August 2024

Nerds Wanted!

JournalFeed is expanding to cover Internal Medicine/Primary Care and Pediatrics. We need new authors and editors.
1) Do you know a great writer who can critically appraise the literature and is a great human being?
2) Do you know someone as above who is more seasoned and has editing experience?

If so, please email us at support@journalfeed.org.

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The MISSION Act Scribes Trial evaluated the implementation of medical scribes in Veterans Health Administration (VHA) EDs. Contrary to expectations, scribes decreased provider productivity and increased patient throughput times.

Source
Effect of the Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act Scribes Trial on Emergency Department Provider Productivity and Patient Throughput Times. J Emerg Med. 2024 Jul;67(1):e89-e98. doi: 10.1016/j.jemermed.2024.03.036. Epub 2024 Mar 30.

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This systematic review and meta-analysis of 43 nonrandomized studies over 30 years looking at termination of resuscitation (TOR) rules in out of hospital cardiac arrest (OHCA) found that there was insufficient evidence to support widespread implementation of TOR rules in clinical practice, as this may lead to missed survivors.

Source
Termination of Resuscitation Rules and Survival Among Patients With Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024 Jul 1;7(7):e2420040. doi: 10.1001/jamanetworkopen.2024.20040. PMID: 38958975; PMCID: PMC11222995.

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This retrospective study assessed the benefit of AI-assisted chest x-ray interpretation for non-radiology residents when compared to radiology residents. Pneumothorax and pulmonary nodule detection, in particular, demonstrated meaningful gains in sensitivity and accuracy for non-radiology providers.

Source
Nonradiology Health Care Professionals Significantly Benefit From AI Assistance in Emergency-Related Chest Radiography Interpretation. Chest. 2024 Jul;166(1):157-170. doi: 10.1016/j.chest.2024.01.039. Epub 2024 Jan 29. PMID: 38295950; PMCID: PMC11251081.

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Residents working in the emergency department were found to do significantly worse on cognitive tests and moral performance after working 5 consecutive night shifts compared to 5 day shifts.

Source
Effect of serial night shifts on the cognitive, psychomotor, and moral performance of residents in the department of Emergency Medicine. Acad Emerg Med. 2024 Jul 15. doi: 10.1111/acem.14980. Online ahead of print. PMID: 39007435

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A new PECARN clinical decision rule for cervical spine imaging in children after blunt trauma identifies children at low risk for C-spine injury utilizing nine risk factors.

Source
PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. 2024 Jul;8(7):482-490. doi: 10.1016/S2352-4642(24)00104-4. Epub 2024 Jun 4. PMID: 38843852; PMCID: PMC11261431.

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Back blows outperformed abdominal thrusts and chest compressions in successful clearance of out-of-hospital foreign body airway obstructions (FBAO).

Source
Evaluation of basic life support interventions for foreign body airway obstructions: A population-based cohort study. Resuscitation. 2024 Aug;201:110258. doi: 10.1016/j.resuscitation.2024.110258. Epub 2024 May 31. PMID: 38825222.

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A single center retrospective treatment of 144 patients who tested positive for C. trachomatis found that 18% (n=26) of patients did not pick up their prescription for doxycycline. Those who did not obtain their doxycycline prescription were 3 times more likely to return to the ED within 28 days for the same chief complaint.

Source
Doxycycline adherence for the management of Chlamydia trachomatis infections. Am J Emerg Med. 2024;81:136-139. doi:10.1016/j.ajem.2024.05.003. PMID: 38728936.

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Using the aortic dissection detection (ADD) risk score in addition to point-of-care ultrasound (POCUS) and D-dimer, providers can increase their diagnostic accuracy and ensure that the appropriate patients are receiving advanced imaging to make the diagnosis of acute aortic syndrome (AAS).

Source
Diagnosis of acute aortic syndromes with ultrasound and d-dimer: the PROFUNDUS study. Eur J Intern Med. 2024 Jun 12:S0953-6205(24)00234-6. doi: 10.1016/j.ejim.2024.05.029. Epub ahead of print. PMID: 38871565.

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This secondary analysis of the CLOVERS trial demonstrated a significant reduction in 90-day mortality, more ventilator free days, and more vasopressor free days among patients with advanced CKD and sepsis-induced hypotension randomized to a restrictive fluid strategy with earlier vasopressor use compared to a more liberal fluid strategy.

Source
Fluid management for sepsis-induced hypotension in patients with advanced chronic kidney disease: a secondary analysis of the CLOVERS trial. Crit Care. 2024 Jul 11;28(1):231. doi: 10.1186/s13054-024-05019-6. PMID: 38992663; PMCID: PMC11238412.

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This comprehensive article on bougie use during emergency airway management covers all things bougie, with a lot of technical tips. We cover the highlights.

Source
Managing Emergency Endotracheal Intubation Utilizing a Bougie. Ann Emerg Med. 2024 2024 Jun 22:S0196-0644(24)00232-4. DOI: 10.1016/j.annemergmed.2024.04.021. PMID: 38912998.