Emergency Medicine
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The Price of Time: 20-Year Study Reveals Pre-Hospital Delay as a Critical Driver of STEMI Mortality
A 20-year analysis of 89,155 patients from the SWEDEHEART registry confirms that pre-hospital delay independently predicts short- and long-term mortality. Despite advances in reperfusion, women, elderly patients, and those with diabetes con
Awake Prone Positioning in COVID-19 Respiratory Failure: A Synthesis of Clinical Trial Evidence and the PROVID Study
This review synthesizes the findings of the PROVID randomized clinical trial and broader literature, demonstrating that awake prone positioning (APP) significantly reduces the probability of intubation and death in patients with COVID-19 hy
One in Three Older Emergency Admissions Face Cognitive Morbidity: Insights from the ORCHARD-EPR Study
A large-scale cross-sectional study of 51,202 admissions reveals that 35.6% of patients aged 70 and older experience cognitive morbidity, predominantly delirium. The findings underscore the urgent necessity for hospital-wide screening and m
High-Sensitivity Cardiac Troponin Risk Stratification Safely Accelerates ED Discharge and Improves 1-Year Outcomes
A secondary analysis of the HiSTORIC trial reveals that using high-sensitivity cardiac troponin for risk stratification significantly reduces ED length of stay and increases safe discharge rates for low- and intermediate-risk patients, with
Beyond Troponin: Cardiac Myosin-Binding Protein C Accelerates NSTEMI Diagnosis and Emergency Department Triage
A secondary analysis of the APACE study demonstrates that Cardiac Myosin-Binding Protein C (cMyC) significantly improves NSTEMI diagnosis, particularly in early presenters. Integrating cMyC with high-sensitivity troponin into a dual-biomark
The Earlier, the Better: INTERACT Pooled Analysis Confirms 3-Hour Golden Window for Intensive Blood Pressure Lowering in Acute ICH
A pooled analysis of over 11,000 patients from the INTERACT trials demonstrates that intensive blood pressure reduction significantly improves functional recovery in acute intracerebral hemorrhage, with the most robust benefits observed whe
Telemedicine is Superior to Onboard Neurologists for Optimizing Mobile Stroke Unit Efficiency: Results from the MSU-TELEMED Trial
The MSU-TELEMED trial demonstrates that a telemedicine model for mobile stroke units significantly improves neurologist resource utilization while maintaining safety, outperforming the traditional onboard neurologist model in a hierarchical
Remote Expertise, Local Impact: Telemedicine Models Outperform Onboard Care in Mobile Stroke Units
The MSU-TELEMED trial demonstrates that telemedicine models for Mobile Stroke Units are superior to onboard neurologist care. By dramatically improving physician resource utilization without compromising safety, telemedicine provides a more
Superior Early Analgesia with PENG Block in Hip Fractures: A Randomized Controlled Trial
A randomized trial demonstrates that the Pericapsular Nerve Group (PENG) block provides significantly better pain relief than the Fascia Iliaca Block (FIB) in the first hour post-intervention for hip fracture patients in the emergency depar
POCUS-Guided Nerve Blocks by Emergency Physicians Significantly Reduce Delirium Risk in Elderly Hip Fracture Patients
A multicenter randomized trial reveals that a brief, structured training intervention for emergency physicians significantly increases the use of ultrasound-guided fascia iliaca blocks, resulting in a 28% reduction in delirium risk for geri
Prehospital Postintubation Hypotension Strongly Linked to 30‑Day Mortality After Severe Traumatic Brain Injury — Especially in Isolated TBI
A multicenter cohort study of 555 patients with severe TBI who underwent prehospital rapid sequence induction found postintubation hypotension (SBP
Why Emergency Medicine Residents Rarely Choose Surgical Critical Care — A Nationwide Survey and a Roadmap to Increase EM-SCC Matriculation
A national survey of 111 emergency medicine trainees identifies limited exposure to surgical critical care, institutional and geographic factors, and program characteristics (ECMO, multidisciplinary teams) as key modifiable drivers of low E
Predicting Serious Bacterial Infections in Young Infants with Fever: A Safer Approach to Lumbar Punctures
An updated clinical prediction tool accurately identifies invasive bacterial infections in infants under 28 days old, potentially reducing unnecessary lumbar punctures while ensuring no cases of bacterial meningitis are missed.
ED-Delivered Education Plus mHealth Lowers Systolic BP — TOUCHED Trial Shows a Modest but Meaningful 4.9 mm Hg Reduction at 6 Months
The TOUCHED randomized trial found that an ED-initiated education plus mHealth and pharmacist/APRN consultation reduced systolic blood pressure by 4.9 mm Hg at 6 months versus usual care in patients discharged with elevated BP.
Inhaled Methoxyflurane Matches or Exceeds Standard Analgesics for Rapid Prehospital Pain Relief: Results from the PreMeFen Randomised Trial
The PreMeFen trial found inhalational methoxyflurane provided rapid, clinically meaningful pain relief at 10 minutes and was non-inferior to intranasal fentanyl and intravenous morphine in the prehospital setting, offering a practical non‑i
Vernakalant Beats Procainamide for Rapid ED Cardioversion of Recent-Onset Atrial Fibrillation: Results from RAFF4
The RAFF4 randomized trial found intravenous vernakalant superior to procainamide for rapid cardioversion of acute atrial fibrillation in the emergency department — higher conversion within 30 minutes, faster time to sinus rhythm, and fewer
Heat and Dehydration Increase Carbohydrate Use During Endurance Exercise — Heat Is the Dominant Driver
A 2025 systematic review and meta-analysis found that endurance exercise in the heat increases carbohydrate oxidation and muscle glycogen use; dehydration amplifies this effect principally when combined with heat. Findings inform fueling an
Noninferiority of Deferring Early Arterial Catheterization in Shock Management: Insights from a Multicenter RCT
A large multicenter trial demonstrated that deferring early arterial catheter insertion in ICU patients with shock is noninferior to early invasive monitoring for 28-day mortality, with fewer catheter-related complications and comparable sa
Evaluating the Impact and Economics of Home Automated External Defibrillators: Insights from the CARES Registry
AEDs improve survival in in-home cardiac arrests with shockable rhythms but are not cost-effective for widespread private home use at current prices and incidence rates, per a large US cohort study using CARES data.
Venomous Snakes and Snakebites in the US: What You Need to Know to Stay Safe
Venomous snakes cause thousands of bites annually in the US, with serious health consequences. Understanding snake types, symptoms, first aid, and prevention can save lives.
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