5 minute Journal Club: shocking Norepi use

Author: Dr. Collin Wulff, DO Study Question: Does early low-dose norepinephrine improve shock control in those with sepsis with hypotension? Design: Mostly good buzzwords here; single center, randomized, double-blind, placebo controlled clinical trial, smallish study (310 total). The study group received a fairly low dose of norepi infusion (0.05 mcg/kg/min). The primary outcome was not

5 Minute Journal: Nec-Fasc fast!

Author: Dr. Jeny Tan-Creevy Background: Necrotizing soft tissue infections more commonly known as necrotizing fasciitis is a life-threatening diagnosis with a high risk for morbidity and mortality. Gold standard for diagnosis is surgical exploration, which unfortunately is difficult in the Emergency Department. The study is a meta-analysis to investigate the accuracy of physical examination, imaging, and

Migraine Cocktail: over IV fluids or neat?

Author: Dr. Calloway Pichette Article: IV Fluids for the treatment of Emergency Department patients with migraine headache: a randomized controlled trial  Background: Headache, a common complaint in the ED. Many times a day we see patients with migraine headaches in the ED. Give them a migraine cocktail (sadly, no martinis involved…) and then viola! They

Central Line Placement

Author:  Lauran Wirfs


Central venous access is an important procedure for critically ill patients. One consideration when placing a venous catheter is the risk of catheter-related bloodstream infections (CRBIs), which can be a significant cause of morbidity and mortality in hospitalized patients. In 2012, there were 15 million central venous catheter (CVC) days per year in the US in ICUs, and the rate of infections per catheter days is 3/1000. This post looks at a systematic review done by Marik et. al. that examines CRBIs among internal jugular, subclavian, and femoral central venous sites.

Journal: Canadian C-Spine

Author:  Dr. Keya Patel


Each year, more than 1 million patients are treated in the emergency department for blunt trauma and potential C-spine injury. Cervical CT remains the mainstay of imaging in assessing for injury. Here, we review the Canadian C-spine Rule in determining the need for advanced imaging such as CT.