Journal Feed Weekly Wrap-Up

We always work hard, but we may not have time to read through a bunch of journals. It’s time to learn smarter.
Originally published at JournalFeed, a site that provides daily or weekly literature updates.
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#1: What’s the Best Target in the Neck for US Guided Central Access

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This was a network meta-analysis of 13 randomized controlled trials comparing 5 different central venous catheterization (CVC) approaches. The supraclavicular subclavian (SupraSCV) demonstrated superior first-attempt success, while artery puncture was similar for all five locations.

Source
Ultrasound-guided central venous catheterization around the neck: Systematic review and network meta-analysis. Am J Emerg Med. 2024;78:206-214.

#2: PECARN Head and Abdomen Rules…Validated!

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This multicenter prospective validation study of the PECARN prediction rules for CT imaging of children with blunt abdominal or minor head trauma performed extremely well (all three having NPVs of 100%).

Source
PECARN prediction rules for CT imaging of children presenting to the emergency department with blunt abdominal or minor head trauma: a multicentre prospective validation study. Lancet Child Adolesc Health. 2024 May;8(5):339-347. doi: 10.1016/S2352-4642(24)00029-4. PMID: 38609287.

#3: What AST/ALT Threshold Warrants CT in Suspected Child Abuse?

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Current American Academy of Pediatrics (AAP) guidelines recommend a lower LFT threshold to obtain CT imaging for abdominal injury in children under 60 months old being evaluated for physical abuse than is recommended by general trauma guidelines – AST or ALT >80 IU/L vs AST>200 or ALT>125. This study suggests that, in the absence of signs and symptoms of abdominal injury, the higher LFT threshold may sufficient…but let’s pump the brakes.

Source
AST and ALT Elevation in Suspected Physical Abuse: Can the Threshold to Obtain an Abdominal CT be Raised? J Trauma Acute Care Surg. 2024 Apr 11. doi: 10.1097/TA.0000000000004329. Epub ahead of print. PMID: 38527969

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