In patients with cirrhosis and ongoing bleeding, it can be challenging to determine whether or not patients are hyper or hypocoagulable. Traditional markers of coagulation status like INR can be difficult to interpret in patients with abnormal synthetic function and potentially increase consumption of coagulation factors. Can TEG (thromboelastography) be a helpful too in these situations? In this journal club recap, Dr. Grisoli recaps a recent article by Rout et al that addresses this issue.

In this journal club recap, Dr Sarah Moulds recaps a recent meta-analysis of papers looking at the therapeutic effect of TXA in patients with severe trauma. Are their higher rates of thromboembolic complications? Is mortality improved? This article by Fouche et al attempts to answer these questions.

Out of hospital cardiac arrest (OOHCA) represents a great cause of morbidity and mortality. Approximately 350,000 cardiac arrests occur in North America annually and 20% can be attributed to Ventricular tachydysrhythmias (i.e. ventricular tachycardia [v fib] and ventricular tachycardia [v tach]without a pulse). In this journal club recap, Dr Kelly Tillotson recaps an article comparing different ways of defibrillation and their effect on outcomes in OOHCA

In this most recent Journal Club recap podcast, Dr. Cole Davis covers a paper investigating the use of sterile vs clean gloves for laceration repair in the ED.

In this journal club breakdown, we analyze an article examining the relationship between invasive arterial line blood pressure measurements and non-invasive cuff measurements.

Can the addition of high-dose methylprednisolone to the treatment of out-of-hospital cardiac arrest make a meaningful difference? In this post-hoc analysis of a placebo-controlled randomized control trial comparing high-dose methylprednisolone versus placebo in out-of-hospital cardiac arrest (OHCA), the authors aimed to assess the hemodynamic effects of prehospital high-dose glucocorticoid treatment in resuscitated comatose OHCA patients.

In this podcast, Dr Charlie Brower PGY-3 at the University of Cincinnati leads a discussion of a recent journal club article looking at the impact of a subcutaneous insulin treatment pathway for mild and moderate DKA. We explore the financial and operational impacts of this pathway as compared to traditional treatment with IV insulin

Pain from rib fractures can be severely limiting in the acute setting. In this recap from our most recent Journal Club, Dr Olivia Gobble leads us through a paper looking at the effectiveness of Serratus Anterior Plane Blocks for treating pain from rib fractures in the Emergency Department.

Ultrasound is an increasingly ubiquitous tool to augment the physical exam in the Emergency Department. Dr Jazmyn Shaw walks us through a paper that looks at whether or not US is a useful adjunct to physical exam for the diagnosis of shoulder dislocation in the Emergency Department

Dr Casey Glenn walks through a study analyzing the 'lever test' for the diagnosis of ACL tears in the acute setting. Given significant swelling and pain the acute diagnosis of ligamentous injury can be both challenging and painful to patients. The lever test is a promising physical exam maneuver that may be more accurate and better tolerated that traditional exam maneuvers.