sooner than proceeding directly to surgery.Wednesday’s Spoon Feed:In patients with intermediate-high-risk acute pulmonary embolism (PE), conventional catheter-directed thrombolysis (CDT) with alteplase plus anticoagulation reduced the 7-day composite of death, recurrent PE or cardiopulmonary decompensation versus anticoagulation alone, without a significant increase in major bleeding.

The JournalFeed podcastThese are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday’s Spoon Feed:This review summarizes the guidelines and evidence behind the pathophysiology, diagnostics, and treatments for acute hyperkalemia.Wednesday’s Spoon Feed:In pediatric emergency department patients with community-acquired pneumonia, no individual physical exam finding demonstrated moderate or strong interrater reliability.

The JournalFeed podcastThese are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday’s Spoon Feed:In patients already at risk for a difficult airway, those with a smaller interincisor distance (distance between top incisor to bottom incisor during maximal mouth opening) were more likely to have failed standard geometry video laryngoscopy (SGVL).Friday’s Spoon Feed:Emergency thoracotomy has evolved with our specialty. This practical review provides an updated approach to indications, technique, and post-thoracotomy management, with a focus on getting the chest open efficiently and safely.

The JournalFeed podcastThese are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday’s Spoon Feed:This perspective piece makes the case that autonomous AI could soon outperform both physicians and physician-AI hybrids at core cognitive medical tasks, though procedural care and real-world validation are major unresolved issues.Wednesday’s Spoon Feed:Febrile infants ≤90 days without a respiratory viral infection were more likely to have an invasive bacterial infection (IBI) than those with a detectable virus, with certain viruses putting children at lower risk of an IBI.

The JournalFeed podcastThese are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday’s Spoon Feed:For hospitalized patients with opioid use disorder (OUD) experiencing acute pain, higher doses of opioids are often needed, in addition to non-opioid analgesics. Medication for OUD (MOUD) such as buprenorphine or methadone should be offered or continued if previously taking, assistance from addiction medicine services and/or acute pain services should be sought, timely hospital follow-up should be arranged, and naloxone should be prescribed at discharge.Wednesday’s Spoon Feed:This secondary analysis of adults ≥ 40 years old with syncope or pre-syncope without a serious diagnosis made in the ED found 5.9% of patients had a serious adverse outcome (SAO) within 30 days.

The JournalFeed podcastThese are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Tuesday’s Spoon Feed:In this randomized trial of patients admitted to the hospital requiring supplemental oxygen, a closed-loop autonomous oxygen titration system increased the time patients spent in the targeted oxygen range and decreased the duration of hypoxemia and hyperoxemia compared to standard care.Friday’s Spoon Feed:Prehospital pelvic binder use was not found to decrease transfusion in this trauma population, but it was associated with increased angioembolization, which may have poor real world application given the limitations of this study.

The JournalFeed podcastThese are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday’s Spoon Feed:This systematic review suggests that non-supine positioning during emergency department intubation is likely either non-inferior or superior to supine positioning with regard to first-pass success.Friday’s Spoon Feed:As access to obstetric care continues to be a growing challenge, EPs need to be prepared to recognize and treat hypertensive disorders of pregnancy (HDP), which require prompt diagnosis and management in the ED.