JACEP Open

In this episode of JACEP Open, Luke Wood and Matthew DeLaney dig into a recent paper from JACEP Open looking at risk stratifying patients who present with altered mental status.

When is VL actually VL? Much of the literature around video laryngoscopy fails to describe how the video laryngoscope is actually used. Too often, we lump all VL devices and techniques into one group when there are actually two broad types of devices (standard and hyperacute geometry blades) as well as two techniques of using standard geometry (direct vs indirect visualization). We review a JACEP open systemic review of the literature to learn how often the literature makes these distinctions. And we even throw a bit of laryngoscope history in for good measure.

References:

1. Pieters BM, Eindhoven GB, Acott C, Van Zundert AAJ. Pioneers of Laryngoscopy: Indirect, Direct and Video Laryngoscopy. Anaesth Intensive Care. 2015;43(1_suppl):4-11. doi:10.1177/0310057X150430S103

2. Dean P, Kerrey BT. Video screen visualization patterns when using a video laryngoscope for tracheal intubation: A systematic review. JACEP Open. 2022; 3: e212630.

This month we dive deep into Urine Pregnancy Testing. Despite being used widely to make major clinical decisions the real world performance of urine pregnancy testing is far from perfect.

Myths are common in Emergency Medicine but often don’t hold up to scrutiny. We cover two papers from JACEP Open that help shed light on two myths: only paramedics can give epinephrine in cardiac arrest and all rollover collisions should be transported to a trauma center because they are predictive of major injury.

Intoxicated patients can pose a unique challenge in the emergency department. While some patients may just need a few hours to sleep it off, intoxicated patients have high rates of both short and long term medical outcomes. In this month's JACEP Open Podcast we dive into the challenge of risk stratifying intoxicated patients.

At the beginning of the pandemic, we all had to change many of our practices to protect ourselves and our colleagues from COVID-19, even though we had little evidence to work with. Fortunately, we are starting to get good data in to help revise our these practices and reach our goal of good care for our patients with good protection for us. Dr. Jarvis covers two JACEP Open papers discussing the risk of oxygenation strategies and the effectiveness of personal protective equipment (PPE).

COVID-19 has radically impacted our day to day lives in the emergency department. In this month's episode Dr. Matthew DeLaney and Dr. Luke Wood discuss COVID-19's potential impact on patient satisfaction. To learn more check out: Jehle, D, Leggett, J, Short, R, Pangia, J, Wilson, C, Gutovitz, S. Influence of COVID‐19 outbreak on emergency department Press Ganey scores of emergency physicians. JACEP Open. 2020; 1: 1413– 1417. https://doi.org/10.1002/emp2.12287

Emergency Physicians see patients commonly see patients with chest pain on every shift. Among other considerations, they have to determine the patient’s risk of having a bad outcome before they’re able to receive further care. This risk stratification has historically depended on clinical gestalt. Over the past decade or so, multiple clinical scores have been developed to help physicians make this decision. The question, though, is how well do they work. Are they better than clinical gestalt alone? How should they be interpreted in light of the ECG and troponin?

In this episode of the JACEP Open podcast, Dr. Jeff Jarvis discusses two recent papers from the Journal that help answer these questions.

Class EM teaching on pre-oxygenation prior to RSI is that we need SpO2 values at or above 93% for at least three minutes to assure adequate de-nitrogenation. But is this 3 minutes actually enough? Is SpO2 the best measure of de-nitrogenation or is there something better? Our anesthesia colleagues use EtO2 for this purpose. The episode of the Podcast reviews a paper in the October edition of JACEP Open in which Dr. Oliver and colleagues evaluate exactly this question. Tune in to hear all about it and be sure to download the paper for free at the JACEP Open website.

If you like this podcast, please give us a 5-star rating on Apple Podcasts. This helps push the algorithms that control all of our lives and can help other EM physicians find our podcast.

The COVID-19 pandemic has impacted all of us in emergency medicine. Emergency physicians are on the front lines of both directly caring for COVID patients and sharing the lessons they’ve learned about these patients with others. The August edition of JACEP Open has 9 great papers discussing the response to this pandemic. We give a brief overview of the highlights of each of these papers in this episode of the podcast. Think of it as the Cliff Notes version.

If you like this podcast, please give us a 5-star rating on Apple Podcasts. This helps push the algorithms that control all of our lives and can help other EM physicians find our podcast.