Updates from Emergency Medicine Journals

Emergency Medicine EMS Orthopedics Pediatric Emergency Trauma

Do Prehospital Pelvic Binders Cause More Harm Than Good?
January 20, 2026January 24, 2026

Spoon Feed —
In the prehospital setting, universal application of pelvic circumferential compression devices (PCCDs) with suspected pelvic injuries could lead to adverse iatrogenic effects which are further compounded by improper diagnosis and thus misapplication, poor technique when deployed, and a false sense of security, which could lead to bias in recognizing other fatal causes of shock and bleeding.

Source
Prehospital Trauma Compendium: Evaluation and Management of Suspected Pelvis Fractures – An NAEMSP Position Statement and Resource Document. Prehosp Emerg Care. 2025 Aug 11:1-35. doi: 10.1080/10903127.2025.2540420. Epub ahead of print. PMID: 40729523.

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Critical Care Emergency Medicine Hematology/Oncology Pediatric Emergency Pharmacy/Pharmacology Trauma

How to Reverse Antithrombotics in TBI
January 19, 2026February 2, 2026

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Antithrombotic medication reversal in traumatic brain injury (TBI) is a nuanced topic, requiring assessments of injury severity, appropriate reversal agent and dosing strategy, and potential risks to the patient.

Source
Reversal of antithrombotic medications in patients with traumatic brain injury: What you need to know. J Trauma Acute Care Surg. 2025 Dec 1;99(6):828-835. doi: 10.1097/TA.0000000000004766. Epub 2025 Aug 19. PMID: 40828405.

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Emergency Medicine Orthopedics Pain/Sedation/Procedure Ultrasound

Block Better – PENG Blocks for Hip Fractures
January 16, 2026January 17, 2026

Spoon Feed —
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.

Source
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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Critical Care Emergency Medicine Neurology Pharmacy/Pharmacology Stroke

Slow and Steady – Be Careful with ICH BP Control
January 15, 2026January 17, 2026

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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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Emergency Medicine Infectious Disease Pediatric Emergency

Febrile Neonates Under 28 Days – Is PECARN Rule Safe?
January 14, 2026January 17, 2026

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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.

Source
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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Emergency Medicine Pediatric Emergency Pulmonary/Allergy

Eosinophil Count Determines Steroids or Not for Asthma?
January 13, 2026January 17, 2026

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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).

Source
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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Airway Critical Care Emergency Medicine Pediatric Emergency Pharmacy/Pharmacology

Hyperkalemia – Can We Use Succinylcholine for RSI?
January 12, 2026January 17, 2026

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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.

Source
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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Cardiology Emergency Medicine Venous Thromboembolism

STORM-PE RCT—Thrombectomy for Intermediate-High Risk PE
January 9, 2026January 10, 2026

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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.

Source
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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Cardiology Emergency Medicine

HiSTORIC Reprise—High-Sensitivity Troponin Here to Stay
January 8, 2026January 10, 2026

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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.

Source
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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Emergency Medicine Medicine/Geriatrics Neurology Psychiatry | Substance Use

Discharging Delirium Is Dangerous
January 7, 2026January 10, 2026

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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.

Source
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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