Mike Winters, MD, and three other members of the Clinical Practice Committee of the American Academy of Emergency Medicine have a clinical practice paper in the March issue of The Journal of Emergency Medicine (52:379?384). Its title asks, “Does Early Goal-Directed Therapy Decrease Mortality Compared with Standard Care in Patients with Septic Shock?” Based on a review of critical care articles published between 2010 and 2015, the authors concluded that early goal-directed therapy does not convey a benefit in terms of mortality rate compared with standard care. Critical components in the management of septic shock remain early recognition, prompt administration of the right antibiotic, source control, aggressive fluid resuscitation, and use of vasoactive medications when indicated to maintain adequate mean arterial pressure.
Members of the Maryland delegation to this year’s annual meeting of the National Association of EMS Physicians, held in New Orleans last week, received top honors for their poster presentation, “Preliminary and Potential Impacts of a Multi-Phase Intervention Utilizing an EMS-Human Services Partnership on Call Volumes Generated by EMS Super-Users.” The poster presented results of a study of call volumes received by the Montgomery County Fire and Rescue Service before and after partnership with the county’s Department of Health and Human Services. By connecting “super-users” with community care resources, the partnership reduced this vulnerable group’s call volume by 64%. The study was conducted by members of the fire and rescue service, working in collaboration with Roger Stone, MD, MS, Clinical Assistant Professor and Medical Director, Montgomery County Fire and Rescue Service, Ben Lawner, DO, MS, EMT-P, Assistant Professor (now Director of Prehospital Services, Allegheny General Hospital), and Jon Mark Hirshon, MD, MPH, PhD, Professor, Department of Emergency Medicine.
Elizabeth Phillips, MD, MA, has been appointed chair of the Committee on Ethics and Judicial Affairs for MedChi (The Maryland State Medical Society). This committee considers questions of medical ethics, especially in relation to social policy issues, interprofessional relations, hospital relations, confidentiality, advertising, communications with the media, fees and charges, record practice matters and professional rights and responsibilities.
Another article from our EM research group: Jasjeet Bhullar, PhD, Postdoctoral Fellow, Veena Bhopale, MPhil, PhD, Lab Manager, Ming Yang, MD, Research Associate, Kinjal Sethuraman, MD, MPH, Associate Professor, and Stephen R. Thom, MD, PhD, Professor, published the article titled “Microparticle Formation by Platelets Exposed to High Gas Pressures – An Oxidative Stress Response” in the December issue of Free Radical Biology & Medicine.
Michael D. Witting, MD, MS, and Mak Moayedi, MD, along with Kathy Dunning (a student at the University of Maryland School of Medicine) and colleagues from MidMichigan Medical Center and Mercy Medical Center, published the article titled “Power Injection Through Ultrasound-Guided IV Lines: Safety and Efficacy Under an Institutional Policy” in the January issue of The Journal of Emergency Medicine. Their study demonstrated the safety of an institutional protocol that allows high-speed injection through proximal arm ultrasound-guided IV lines, provided the line is inspected and tested with 10 mL of saline before injection.
Ben Lawner, DO, MS, EMT-P, with co-authors J.V. Nable, MD, EMT-P, and William Brady, MD, published a review of recent emergency medical services articles in the November issue of the American Journal of Emergency Medicine. Their article focuses on trends in prehospital care and medical conditions at the intersection of EMS and emergency medicine, addressing the following topics: acute myocardial infarction, behavioral emergencies, cardiac arrest, sepsis, stroke, and trauma.
Laura Bontempo, MD, MEd, Michael Bond, MD, and Bryan Hayes, PharmD, with colleagues from the School of Pharmacy (Michelle C. Hines, PharmD, Brent Reed, PharmD, and Vijay Ivaturi, PhD), published the article titled “Diltiazem Versus Metoprolol for Rate Control in Atrial Fibrillation with Rapid Ventricular Response in the Emergency Department” in the December issue of the American Journal of Health-System Pharmacy (73:2068-2076). Based on their retrospective review of 100 patients’ records, the authors found that the most significant predictor of medication selection in the ED was the drug class used for rate control before the ED admission.
Dr. Amal Mattu and his colleagues from the University of Virginia, the University of California San Francisco, and Oregon Health & Sciences University, have back-to-back electrocardiographic case reports in the December issue of Annals of Emergency Medicine. The first article (68:671-3) describes the assessment of a woman with Wolff-Parkinson-White syndrome, who came to the emergency department when she experienced palpitations and weakness. The second report (68:674-7) describes a woman with hypertension and diabetes mellitus, who sought emergency treatment for chest pain, nausea, dyspnea, and diaphoresis. This column in Annals starts with a description of patients’ presentations, including the ECG, and asks the reader to reach a diagnosis before reading the experts’ analysis.