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Journal Jam 21 Laceration Management – Does Timing of Closure, Irrigation, Gloves Type, Eversion Matter?

In this Journal Jam podcast Anton and Justin welcome special guest Dr. Haley Cochrane. We dive deep into the evidence for timing of closure and infection rate, fluid choice, volume and pressure of irrigation of lacerations, glove type and infection rate, how eversion of wound edges effects cosmetic outcomes and much more. You might be surprised to discover that the evidence for many things we do for lacerations that are considered "standard of care", is either weak or non-existent. But do not fret - we deliver practical bottom line practical recommendations to help improve outcomes, save time and decrease resource utilization...

By Anton Helman|2023-05-14T18:02:15-04:00December 6th, 2022|Categories: EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Plastics|Tags: EBM, laceration repair, povidone-iodine, sterile gloves, wound irrigation|8 Comments

Journal Jam 19 Therapeutic Hypothermia After Cardiac Arrest – Mixed Evidence

In this Journal Jam podcast, special guest Dr. Mizuho Morrison joins Anton and Justin to clear up the muddy waters of therapeutic hypothermia with a deep dive into the world’s literature...

By Anton Helman|2023-05-14T18:07:42-04:00October 5th, 2021|Categories: EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Resuscitation|Tags: journal jam, targeted temperature, therapeutic hypothermia, TTM2|0 Comments

Journal Jam 18 The Evidence for TXA – Should Tranexamic Acid Be Routine Therapy in the Bleeding Patient?

With the help of a special guest, EBM guru Dr. Ken Milne of the The SGEM, Anton and Justin look at all the various potential indications for TXA and review the available evidence. Should we be using TXA for epistaxis, postpartum hemorrhage, hyphema or hemoptysis? Is it a miracle drug that stops all bleeding? Or has it been drastically overhyped? Was CRASH-2 enough to be definitive, or does the classic EBM mantra of "we need more studies" remain true?...

By Anton Helman|2023-05-14T18:12:30-04:00June 29th, 2021|Categories: EM Cases, Emergency Medicine, Hematology, Journal Jam, Medical Specialty, Obstetrics & Gynecology, Ophthalmology, Trauma|Tags: CRASH-2, CRASH-3, DUB, epistaxis, GI bleed, HALT-IT, head injujry, hemoptysis, SAH, subarachnoid hemorrhage, tranexamic acid, TXA|2 Comments

Journal Jam 17 – Steroids for CAP and COVID Pneumonia

What are the indications for steroids in patients with pneumonia besides those with concurrent COPD exacerbations, ARDS or adrenal shock? What is the evidence for benefit for steroids in CAP, the flu and COVID pneumonia? And if there is benefit, do those benefits outweigh the potential harms? To help us sort this out, Justin and Anton have the mighty return of a special guest - Dr. Andrew Morris in this Journal Jam podcast...

By Anton Helman|2023-05-14T18:13:59-04:00January 25th, 2021|Categories: COVID-19, EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Respirology|Tags: CAP, community acquired pneumonia, COVID-19, dexamenthasone, Dr. Andrew Morris, EBM, hydrocortisone, methylprednisolone|0 Comments

Journal Jam 11 Post Contrast Acute Kidney Injury – PCAKI

Lauren Westafer joins Justin Morgenstern, Rory Spiegel and Anton Helman in a deep dive discussion on the world's literature on Post Contrast Acute Kidney Injury (PCAKI) in this Journal Jam podcast. Hospitals continue to insist on time consuming, and potentially dangerous protocols for administration of fluids to patients with renal dysfunction prior to CT IV contrast despite the lack of evidence that Contrast Induced Nephropathy (CIN) even exists. Would you choose a different imaging modality if your radiologist suggested that a patient with renal dysfunction who required a CT with IV contrast should forgo the contrast risking a missed diagnosis?

By Anton Helman|2023-05-14T18:19:36-04:00November 21st, 2017|Categories: EM Cases, Emergency Medicine, Genitourinary, Journal Jam, Medical Specialty|Tags: contrast induced nephropathy, IV contrast, Lauren Westafer, PCAKI|0 Comments

Journal Jam 10 Part 2 Endovascular Therapy for Stroke

In this part 2 of EM Cases Journal Jam podcast on Thrombolysis and Endovascular Therapy for Stroke Justin Morgenstern, Rory Spiegel and Anton Helman do a deep dive into the world's literature on endovascular therapy for stroke. While the evidence for endovascular therapy is stronger than that for IV systemic thrombolysis for stroke outcomes at 90 days, a closer look at the literature reveals that a very small minority of patients are eligible for endovascular therapy and we still don't know which patients benefit most from endovascular therapy...

By Anton Helman|2018-12-21T19:08:04-05:00July 4th, 2017|Categories: EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Neurology|Tags: ESCAPE, journal jam, Justin Morgenstern, MR CLEAN, Rory Spiegel, SWIFT PRIME, THRACE|3 Comments

Journal Jam 10 Thrombolysis & Endovascular Therapy for Stroke Part 1

In this two part EM Cases Journal Jam podcast Justin Morgenstern, Rory Spiegel and Anton Helman do a deep dive into the world's literature on systemic thrombolysis for ischemic stroke followed by an analysis of endovascular therapy for stroke. We elucidate the important issues related to p-values, ordinal analysis, fragility index, heterogeneity of studies, stopping trials early and conflicts of interest related to this body of evidence. While "calling a code stroke" is now considered standard for most stroke patients and tPA for stroke is considered a class 1A drug, a close look at the literature tells us that the evidence is not as strong as our stroke protocols suggest...

By Anton Helman|2022-05-03T21:31:49-04:00July 4th, 2017|Categories: EM Cases, Emergency Medicine, Journal Jam, Medical Specialty, Neurology|Tags: CVA, ECASS-3, fragility index, Justin Morgenstern, NINDS, Rory Spiegel, tPA|6 Comments

Journal Jam 9 – D-dimer to Rule Out Aortic Dissection

The EM Cases Team is very excited to bring you not only a new format for the Journal Jam podcast but a new member of the team, Dr. Rory Spiegel, aka @EM_Nerd an Emergency Medicine physician from The University Maryland Medical Center in Baltimore, the founder of the EM Nerd blog and the co-host of the Annals of EM podcast. The new format sees Justin Morgenstern, Teresa Chan, Rory Spiegel and Anton Helman doing deep dives into the world's literature on specific practical questions while highlighting some important evidence-based medicine concepts. The question we ask in this Journal Jam podcast: Is there a role for D-dimer testing in the workup of aortic dissection in the ED?

By Anton Helman|2018-12-21T19:15:51-05:00February 7th, 2017|Categories: Cardiology, EM Cases, Emergency Medicine, Hematology, Journal Jam, Medical Specialty|Tags: ADD score, aortic dissection, D-dimer, EBM, Justin Morgenstern, Rory Spiegel, spectrum bias, Teresa Chan|1 Comment

Journal Jam 8 – Dilute Apple Juice for Pediatric Gastroenteritis

This is EM Cases Journal Jam podcast on a randomized control trial of dilute apple juice vs PediaLyte for mild pediatric gastroenteritis. While IV rehydration is required in cases of severe gastroenteritis (which we rarely see in North America) and oral rehydration with electrolyte maintenance solutions is still the mainstay in treating moderate gastroenteritis, could better-tasting, more cost-effective fluids such as diluted apple juice be just as effective as traditional electrolyte solutions in milder cases? Listen to Dr. Justin Morgenstern (@First10EM) interviewing Dr. Stephen Freedman, the world-renowned pediatric EM researcher who put ondansetron for pediatric gastroenteritis on the map and who was one of our guest experts on our main episode on Pediatric Gastroenteritis, Constipation and Bowel Obstruction, about this practice-changing paper. This is followed by a hilarious rant on the topic from Dr. Anthony Crocco ("Ranthony"), the Division head and medical director of pediatric EM at Hamilton Health Sciences.

By Anton Helman|2018-12-21T19:20:46-05:00November 8th, 2016|Categories: EM Cases, Emergency Medicine, Gastroenterology, Journal Jam, Medical Specialty, Pediatrics|Tags: Anthony Crocco, dehydration, gastroenteritis, Justin Morgenstern, pediatlyte, Stephen Freedman|1 Comment

Journal Jam

Journal Jam is the EM Cases podcast that brings together leading EM researchers, EM educators and EM clinicians from around the world to discuss practice-changing EM articles or does deep dives into the world's literature on a particular topic; with Anton Helman, Justin Morgenstern and special guests like Rory Spiegel, Ken Milne, Lauren Westafer, Andrew Morris, and more . Together, we’re smarter!

By Garron Helman|2021-07-01T19:41:23-04:00July 30th, 2016|Comments Off

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