The Best Valsalva | When To Scan

The JournalFeed podcast for the week of March 2-6, 2026.These 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:Combined elevation in two blood biomarkers (GFAP and UCH-L1) showed high sensitivity and negative predictive value (NPV) for positive findings on head CT in anticoagulated patients with mild traumatic brain injury but were not helpful at identifying who would develop post-concussive syndrome.Thursday’s Spoon Feed:In this randomized controlled trial, adding 1 liter of IV normal saline to intramuscular diclofenac for acute migraine in the ED did not significantly improve pain relief at 2 hours compared with diclofenac alone.

The JournalFeed podcast for the week of 23-27, 2026.These 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:Patients presenting with anginal symptoms and a new right bundle branch block (RBBB) on ECG or RBBB-specific high-risk features should prompt emergent evaluation for reperfusion therapy.Thursday’s Spoon Feed:Meningococcal disease is a rapidly progressive infection associated with high mortality that often begins with nonspecific symptoms; early recognition, early antibiotics, and aggressive resuscitation are critical to improving outcomes.

The JournalFeed podcast for the week of Feb 16-20, 2026.These 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:Using Wells-based pretest probability with an age-adjusted D-dimer safely ruled out lower-extremity DVT in ED outpatients with zero 3-month VTE events among patients between the conventional and age-adjusted cutoffs.Friday’s Spoon Feed:This evidence-based expert position statement on necrotizing soft tissue infections (NSTIs) provides best practices for assessment, diagnosis, treatment, antimicrobials, adjunctive therapies, and long term management.

The JournalFeed podcast for the week of Feb 9-13, 2026.These 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:When eye exam is limited by trauma, we rely on orbital CT. While specificity is 94%, sensitivity is only 75% for open globe injuries (OGI), making surgical consultation necessary when suspicion remains.Friday’s Spoon Feed:This retrospective, propensity-matched study of adult and pediatric patients with severe asthma confirms what we already know clinically: non-invasive positive pressure ventilation (NIPPV) decreases mortality and need for intubation.

The JournalFeed podcast for the week of Feb 2 – 6th, 2026.These 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:A simple 4-factor clinical decision rule accurately distinguished true bacteremia from contaminants in children with positive blood cultures, achieving 99% sensitivity while potentially reducing unnecessary hospitalizations.Friday’s Spoon Feed:Point-of-care ultrasound (POCUS) is a powerful adjunct during cardiac arrest that can identify reversible causes, improve pulse checks, optimize chest compressions, and aid prognostication—as long as it does not interrupt high-quality CPR. When utilized correctly, POCUS may meaningfully guide resuscitation without prolonging pauses.

The JournalFeed podcast for the week of Jan 26-20, 2026.These 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 modified Valsalva maneuver is the most effective first-line vagal maneuver for stable supraventricular tachycardia, achieving higher conversion rates and reducing the need for intravenous antiarrhythmics without increasing adverse events.Wednesday’s Spoon Feed:Approaches to repeat CT scans in traumatic brain injuries (TBIs) are highly variable. This study recommends a risk-stratified approach based upon injury severity, patients’ clinical factors, and timing of initial CT.

The JournalFeed podcast for the week of Jan 19-23, 2026.These 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 the prehospital setting, universal application of pelvic circumferential compression devices (PCCDs) with suspected pelvic injuries could lead to adverse iatrogenic effects which are further compounded by improper diagnosis and thus misapplication, poor technique when deployed, and a false sense of security, which could lead to bias in recognizing other fatal causes of shock and bleeding.Friday’s Spoon Feed:Pigtail catheters had a similar safety profile and rates of catheter failures compared to chest tubes for treatment of hemodynamically stable children with hemothorax or hemopneumothorax.

The JournalFeed podcast for the week of Jan 12-16, 2026.These 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 retrospective cohort study found no 24-hour mortality difference when intubating hyperkalemic patients (K > 5.5mmol/L) with succinylcholine versus rocuronium for RSI.Wednesday’s Spoon Feed:In a large international cohort of well-appearing febrile infants ≤28 days old, the updated PECARN rule had high sensitivity and negative predictive value for invasive bacterial infection, with no missed cases of bacterial meningitis, supporting selective avoidance of routine lumbar puncture in low-risk neonates.

The JournalFeed podcast for the week of Jan 5-9, 2026.These 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:Older adults discharged from the ED with delirium had almost 3 times the risk of 30-day mortality compared to those discharged without delirium.Friday’s Spoon Feed:This RCT of 100 patients with intermediate-high risk PE showed that mechanical thrombectomy plus anticoagulation was superior to anticoagulation alone in reducing RV/LV ratio and earlier normalization of vitals.

The JournalFeed podcast for the week of Dec 29, 2025 to Jan 2, 2026Monday’s Spoon Feed:Implementing Spanish-language discharge instruction videos, interpreter-needed EMR icons, and standardized communication processes in a pediatric ED eliminated a 10% communication equity gap between Spanish- and English-speaking families without increasing length of stay or ED return visits.Tuesday’s Spoon Feed:Similar to prior research on the topic, prehospital endotracheal intubation (ETI) is more successful with both sedative and paralytic than with no medications or sedative alone.Wednesday’s Spoon Feed:The updated AHA and AAP guidelines on neonatal life support provide the most current, evidence-based recommendations for recognizing and managing newborns who require resuscitation, a time-critical responsibility that has a major impact on survival and neurodevelopmental outcomes.Thursday’s Spoon Feed:Here are the top ten most viewed JournalFeed posts in 2025 (from our Google Analytics data). I've dropped a comment on how each article has impacted me this year. Enjoy!Friday’s Spoon Feed:Bag valve mask (BVM) ventilations provided by Basic Life Support (BLS) teams during 30:2 cardiopulmonary resuscitation (CPR) in out of hospital cardiac arrest (OHCA) frequently fell well short of the guideline goals for expiratory tidal volume (Vte).