There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs. AI (Queen of Hearts by PMcardio). Am J Emerg Med. 2025 Jul […]
The post Research Roundup (October 2025) appeared first on First10EM.
The medical content discussed includes several research updates.
Regarding pulmonary embolism, the use of ultrasound for risk stratification in high risk cases was reviewed. A normal right ventricle on ultrasound might suggest lower mortality even in hypotensive patients, though more study is needed. Overall mortality for pulmonary embolism has decreased due to improved treatment.
For intracerebral hemorrhage, the use of tranexamic acid was examined. Multiple trials, including TICH-2 and PATCH, did not show benefit in reducing hematoma expansion or improving functional outcomes, and some suggested potential for increased seizures or harm. Tranexamic acid is not recommended for this condition.
In airway management, the REVERT trial compared standard and video laryngoscopy for first pass success in endotracheal intubation. No significant difference was found between the methods when performed by emergency medicine residents, although providers often prefer video laryngoscopy. Another trial, APEX, studied high flow nasal oxygen during extubation. It found no reduction in reintubation rates compared to standard oxygen therapy in general, but it might benefit a subgroup of high risk patients.
For atrial fibrillation with rapid ventricular response, specifically new onset cases, it was noted that a rhythm control strategy did not show a clear benefit over rate control in stable patients and might lead to more adverse events in the emergency department. The focus for stable patients should be on initial rate control.
Resuscitative thoracotomy was discussed, with a review indicating a survival rate of about 9.5 percent, better for penetrating trauma than blunt trauma. Irreversible shock was the most common cause of death for non-survivors.
Regarding pain management, a meta-analysis on intravenous magnesium for acute pain in the emergency department found that it might reduce pain when used as an adjunct to standard analgesics, showing a small but statistically significant effect with few side effects.
The CLOUDS trial, comparing balanced crystalloids to normal saline for fluid resuscitation in critically ill adults, found no significant difference in mortality or major adverse kidney events between the two fluid types. This suggests the choice may not substantially impact outcomes.
Finally, the INSIGHT trial on intra-arterial thrombolysis after endovascular thrombectomy for acute ischemic stroke found that adding thrombolysis did not improve functional outcomes at 90 days but increased the risk of intracerebral hemorrhage. Therefore, it is not recommended.
https://first10em.com/research-roundup-october-2025/
