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NEJM Journal Watch: Emergency Medicine RSS Feed

• A Synopsis of Other Important Research from 2022
  In 2022, NEJM Journal Watch covered many studies that are not included in our detailed Year in Review feature but nevertheless are highly relevant for clinical practice. Here are brief synopses of some of those studies.
  Allan S. Brett, MD
• CT Coronary Angiography as the Initial Anatomic Imaging Test for Stable Chest Pain?
  A randomized trial suggested some advantages for this approach.
  Kirsten E. Fleischmann, MD, MPH, FACC
• Prolonged Active Fever Management After Out-of-Hospital Cardiac Arrest Showed No Benefit
  Researchers found no difference in mortality or severe neurological impairment when low temperature was maintained after initial cooling.
  Patricia Kritek, MD
• Reducing Unnecessary Ordering of T3 Tests
  Measuring triiodothyronine levels rarely is necessary; an electronic prompt decreased T3 orders by 50%.
  Allan S. Brett, MD
• Trends in Imaging for Suspected Urinary Stones in the Emergency Department
  Ultrasound appears to be underused, and CT overused, for patients presenting acutely with suspected nephrolithiasis.
  Paul S. Mueller, MD, MPH, FACP
• Testing New Defibrillation Techniques in Out-of-Hospital Cardiac Arrest
  In cases of refractory ventricular fibrillation after three shocks, double sequential defibrillation improved outcomes but may have practical limits to its use.
  Mark S. Link, MD
• No Benefit of Targeted Temperature Management for In-Hospital Cardiac Arrest
  In a randomized, controlled trial, mortality and functional outcome at 6 months were not improved with active cooling compared with normothermia.
  Mark S. Link, MD
• Acute Pancreatitis: How Much Fluid Should We Give?
  Moderate fluid resuscitation resulted in similar clinical outcomes as did aggressive resuscitation, with less fluid overload.
  Aaron J. Calderon, MD, FACP, SFHM
• Hypothermia Isn't Better Than Normothermia After Cardiac Arrest
  Meta-analysis of two large trials showed no difference in mortality or functional outcomes.
  Aaron J. Calderon, MD, FACP, SFHM
• Normal Saline vs. Balanced Crystalloid for Diabetic Ketoacidosis
  Balanced electrolyte solutions led to slightly faster resolution of DKA.
  Daniel D. Dressler, MD, MSc, MHM, FACP