Papers of March

Welcome back to March’s papers of the month. Below are the papers we’re covering in the podcast. Make sure to take a look at the full papers yourself for a full critical appraisal.

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Singer M. JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287.

This month has been a big one for sepsis and probably the most talked about paper is from JAMA with some next definitions on sepsis

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Many of us our quick adopters of new guidelines and evidence to us practice. We ran a twitter poll to see how quickly these definitions are likely to be brought into our practice. The results are below and may be surprising to some of us with no external validation for this work in our population.

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The Sepsis Trust certainly isn’t advocating their use yet, their statement can be found here; Interim statement regarding the new international consensus definitions of sepsis

Prehospital management and identification of sepsis by emergency medical services: a systematic review. Lane D. Emerg Med J. 2016 Feb 10. pii: emermed-2015-205261. doi: 10.1136/emermed-2015-205261. [Epub ahead of print]

Next up a related paper from the EMJ looking at sepsis but this time how easy it currently is to identify these patients;

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Incidence of Adverse Events in Adults Undergoing Procedural Sedation in the Emergency Department: A Systematic Review and Meta-analysis. Bellolio MF. Acad Emerg Med. 2016 Feb;23(2):119-34. doi: 10.1111/acem.12875. Epub 2016 Jan 22.

Changing topic completely and onto sedation, how do you consent your patients for sedation and what’s your feel for the risks involved? Although not perfect the next paper may give us some help with this;

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Invasive versus conservative strategy in patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris (After Eighty study): an open-label randomised controlled trial.Tegn N. Lancet. 2016 Jan 12. pii: S0140-6736(15)01166-6. doi: 10.1016/S0140-6736(15)01166-6. [Epub ahead of print]

Finally for this month, ever wondered if taking an invasive approach to NSTEMI and unstable angina is bit too aggressive in the elderly population? This interesting study from Norway looks at just that question;

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So that’s it for this months round up. Have a listen to the podcast for much more on this and please take a look at the full papers yourself and make up your own mind on the validity of the evidence and how it correlates to your practice.

Simon

Further Resources

FOAMcast; sepsis redefined

Stemlynsblog; Holy Smokes! Batman, the SOFA and the Latest Sepsis Definitions

  PulmCrit; Top 10 problems with the new sepsis definition  

 

 

 

 

 

 

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