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Ken Milne MD

@TheSGEM

Jul 6, 2021 • 6 tweets • 6 min read • Read on X

Scrolly

@First10EM

Patient has ROSC after OHCA but is comatose. What's your target temperature in the ED? #EBM #FOAMed thesgem.com/2021/07/sgem33… @First10EM @emcrit @NEJM @ACEPNow @srrezaie @stemlyns

The 5 Step Process:
1-Vote on the twitter poll
2-Retweet the twitter poll
3-Read the primary pub (TTM2 trial) nejm.org/doi/full/10.10…
4-Check out the TheSGEM.com appraisal
5-Earn your CME credits sgem.ccme.org

@PulmCrit

Is hypothermia really "therapeutic" post OHCA with ROSC but still comatose? #EBM #FOAMed @PulmCrit @EMNerd_ @hp_ems @EMS1
thesgem.com/2021/07/sgem33…

Listen to Dr. Morgenstern and I do a structured critical appraisal of the TTM2 trial. Turn your car into a classroom. Cut that knowledge translation down from over ten years to less than one year with the power of social media
#EBM #FOAMEd thesgem.com/2021/07/sgem33…

vote about the targeted temperature for OHCA with ROSC but still in coma.

Last few minutes to get your vote in on this TTM2 twitter poll.

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More from @TheSGEM

Ken Milne MD

@TheSGEM

Jul 8, 2021

@KirstyChallen

Hypothermia not superior to normothermia in OHCA for patients sill comatose. #paperinapic by the talented @KirstyChallen #FOAMed #EBM
thesgem.com/2021/07/sgem33…
@NEJM @RCEMLearning @stemlyns

thesgem.com/2021/07/sgem33…

Therapeutic? thesgem.com/2021/07/sgem33…

Read 4 tweets

Ken Milne MD

@TheSGEM

May 21, 2021

This is a reason why there is a lack of consensus on lytics for #stroke:
- 13 foundational RCTs
- 4 stopped early for harm or futility
- 8 of 13 used tPA
- Only 2 reported benefit for primary outcome
- Neither were replicated
-Both reanalyzed & failed to confirm benefit.

@First10EM

This lack of consistent evidence for potential benefit combined with the evidence of increase for potential harm (ICH&death) is a reason we (@First10EM) downgraded the NNT recommendation to yellow. It highlights the uncertainty of the existing evidence. thennt.com/nnt/tissue-pla…

@epmonthly

I've was asked what the majority of EM think about tPA for stroke? Found @epmonthly poll when ACEP updated guidelines in 2013 to level "A". It reported 88% thought guidelines should be revised/rescinded. They were then downgraded to Level B&C in 2015. acep.org/patient-care/c…

Read 4 tweets