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Ultrasound-guided pericapsular nerve group (PENG) blocks significantly improve short-term pain control and reduce opioid requirements in adult ED patients with hip fractures without increasing adverse events.
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Efficacy of Ultrasound-Guided PENG Block for Acute Pain Relief in Adult Hip Fracture Patients: A Double-Blind Randomized Trial. Acad Emerg Med. 2025 Dec 12. doi: 10.1111/acem.70206. Epub ahead of print. PMID: 41387636.
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In this retrospective multicenter study, both early, overly rapid systolic blood pressure (SBP) reduction after intracerebral hemorrhage (ICH) and overshooting SBP targets (<120 mmHg) were linked with worse functional outcomes at discharge.
Source
Early Intensive Blood Pressure Reduction After Intracerebral Hemorrhage Is Associated With Worse Functional Outcome: The Risk of Overshooting Blood Pressure Goals. Ann Emerg Med. 2025 Dec 9:S0196-0644(25)01303-4. doi: 10.1016/j.annemergmed.2025.10.009. Epub ahead of print. PMID: 41369631; PMCID: PMC12757810.
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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.
Don’t miss Dr. Josh Belfer’s interview with lead author Dr. Burstein and senior author Dr. Kuppermann on his blog HipPEMcrates.com.
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Prediction of Bacteremia and Bacterial Meningitis Among Febrile Infants Aged 28 Days or Younger. JAMA. 2025 Dec 8:e2521454. doi: 10.1001/jama.2025.21454. Epub ahead of print. PMID: 41359314; PMCID: PMC12687207.
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In this trial, randomizing adult patients admitted for asthma exacerbation to shorter duration of steroids (3 days or 5 days) based on their peripheral eosinophil counts was non-inferior to the control group (5 days of steroids).
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Blood eosinophil-guided systemic corticosteroid duration in adults hospitalised for asthma exacerbation: a randomised, controlled, open-label, non-inferiority trial. Thorax. 2025 Dec 3:thorax-2025-223961. doi: 10.1136/thorax-2025-223961. Epub ahead of print. PMID: 41339088.
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This retrospective cohort study found no 24-hour mortality difference when intubating hyperkalemic patients (K > 5.5mmol/L) with succinylcholine versus rocuronium for RSI.
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Hyperkalemic emergency department patients intubated with rocuronium or succinylcholine: Retrospective study of clinical outcomes. Am J Emerg Med. 2025 Dec 2;100:154-164. doi: 10.1016/j.ajem.2025.11.030. Epub ahead of print. PMID: 41380422.
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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.
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STORM-PE Trial Investigators. Randomized Controlled Trial of Mechanical Thrombectomy With Anticoagulation Versus Anticoagulation Alone for Acute Intermediate-High Risk Pulmonary Embolism: Primary Outcomes from the STORM-PE Trial. Circulation. 2025 Nov 3. doi: 10.1161/CIRCULATIONAHA.125.077232. Epub ahead of print. PMID: 41183181.
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High-sensitivity cardiac troponin for risk stratification in both low- and intermediate-risk patients reduced length of stay and increased discharges from the ED for patients with suspected acute coronary syndrome. Also, risk of subsequent myocardial infarction or cardiac death at 1 year was lower.
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HiSTORIC Trial Investigators. Safety of Using Risk Stratification Along With High-Sensitivity Cardiac Troponin in the Emergency Department: A Secondary Analysis. J Am Coll Cardiol. 2025 Nov 11;86(19):1738-1748. doi: 10.1016/j.jacc.2025.08.059. PMID: 41193094.
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Older adults discharged from the ED with delirium had almost 3 times the risk of 30-day mortality compared to those discharged without delirium.
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Outcomes of Older Adults With Delirium Discharged From the Emergency Department. Ann Emerg Med. 2025 Nov;86(5):484-495. doi: 10.1016/j.annemergmed.2025.02.003. Epub 2025 Mar 12. PMID: 40072382; PMCID: PMC12353625.
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For lower GI bleeds, the Oakland and SALGIB risk stratification scores performed well in predicting adverse events and severe bleeding and in identifying patients safe for discharge, but none of the 5 scoring systems reliably predicted need for intervention.
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Predictive value of clinical risk scores for adverse outcomes and safe discharge in acute lower gastrointestinal bleeding. Am J Emerg Med. 2026 Jan;99:370-375. doi: 10.1016/j.ajem.2025.10.051. Epub 2025 Oct 25. PMID: 41175440.
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Using EHR data from the first 4 hours of ED care, machine learning models accurately predicted which children would develop sepsis within 48 hours—before organ dysfunction was present.
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Derivation and Validation of Predictive Models for Early Pediatric Sepsis. JAMA Pediatr. 2025 Dec 1;179(12):1318-1325. doi: 10.1001/jamapediatrics.2025.3892. PMID: 41082207; PMCID: PMC12519407.