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A Pain in the Neck
There are some areas in our practice where the literature grants us a somewhat sure path forward in the evaluation of our patients. The decision whether or not to pursue cervical spine imaging studies following a traumatic mechanism of injury is one of these areas. The NEXUS criteria and Canadian C-Spine Rule are useful guides for the evaluation of these patients. What comes after the imaging can be a bit more challenging. What do we do with patients who have persistent pain but negative imaging? To what extent do we pursue the possibility of a ligamentous injury? Must we wait for all patients to be sober so that we can "clinically clear" them in addition to our radiographic clearance. The 3 articles below seek to answer some of these challenging questions. Take a listen to the podcast and read the summaries to familiarize yourself with some of the latest literature addressing these challenging patient care scenarios.
The Future of Airway Management?
What is the future of airway management in the ED? How can we make our practice more effective and more efficient? In this journal club recap, we focus on 2 topics emerging in the literature - flush rate O2 for pre-oxygenation and head of bed elevation during intubation.
The Radioactive Heart
For Journal Club this past week we covered what is undoubtably one of the more controversial diagnostic tests used in the evaluation of patients presenting to physicians with chest pain. The most recent NICE guidelines recommend Coronary CT as the first line test for patients with stable angina symptoms but don't Coronary CT's lead to increased downstream testing? more radiation exposure? To investigate this topic we took a look at 3 articles focused on the utility of Coronary CT scans. Take a listen to the podcast and read the recap to learn for yourself.