TamingtheSRU

Trauma imaging has never been more accessible, and the pan‑scan often feels like the fastest path to certainty. In this edition of our resident journal club, join Drs Gallen and Vaughn as they pair and review two articles regarding trauma CT utilization - REACT-2 and Ather et al, with a hope of exploring the question of when whole-body CT improves care vs when selective imaging can be equally as effective.

Basilar artery occlusion (BAO) remains one of the most devastating strokes we face, and treatment decisions often stretch beyond the familiar anterior‑circulation playbook. This study, TRACE‑5, takes a bold step into that uncertainty, testing Tenecteplase in BAO patients presenting up to 24 hours from symptom onset. Join Dr. Onuzuruike as he unpacks the trial’s design, its surprising and practice‑shaping findings, and what this study might mean for the future of posterior circulation stroke care.

Cardiac arrest care hinges on high‑quality CPR, but pulse checks remain a stubborn source of interruptions — often longer than the recommended 10 seconds and repeated every two minutes. What if we could detect ROSC without ever pausing compressions? This diagnostic accuracy study evaluates whether femoral arterial Doppler waveforms obtained during active CPR can predict arterial line pulsatility at the next pulse check. Join Dr. Qin as she reviews how well Doppler‑detected pulsatility and anterograde flow signal true cardiac activity — and whether ultrasound could offer a future where pulse checks no longer slow us down.

Diabetic ketoacidosis is a familiar ED diagnosis, but the best fluid strategy is still up for debate. Many of us default to the traditional one‑bag system, even though it can be slow to adjust and prone to glucose swings. This new meta‑analysis compares one‑bag versus two‑bag DKA management across adults and children, examining hypoglycemia rates, time to resolution, and operational impact. Join Dr. Knudsen-Robbins as she breaks down what the evidence shows — and whether the two‑bag fluid system truly offers a clinical edge for treatment.

Point‑of‑care echo is fast, powerful—and famously operator‑dependent. Most of us rely on quick visual impressions because precise measurements take time we often don’t have. This new study puts three automated, real‑time AI tools to the test, comparing their ejection fraction, VTI, and IVC assessments against an expert’s read. Join Dr. Sookdeo as she breaks down how well the algorithms performed and what this could mean for the future of bedside echo.

Documentation load is a major driver of burnout in emergency medicine, and the ED’s pace only intensifies the pressure. Ambient AI scribes offer a hands‑free way to capture encounters and ease charting—but how often are these tools actually used, and do they meaningfully change documentation time? Join Dr. Kopel as she unpacks what early use reveals about the promise and limitations of AI‑generated documentation in emergency care.

Survival after out‑of‑hospital cardiac arrest hinges often on getting an AED to the patient within minutes - but in most communities (especially more rural areas), that simply doesn’t happen fast enough. First responders often arrive too late, and bystanders rarely have immediate access to a device. This study explores whether pairing first responders with strategically deployed AED‑carrying drones could finally make 5‑minute defibrillation a reality. Join Dr. Boyer as he breaks down what this model suggests about the future of rapid OHCA response.

Ground-level falls are a leading reason older adults get head CTs in the ER, largely because current rules treat age > 65 as a risk factor by itself. Yet many emergency physicians question whether that’s always necessary for well-appearing patients. A new systematic review and meta-analysis in Annals of Emergency Medicine digs deeper, asking: what other factors truly predict intracranial hemorrhage after ground-level falls? Join Dr. Snyder as she explores the findings, limitations, and what they mean for everyday practice.

Tranexamic acid (TXA) is an anti-fibrinolytic that may reduce hemorrhage and improve survival in trauma. While early studies raised safety concerns, newer evidence supports its use in select patients. Join Dr. Segev as he reviews key TXA trials and highlights the updated EAST guidelines on pre-hospital and in-hospital administration.

Gastrointestinal bleeding is a frequent and potentially life-threatening presentation in the ED. With CT angiography increasingly being used as a first-line diagnostic tool, are we improving detection or simply overusing imaging? Join Dr. Guillaume as she discusses this recent JAMA Network Open study examining trends in CTA utilization for GI bleeding and whether rising scan rates are truly leading to better diagnostic yield.