All in EBM
An otherwise healthy 7-year-old male presents to the emergency department with fever, cough and shortness of breath. After a review of his vitals, you immediately put him on a nasal cannula, establish IV access, and order a sepsis workup. Lactate on a point of care lab comes back as 6.5. The nurse then asks: Which fluids would you use for resuscitation?
A 79-year-old male with a history of hypertension, peripheral arterial disease, hyperlipidemia, coronary artery disease, and diabetes presents to your community emergency department with sudden onset vision loss of the right eye, with onset two hours prior to arrival. Should you administer tenecteplase to this patient?
A thirty-year-old male presents to the emergency department (ED) as the unrestrained driver of a rollover motor vehicle accident. During his trauma assessment, the patient becomes progressively more dyspneic, and you are unable to auscultate breath sounds on the right chest wall. Do you reach for the pigtail catheter (PTC) (</=14 French) or the large bore catheter (LBC) that you were trained to place for a hemothorax (28-32 French)?
A patient is brought to the emergency department (ED) by emergency medical services (EMS) with concern for sepsis. The patient has a history of urosepsis but is oriented with vital signs in the normal range. You - the physician - are deciding if it is appropriate to sepsis alert the patient now, or if you should first collect more data. What other information could be used to better inform this decision?
It is a busy shift when a 61-year-old male presents to your ED with chest pain. He is roomed immediately, but your lobby is pushing capacity and there are 42 admitted patients boarding in your department. How do you maximize throughput while maintaining high-quality patient care?
When choosing induction agents, does ketamine decrease the risk of death compared to etomidate? Authors, reviewers, and editors from VCU Health, Eastern Virginia Medical School at Old Dominion University, and the Virginia Tech Carilion School of Medicine review a December 2025 NEJM article to find out.
Enjana Bylykbashi, MD & Emily Kershner, MD from VCU Health review the October 2025 study on the re-evaluation of Nonoperative Management for Pediatric Uncomplicated Acute Appendicitis. Here's their analysis.
Megyn Christensen, DO & Martin Klinkhammer, MD, MHP, FACEP from Eastern Virginia Medical School at Old Dominion University review the September 2025 study on the usage of shock index as a indicator of compensated shock among trauma patients. Here's their analysis.
Paige Darrow, DO, and Martin D. Klinkhammer, MD, from Eastern Virginia Medical School, review the September 2024 JAMA Network Open study on the diagnostic performance of TBI biomarkers. Here's their analysis.
Physicians at Naval Medical Center Portsmouth and VCU Health consider the October 2024 JAMA study on transfusion strategies in acute brain injury. Here's their review.
Physicians at VCU Health and UVA Health consider a June 2024 study in the New England Journal of Medicine that looks at noninvasive ventilation for preoxygenation during emergency intubation. Here’s their review.
Physicians at VCU Health and Naval Center Portsmouth analyze a recent peer-reviewed clinical study on bloodstream infection in the ED from the Journal of Emergency Medicine’s December 2024 edition as part of our latest Evidence-Based Medicine Review Series.
Physicians at Naval Medical Center Portsmouth and Virginia Tech Carilion review a study looking at high-flow nasal oxygen vs. noninvasive ventilation for acute respiratory failure.
Emergency physicians from Virginia Tech Carilion School of Medicine and UVA health review a study looking at identification of posterior circulation ischemic stroke in the ED.
Physicians from UVA Health analyze a peer-reviewed clinical study in the New England Journal of Medicine looking at defibrillation strategies for refractory ventricular fibrillation.
Physicians from Eastern Virginia Medical School review the recent peer-reviewed clinical study, Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department.
This month, emergency physicians from Carilion Clinic review a study that considers whether acetazolamide, a carbonic anhydrase inhibitor that reduces proximal tubular sodium reabsorption, can improve the efficiency of loop diuretics, potentially leading to more and faster decongestion in patients with acute decompensated heart failure with volume overload.
Physicians from Riverside Health System review a December 2021 study that considers palliative care training for pre-hospital personnel, who may hold a key to an unwanted, avoidable, and potentially costly emergency department visit or hospital admission.
Our members look at an April 2022 study evaluating ECMO versus conventional rewarming for severe hypothermia patients.
Pediatric patients account for more than 30 million emergency department (ED) visits each year, making up 20% of all ED visits in the U.S. In order to improve pediatric readiness in the nation’s hospitals, joint guidelines were created for the care of children in EDs. In April 2022, a retrospective cohort study in JAMA Surgery evaluated the association between ED pediatric readiness and mortality of injured children. Virginia's emergency physicians took a look at the study, and here’s what they found.
