Journal Club

Rettungskorsett by Florian Thillmann, via Wikimedia Commons.

When a trauma patient is altered or obtunded, even with vitals signs that do not indicate the need for immediate operative intervention, one’s suspicion for significant injury is higher than if the same patient had a GCS of 15. This concern often persists even after an exhaustive diagnostic work-up that frequently includes advanced imaging of the head and cervical spine, and has raised the question of how good is CT at identifying significant cervical spine pathology in the absence of an accompanying clinical exam.
Dr. Jennifer Roh lead our most recent Journal Club looking at the Patel et al.’s systematic review of just this topic.
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The Journal Club on July 1 resulted in a great discussion around the acute and chronic management of atrial fibrillation. Keep reading after the jump for Dr. Cristiana Baloescu’s summary of current article on the acute management of atrial fibrillations in complex patients in the ED.
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ARDSNet was a practice-changing publication that has since been extended to ventilator management of patient who do not have ALI or ARDS, so use 6-8 mL/kg of predicted body weight when using volume AC.


There may be a link between depth of sedation in the first 48 hours after intubation and time to extubation and mortality, but if you cannot determine how depth of sedation is defined, nor what link there might be between RASS score and medications given, you cannot act upon the findings in the publication.


Go to the Yale Box for a full summary of last week’s journal club, and articles, on the management of ventilated, critically ill patients.

Triad of Care

Iatrogenic infections are a reality of any medical practice, regardless of the specific in-patient, out-patient, or emergency department setting, but no clinician wants to be cause of them. This week’s Journal Club, led by PGY-3 Clare Buckingham, and Drs. Melnick, and Evans, focuses on Emergency Department-related iatrogenic infections (okay fine one of the studies was done in the ICU, but we put in tons of central lines) and putting systems of care in place to minimize them.
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Kidney Stone, by A. Minnocci via Wikimedia Commons

With the increasing use of CT scans for patients with abdominal pain and flank pain, and the increasing awareness that all this radiation might be avoidable in an appropriately selected patient population. This week’s journal club, led by PGY-3 Dan Savage, and Drs. Moore and Venkatesh, focuses on imaging options and management of renal stones. Keep reading for the synopses of this Journal Club’s Classic and Current articles.
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