RAP 82

1) Occlusive Myocardial Infarction and Artificial Intelligence

Review Summary

  • Source: REBEL EM
  • Author: Marco Propersi, DO
  • Reviewer: Stella Duong, MD
4
/ 7
BEEM Rater Scale
3
/ 7
Educational Utility
6
/ 7
Evidence Based Medicine

Takeaway

The Queen of Hearts AI model (used to help detect subtle OMI EKG changes) surpasses STEMI criteria alone for detecting OMI on EKG. This may be overestimated based on the dataset used, but it is worth further investigation.

2) Acute Pain Management in Patients on Buprenorphine

Review Summary

  • Source: EMRAP
  • Author: Ruben Strayer, MD
  • Reviewer: Confidence Kpegeol, MD
7
/ 7
BEEM Rater Scale
7
/ 7
Educational Utility
5
/ 7
Evidence Based Medicine

Takeaway

There are a lot of good options to manage patients with pain in the ED, it is important to understand the nature of patients’ pain, along with chronic medications they take to ensure you are properly addressing their pain.

3) Oxygen “Dosing” in Critically Ill Children

Review Summary

  • Source: The Skeptics’ Guide To EM
  • Author: Dennis Ren
  • Reviewer: Mark Rockwell, MD
5
/ 7
BEEM Rater Scale
3
/ 7
Educational Utility
5
/ 7
Evidence Based Medicine

Takeaway

A Conservative Oxygen Saturation Target <94% May be Tolerable in Critically Ill Children, in certain circumstances.

4) NSAIDs and Emergency Contraception

Review Summary

  • Source: EMA
  • Author: Mike Menchine, MD
  • Reviewer: Sam Cox, MD
7
/ 7
BEEM Rater Scale
7
/ 7
Educational Utility
6
/ 7
Evidence Based Medicine

Takeaway

Piroxicam may augment the efficacy of levonorgestrel as emergency contraception. It is worthwhile to consider adding NSAIDs when prescribing emergency contraception. More research needs to be done to assess generalizability to other NSAIDs and patient populations.

5) Clinical Gestalt in Sepsis

Review Summary

  • Source: First10EM
  • Author: Justin Morgenstern, MD
  • Reviewer: Felix Ankel, MD
4
/ 7
BEEM Rater Scale
4
/ 7
Educational Utility
3
/ 7
Evidence Based Medicine

Takeaway

Gestalt (gut feeling) may be important in the diagnosis of sepsis and may be as good if not better than clinical decision rules, but it remains unclear if this changes practice.