July 2014: Intranasal Naloxone

P: In patients with acute opiate overdose

I: Does the use of intranasal (IN) Narcan

C: Compared to parenteral Narcan

O: Provide effective antidotal response and improved safety profile

Articles:

Kerr D, Kelly AM, Dietze P, Jolley D, Barger B. Randomized controlled trial comparing the effectiveness and safety of intranasal and intramuscular naloxone for the treatment of suspected heroin overdose. Addiction. 2009 Dec;104(12):2067-74.   
Critical Appraisal Answer Key
 

Kelly AM, Kerr D, Dietze P, Patrick I, Walker T, Koutsogiannis Z. Randomised trial of intranasal versus intramuscular naloxone in prehospital treatment for suspected opioid overdose. Med J Aust. 2005 Jan 3;182(1):24-7. 
Critical Appraisal Answer Key

Merlin MA, Saybolt M, Kapitanyan R, Alter SM, Jeges J, Liu J, Calabrese S, Rynn KO, Perritt R, Pryor PW 2nd. Intranasal naloxone delivery is an alternative to intravenous naloxone for opioid overdoses. Am J Emerg Med. 2010 Mar;28(3): 296-303 
Critical Appraisal Answer Key 

May 2014: EGDT Revisited

P: In patient’s with evidence of severe sepsis or septic shock

I:  Does protocol based early goal directed therapy (EGDT)

C: Compared to “routine” non protocol based standard of care

O: Favorably impact 60 day patient mortality
 

Rivers E. et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77.
Critical Appraisal Answer Key

Yealy DM, & The ProCESS Investigators, A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014 May 1;370(18):1683-93.
Critical Appraisal Answer Key

Wacker C. et al. Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis. Lancet Infect Dis. 2013 May;13(5):426-35
Critical Appraisal Answer Key

April 2014: Tranexamic Acid & Bleeding

CRASH-2 trial collaborators Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3; 23-32. 2010 Jun 14.

Critical Apprasal Answer Key

Reza Zahed et al., A new and rapid method for epistaxis treatment using injectable form of Tranexamic acid topically: a randomized controlled trial Obstet Gynecol. 2010 Oct;116(4):865-75.

Critical Appraisal Answer Key

Lukes AS et al Tranexamic acid treatment for heavy menstrual bleeding: a randomized controlled trial. Obstet Gynecol. 2010 Oct;116(4):865-75.

Critical Appraisal Answer Key