Some of the papers that caught our eye this month…..

Is risk stratifying TIA’s time well spent?

Validation of ABCD2 scores ascertained by referring clinicians: a retrospective transient ischaemic attack clinic cohort study. Dutta D. Emerg Med J. 2016 Apr 7. pii: emermed-2015-205519. doi: 10.1136/emermed-2015-205519. [Epub ahead of print]

As we think about upskilling our airway skills in the ED this paper has a look at the safety in an adolescent age group.

Adolescent tracheal intubation in an adult urban emergency department: a retrospective, observational study. Hale JJ. Eur J Emerg Med. 2016 Apr 1. [Epub ahead of print]

Continuing the hot topic of not too little, not too much but just the right amount of oxygen please, this paper looks specifically at ECMO.

Hyperoxia Is Associated With Poor Outcomes in Pediatric Cardiac Patients Supported on Venoarterial Extracorporeal Membrane Oxygenation. Sznycer-Taub NR. Pediatr Crit Care Med. 2016 Apr;17(4):350-8. doi: 10.1097/PCC.0000000000000655.

How your smartphone may be recording data that you REALLY need!

Interrogation of Patient Smartphone Activity Tracker to Assist Arrhythmia Management. Rudner J. Ann Emerg Med. 2016 Mar 29. pii: S0196-0644(16)00143-8. doi: 10.1016/j.annemergmed.2016.02.039. [Epub ahead of print]

About to lyse a PE? Should you be doing it systemically or is it time to move to catheter directed thrombolysis?

Comparison between systemic and catheter thrombolysis in patients with pulmonary embolism. Yoo JW. Am J Emerg Med. 2016 Feb 15. pii: S0735-6757(16)00117-0. doi: 10.1016/j.ajem.2016.02.037. [Epub ahead of print]

How have outcomes in resuscitation changed over the last 5 years?

Meta-analysis of outcomes of the 2005 and 2010 cardiopulmonary resuscitation guidelines for adults with in-hospital cardiac arrest. Zhu A. Am J Emerg Med. 2016 Mar 8. pii: S0735-6757(16)00190-X. doi: 10.1016/j.ajem.2016.03.008. [Epub ahead of print]

With the difficult presentation of an undifferentiated elderly patient with syncope; how much variability is there between our assessments and prediction of poor outcomes?

Reliability of clinical assessments in older adults with syncope or near syncope. Nishijima DK. Acad Emerg Med. 2016 Mar 29. doi: 10.1111/acem.12977. [Epub ahead of print]

Should we grab the nearest laryngoscope during CPR or reach for the video?

Video laryngoscopy vs. direct laryngoscopy: Which should be chosen for endotracheal intubation during cardiopulmonary resuscitation? A prospective randomized controlled study of experienced intubators. Kim JW. Resuscitation. 2016 Apr 16. pii: S0300-9572(16)30014-4. doi: 10.1016/j.resuscitation.2016.04.003. [Epub ahead of print]

You’ve seen it in the movies but should the ball point pen really be used as a last resort for a surgical airway??

Bystander cricothyrotomy with ballpoint pen: a fresh cadaveric feasibility study. Kisser U. Emerg Med J. 2016 Apr 19. pii: emermed-2015-205659. doi: 10.1136/emermed-2015-205659. [Epub ahead of print]

How quickly do we need to hang the fluids in sepsis?

Association of Fluid Resuscitation Initiation Within 30 Minutes of Severe Sepsis and Septic Shock Recognition With Reduced Mortality and Length of Stay. Leisman D. Ann Emerg Med. 2016 Apr 14. pii: S0196-0644(16)00148-7. doi: 10.1016/j.annemergmed.2016.02.044. [Epub ahead of print]

They bumped their head more than 24hrs ago, surely they don’t need a scan……..

CT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study. Marincowitz C. Emerg Med J. 2016 Apr 13. pii: emermed-2015-205370. doi: 10.1136/emermed-2015-205370. [Epub ahead of print]

How good are we at diagnosing UTI’s? Running through the dogma of making the diagnosis

Top Ten Myths Regarding the Diagnosis and Treatment of Urinary Tract Infections. Schulz L. J Emerg Med. 2016 Apr 7. pii: S0736-4679(16)00122-0. doi: 10.1016/j.jemermed.2016.02.009. [Epub ahead of print]

We know what a great tool chest US is to diagnose heart failure but how good id it to monitor response to therapy?

Resolution of sonographic B-lines as a measure of pulmonary decongestion in acute heart failure. Martindale JL. Am J Emerg Med. 2016 Mar 19. pii: S0735-6757(16)00247-3. doi: 10.1016/j.ajem.2016.03.043. [Epub ahead of print]