EM physicians should stay current on studies to up their critical care game

May 22, 2017, University of Michigan
Credit: University of Michigan

Reviewing studies can be a tedious task. But Matthew Stull, M.D., says it's a necessary one.

Stull, a fellow at Michigan Medicine's Department of Emergency Medicine and Department of Anesthesiology, presented at the 2017 Society for Academic Emergency Medicine annual meeting in Orlando, Florida, on the importance of staying up to date on medical literature, even outside of one's primary field of medicine.

Instead of simply lecturing on what they felt was important, in a panel titled "Upping Your Critical Care Game," Stull and his fellow Michigan Medicine presenters, Carrie Harvey, M.D., assistant professor of emergency medicine, and Colin McCloskey, M.D., first-year critical care fellow, mixed it up. They asked the crowd for input on topics they thought should be covered and, sometimes, debated.

Stull, Harvey and McCloskey are the only three physicians trained through the anesthesia pathway in the Department of Emergency Medicine's Critical Care Fellowship. The unique training allows them to share and grow emergency medicine knowledge and skills with their fellow critical care physicians.

Stull explains more about the session and why it matters for emergency medicine physicians.

Describe your session and its take-home message for attendees.

Stull: There is so much going on in critical care right now. So instead of a traditional lecture format, we let the audience choose the topics they wanted to cover.

As a result, topics ranged from resuscitation of the sick septic patient to caring for a patient who is crashing due to a pulmonary embolism. Essentially, we hope the session encouraged folks to widen their review of the literature out there right now and think critically on some of the biggest issues facing our sickest .

As both doctors and intensivists, we know that the amount of medical literature one needs to keep up with to stay sharp in the resuscitation bay is enormous and constantly growing. We wanted to make it just a little easier for our colleagues in academic to keep up on cutting-edge critical care by bringing up studies they may have missed.

What were some of the pieces of literature you highlighted?

Stull: We spotlighted some discussions on both pulmonary embolism and sepsis, as well as a ton of quick hits on a wide variety of topics.

For example, we discussed the recent PEITHO 2 study and how it has started to make us question exactly how aggressive we need to be about pulmonary embolism treatment and sheds some light on who might benefit from certain treatments.

For , I think the jury is still out on the right pathway. You really have to individualize your approach depending on what's happening with these patients, as they can be very dynamic.

In terms of sepsis care, I think the major take-home point is to be a bit more mindful when your resuscitation isn't necessarily going the way you hoped. For example, switch up your fluid type, add pressors early, follow up on culture data, etc.

Other topics included the use of various types of viscoelastic testing during massive transfusion of trauma patients, setting goals for oxygenating your ventilated patients and being wary of the methodological quality of some recent newsworthy studies on sepsis care.

Explore further: Lung ultrasound can help doctors see other diseases that mask as lethal clots in lung

Related Stories

Lung ultrasound can help doctors see other diseases that mask as lethal clots in lung

January 31, 2017
A pretest risk stratification enhanced by ultrasound of lung and venous performs better than Wells score in the early diagnostic process of pulmonary embolism (PE). That is the main finding of a study to be published in the ...

Patients with asthma give doctors their thoughts on treatment goals

April 24, 2017
There is increasing emphasis on the importance of measuring patient-centered outcomes of emergency care; however, the existing and most commonly used discharge metrics, which were developed outside of the emergency department ...

Dying patients who received palliative care visited the ER less

February 21, 2017
Community-based palliative care—care delivered at home, not the hospital—was associated with a 50 percent reduction in emergency department visits for patients in their last year of life. The results of an Australian ...

Pulmonary embolism may be cause of syncope in some elderly

October 20, 2016
(HealthDay)—About one of every six patients hospitalized for a first episode of syncope has a pulmonary embolism, according to a study published in the Oct. 20 issue of the New England Journal of Medicine.

Confusion on end-of-life forms can cause elderly patients to receive more emergency care than they may have wanted

September 29, 2016
In recent years, physicians' orders for life sustaining treatments (POLST) forms have been seen as an important way to honor the end-of-life wishes of frail elderly or terminally ill patients who cannot speak for themselves.

Seniors with more continuity of care use the ER less

August 24, 2016
Seniors with traditional Medicare coverage who have more continuity of care - defined as consistently seeing the same physician in an outpatient setting - have lower chances of visiting an emergency department, according ...

Recommended for you

Juul e-cigarettes pose addiction risk for young users, study finds

October 19, 2018
Teens and young adults who use Juul brand e-cigarettes are failing to recognize the product's addictive potential, despite using it more often than their peers who smoke conventional cigarettes, according to a new study by ...

Adding refined fiber to processed food could have negative health effects

October 19, 2018
Adding highly refined fiber to processed foods could have negative effects on human health, such as promoting liver cancer, according to a new study by researchers at Georgia State University and the University of Toledo.

Self-lubricating latex could boost condom use: study

October 17, 2018
A perpetually unctuous, self-lubricating latex developed by a team of scientists in Boston could boost the use of condoms, they reported Wednesday in the journal Royal Society Open Science.

How healthy will we be in 2040?

October 17, 2018
A new scientific study of forecasts and alternative scenarios for life expectancy and major causes of death in 2040 shows all countries are likely to experience at least a slight increase in lifespans. In contrast, one scenario ...

Adequate consumption of 'longevity' vitamins could prolong healthy aging, nutrition scientist says

October 16, 2018
A detailed new review of nutritional science argues that most American diets are deficient in a key class of vitamins and minerals that play previously unrecognized roles in promoting longevity and in staving off chronic ...

Study finds evidence of intergenerational transmission of trauma among ex-POWs from the Civil War

October 16, 2018
A trio of researchers affiliated with the National Bureau of Economic Research has found evidence that suggests men who were traumatized while POWs during the U.S. Civil War transmitted that trauma to their offspring—many ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.