March 2022

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A Society for Academic Emergency Medicine (SAEM) task force interviewed academic EM leaders to determine areas for improvement in equitable faculty advancement and compensation, and to create systems-based recommendations in each area.

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Institutional solutions addressing disparities in compensation and advancement of emergency medicine physicians: A critical appraisal of gaps and associated recommendations. Acad Emerg Med. 2022 Jan 22. doi: 10.1111/acem.14452. Epub ahead of print.

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There are a variety of therapeutic agents available for use in outpatients with COVID-19. Each has advantages and disadvantages that can help you decide which medication is best for your patient.

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COVID-19 Therapeutics for Nonhospitalized Patients. JAMA. 2022 Feb 15;327(7):617-618. doi: 10.1001/jama.2022.0335.

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Scalpel-finger-cannula was faster and had higher first-attempt success rate than scalpel-finger-bougie for front-of-neck access in simulated obese, bleeding manikin models.

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Success and Time to Oxygen Delivery for Scalpel-Finger-Cannula and Scalpel-Finger-Bougie Front-of-Neck Access: A Randomized Crossover Study With a Simulated "Can't Intubate, Can't Oxygenate" Scenario in a Manikin Model With Impalpable Neck Anatomy. Anesth Analg. 2022 Mar 3. doi: 10.1213/ANE.0000000000005969. Online ahead of print.

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A high-fidelity simulation training program was very effective in teaching anesthesiologists to place invasive subglottic airways; skill retention was outstanding as well.

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Emergency Subglottic Airway Training and Assessment of Skills Retention of Attending Anesthesiologists With Simulation Mastery-Based Learning. Anesth Analg. 2022 Feb 10. doi: 10.1213/ANE.0000000000005928. Online ahead of print.

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More intense follow-up noninvasive cardiac stress testing within 72 hours among patients with chest pain discharged from the ED was associated with greater major adverse coronary outcomes at 60 days, but this was mainly driven by more downstream procedures.

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Higher intensity of 72-h noninvasive cardiac test referral does not improve short-term outcomes among emergency department patients with chest pain. Acad Emerg Med. 2022 Jan 22. doi: 10.1111/acem.14448. Online ahead of print.

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Among patients with acute ischemic stroke with large vessel occlusion that have been successfully reperfused with thrombectomy, the use of post-thrombectomy adjunctive intra-arterial alteplase results in greater likelihood of excellent neurologic outcome at 90 days - modified-Rankin score 0 or 1 - when compared with placebo.

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Effect of Intra-arterial Alteplase vs Placebo Following Successful Thrombectomy on Functional Outcomes in Patients With Large Vessel Occlusion Acute Ischemic Stroke: The CHOICE Randomized Clinical Trial. JAMA. 2022 Feb 10;e221645. doi: 10.1001/jama.2022.1645. Online ahead of print.

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Higher doses of intranasal fentanyl for pain ranging from 2-5 μg/kg (with a maximum of 200 μg) were given in a pediatric emergency department, with no documented episodes of apnea, hypotension, or respiratory failure.

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The Safety of High-Dose Intranasal Fentanyl in the Pediatric Emergency Department. Pediatr Emerg Care. 2022 Feb 1;38(2):e447-e450. doi: 10.1097/PEC.0000000000002627.

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Time from symptom onset of a basilar artery occlusion (BAO) to endovascular therapy (EVT) of less than 6 hours compared to greater than 6 hours (up to 24 hours) was associated with lower odds of in-hospital mortality, disability, symptomatic intracranial hemorrhage, and higher odds of ambulation at discharge, discharge home and reperfusion.

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Association Between Endovascular Therapy Time to Treatment and Outcomes in Patients with Basilar Artery Occlusion. Circulation. 2022 Jan 20. doi: 10.1161/CIRCULATIONAHA.121.056554. Online ahead of print.

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Continuous epinephrine infusion for post-resuscitation shock in out of hospital cardiac arrest (OHCA) was associated with both higher all-cause and cardiovascular specific mortality when compared to norepinephrine.

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Epinephrine versus norepinephrine in cardiac arrest patients with post-resuscitation shock. Intensive Care Med. 2022 Mar;48(3):300-310. doi: 10.1007/s00134-021-06608-7. Epub 2022 Feb 7.

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When treating this wide complex tachycardia with synchronized cardioversion, the machine interpreted the T wave as the R wave. Nothing good comes of that!
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An Adverse Outcome With Cardioversion of a Wide-Complex Tachycardia. Ann Emerg Med. 2022 Feb;79(2):113-115. doi: 10.1016/j.annemergmed.2021.06.011.