Welcome back to the Journal Club with Dr Justin Morgenstern. It has been 2 months since we last dusted off the papers on Justin’s bedside table… but like a mythical (nerdy) Sisyphus Justin must push another load of evidence out into the ether in order to go back and start the whole process again.
This episode is on steroids. I mean it is largely about steroids, not actually “on steroids” but there is a sprinkling of other stuff and a bit of philosophical banter about machine learning at the end.
Bottom line: We really need to get our acts together and get droperidol back in our emergency departments.
Bottom line: Until someone brings droperidol back to Canada, haloperidol will remain a key component of my cyclic vomiting management strategy.
Bottom line: Steroids will decrease pain from pharyngitis, although the exact balance of harms and benefits is probably not known.
Bottom line: We know there are adverse events from steroid prescriptions, but this study really doesn’t give us much information.
This is a well done clinical practice guideline (meaning transparently based in evidence) with a few decent take homes about gout for emergency practitioners.
Bottom line: Stop blaming patients for using the emergency department. We have system issues and societal education issues that we need to address, but for now I am happy to look after any patient who is scared about their health.
Bottom line: Some patients will benefit from antibiotics after I+D of their abscess.
Bottom line: The ability to rapidly (and safely) place a peripheral IV into the internal jugular could be lifesaving in the correct patient, but shouldn’t be used routinely.
Bottom Line: Machines may help us make better decisions in the future. But we still need to know what the data input looks like and what goes on inside the black box!
OK Here is the podcast, thanks for joining us once again. Comments are always welcomed.