Podcast summarizing recent emergency medicine posts from the past week.
**JAMA: Loberamisal for Acute Ischemic Stroke The LAIS Randomized Clinical Trial**
Loberamisal is a small-molecule compound that dually targets the postsynaptic density 95 (PSD-95) pathway and α2 γ-aminobutyric acid type α (α2-GABAA) receptor. OBJECTIVE To evaluate the efficacy and safety of intravenous loberamisal for improving functional outcomes in patients with acute ischemic stroke.
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**PODCAST: Managing Severe TBI**
In this episode, ED Clinical Pharmacist Haley Burhans returns to walk us through key medications for the acute management of severe TBI. Lidocaine (1.5 mg/kg): Theoretically blunts airway-reflex-induced ICP spikes during intubation, but takes 2–5 minutes to reach peak effect and introduces cardiac risks in undifferentiated trauma patients.
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**Is Syncope or Pre-Syncope Worth Hospitalization?**
This secondary analysis of data prospectively collected from a U.S. multicenter observational study asked if rates and time to diagnosis of SAOs* differed significantly between hospitalized or discharged patients ≥40 years old with syncope or pre-syncope without a dangerous diagnosis identified in the ED. This study provides fascinating data and context that will inform my shared decision-making discussions with patients whom I think need hospitalization after syncope or pre-syncope.
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**Emergency Department Observation and Computed Tomography Use in Children with Blunt Abdominal Trauma**
Clinicians documented Pediatric Emergency Care Applied Research Network abdominal trauma rule variables and whether a period of observation with deferred CT decisionmaking was performed. The post Emergency Department Observation and Computed Tomography Use in Children with Blunt Abdominal Trauma first appeared on האיגוד הישראלי לרפואה דחופה.
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**Injury: Prehospital pelvic binder use and transfusion requirements in patients with pelvic fractures: A nationwide propensity-matched cohort study**
Subgroup analyses, including patients with acetabular and proximal femur fractures, showed no evidence of effect modification. These findings suggest that prehospital pelvic binder use may influence, or reflect differences in, subsequent hemorrhage-control strategies rather than directly reducing transfusion requirements.
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**JAMA: Autonomous Oxygen Titration for Maintaining Normoxemia in Acutely Ill Adults: The SAVE-O2 AI Randomized Clinical Trial**
David J Douin 1, John D Rice 2, Mengli Xiao 3, Laurel E Beaty 3, Claire J Guo 3, Cori Withers 4, Amy Sullivan 4, Erin L Anderson 4, Alex C Cheng 5, Mary K Banasiewicz 6, Matthew W Semler 7, Bradley D Lloyd 8, Amelia W Maiga 9, Kevin W Gibbs 10, Gregory R Stettler 11, Akram Khan 12, Mitchell B Sally 13, Franklin L Wright 14, Arek J Wiktor 14, Neil R Aggarwal 15, Vikhyat S Bebarta 4 16, Adit A Ginde 4 16; SAVE-O AI Investigators Importance: For acutely ill adults who are hospitalized with hypoxemia, supplemental oxygen is titrated to maintain normoxemia.
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**Hypertensive disorders of pregnancy: A review and updates for the emergency physician**
HDPs represent a spectrum of disease including gestational hypertension; chronic hypertension in pregnancy; pre-eclampsia; superimposed pre-eclampsia; Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome; and eclampsia. This is a review of the current literature and guidelines of HDPs, including updated HDP diagnostic criteria, diagnostic testing, and initial management.
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**BRACHA Score – Predicting Child/Teen Agitation**
This prospective observational prognostic validation study enrolled 472 children aged 5–18 years presenting with MBH to two pediatric EDs. I look forward to implementation studies of this tool and perhaps a BRACHA-S-guided care pathway for proactive safety planning.
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**One and Done? Dexamethasone for Pediatric Asthma**
Written by Joshua Belfer Spoon Feed While most children discharged after an asthma exacerbation receive two doses of dexamethasone, this retrospective cohort study found no difference in ED revisits or hospitalizations compared with a single-dose regimen. Asthma exacerbations account for more than 700,000 ED visits annually, but evidence and guidelines vary with regard to a one- or two-dose regimen of dexamethasone.
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**PODCAST: Nerve Blocks and Pain Management with Dr. Igor Middlebrook**
In this episode of ACEP Frontline, Dr. Ryan Stanton is joined by Dr. Igor Middlebrook at Michigan ACEP's Summer Assembly on Mackinac Island to discuss the expanding role of ultrasound-guided regional nerve blocks and multimodal pain management in emergency medicine. He shares practical strategies for implementing a nerve block program, highlights high-yield blocks for community physicians, and explains how these techniques can improve patient outcomes, reduce opioid use, avoid unnecessary admissions, and add value to emergency department care.The post PODCAST: Nerve Blocks and Pain Management with Dr. Igor Middlebrook first appeared on האיגוד הישראלי לרפואה דחופה.
