July 01, 2017

Journal Club May 2017 - Suicide Risk Assessment

July 01, 2017/ Jeff Holmes

Emergency physicians regularly see psychiatric patients who are having suicidal thoughts or engage in non-suicidal self-injurious (NSSI) behavior. In addition to working these patients up medically, it is part of our job to determine who needs emergent evaluation by a psychiatric provider and who is safe for discharge. This is a very important decision, as we do not want to send high risk patients home and keep low risk patients for extended periods of time while they await their evaluation. Balancing this can be difficult - oftentimes it is not obvious where a patient falls on this spectrum. We are taught various decision aids in medical school to help us risk stratify these patients - but how do they perform on emergency department patients? For this month's journal club, we looked at three papers that examine three different decision aids to help elucidate this issue.

May 12, 2017

Journal Club April 2017 - Pelvic Inflammatory Disease

May 12, 2017/ Pete Croft, MD

Urinary complaints in females are an incredibly common reason for visits to emergency departments. We are often left to make the decision of whether to treat for infection on fairly equivocal urinalysis results without the help of a definitive culture. Muddying the waters is the risk of sexually transmitted infections (STI's) which can cause similar if not more benign symptomatology (even at times completely asymptomatic). Can the history help? Do reported symptoms correlate with a diagnosis? In April's journal club, we chose articles that aimed to clarify the distinction between two entities (UTI vs. STI) that are incredibly frequent in sexually active women.

March 31, 2017

Journal Club March 2017 - Herbal Medicines

March 31, 2017/ Jeff Holmes

The availability of herbal and dietary supplements in the U.S. is increasing exponentially: 4,000 in 1994 to 80,000 today. Half of all adults have reported using at least one dietary supplement in the past month, but many do not openly relay this to their primary care physicians or emergency medicine physicians. This month’s journal club focused on the utilization of these products, their adverse events/complications as well as their “regulation”.

February 23, 2017

Journal Club February 2017 - Syncope and Pulmonary Embolism

February 23, 2017/ Christine Hein, MD

Since Prandoni et al published their findings in the NEJM's October 2016 issue (reporting a 17.3% incidence of pulmonary embolism among patients admitted with first time syncope), there has been controversy swirling in the EM community. Questions have been raised regarding the impact of this study, its generalizability, and its implications for clinical practice. At this month’s journal club, we broke down the findings in the Prandoni study as well as looked at two other studies (Castelli et al and Altinsoy et al) that examined the clinical characteristics of patients with PE who presented with syncope.

February 05, 2017

Journal Club January 2017: Appendicitis - Is it still an Operative disease?

February 05, 2017/ Jeffrey A. Holmes, MD

At this journal club we looked at a number of studies examining the concept. While they were of varied design, the premise of all was the same; namely with an antibiotic only approach, what is the success rate, recurrence rate, and cost savings / loss?

November 22, 2016

Journal Club November 2016 - Bedside Imaging Decisions in Trauma

November 22, 2016/ Jeff Holmes

This month Dr. Rappold opened up his home to us where we discussed the utility of bedside ultrasound and plain films in the resuscitation of the trauma patient.