EMOttawa - Emergency Medicine Ottawa

Journal Club SummaryMethodology Score: 3/5                  Usefulness Score:  2.7/5
Martindale JL, et al. Acad Emerg Med. 2016 Mar;23(3):223-42
Abstract Link

In patients presenting to the ED with undifferentiated dyspnea and a moderate pre-test probability of acute heart failure, a bedside lung U/S and echo are useful diagnostic modalities, with the caveat that there is high inter-operator variability in bedside lung ultrasound.  BNP testing, where available, can be used to help to rule out acute heart failure.  However, the study was limited by numerous methodological issues including study selection, quality of evidence, and significant heterogeneity.  By: Dr. Daniel James
Epi lesson:QUADAS-2Tool for Evaluation of Systematic Reviews of Diagnostic Accuracy Studies

Please note: Dr. Noam Katz has no conflicts of interest to disclose. He has not received funding to promote any of the products discussed in this post. 




Out-of-hospital cardiac arrest (OHCA) remains a major cause of mortality for which we rely on advanced cardiac life support (ACLS) guidelines to manage within the ED.  However, when these guidelines fail, we are left with almost no additional options as lifesaving measures.  Worldwide there has been exponential growth in the use of veno-arterial extracorporeal membranous oxygenation (VA ECMO) – a bedside heart-lung bypass modality – in order to take control of the physiology of patients in cardiac arrest in order to perform additional life-saving interventions.

I had the opportunity to attend a conference – Reanimate 2016 – in order to learn more about this modality, how it is being applied in the ED for cardiac arrest patients and how Sharp Memorial Hospital in San Diego, CA, has improved their cardiac arrest survival rates regardless…