Great Papers + Resources

Papers that solidify clinical material — heavy on critical care, evidence-based medicine, and clinical reasoning. Not the “seminal” papers per se; see Wiki Journal Club for those.

Critical Care

• A Practical Approach to Acid-Base Disorders (1991, PDF)
• IBCC — Fluid Selection + pH-Guided Fluid Resuscitation
• The Delta Gap and Delta Ratio (Deranged Physiology) — and the underlying Tsapenko 2013.
  • If ΔAG < ΔHCO₃ → combined HAGMA + NAGMA
  • If ΔAG > ΔHCO₃ → combined HAGMA + metabolic alkalosis
  • Trick: Delta Gap ≈ Na − Cl − 36 (no HCO₃ needed)
• The Fifth Vital Sign? Nurse worry predicts inpatient deterioration within 24 hours (PDF)
• A Simplified and Structured Teaching Tool for PEA (2014, PDF)
  • Narrow-complex PEA → POCUS for tamponade, PTX, hyperinflation, PE
  • Wide-complex PEA → bicarb, calcium (hyperK, Na-channel blocker tox)

Endocrinology

• NICE-SUGAR: Intensive vs Conventional Glucose Control in Critically Ill Patients (2009, PDF) — N Engl J Med 360:1283-97.

Nephrology

• Using Electrolyte-Free Water Balance to Rationalize and Treat Dysnatremias (2018, PDF)
• Contrast Nephropathy — the myth thereof (IBCC)
  • “We worry a lot about contrast nephropathy because it has its own special name. Meanwhile, we often don’t think much about other drugs (vancomycin, aminoglycosides, amphotericin, acyclovir, ACEi/ARBs, NSAIDs, mannitol) which are proven nephrotoxins.”

Pulmonary Embolism & Cardiology

• Diagnostic Accuracy of Early Right Ventricular Dysfunction Markers in Normotensive ED Patients with Acute PE (2016, PDF)
  • Echo for RV dysfunction: +LR 90, –LR 0
  • RV ≥ LV, TAPSE <10 mm, septal flattening toward LV
• The OMI Manifesto (PDF) — commentary at RebelEM and LITFL.
• Why cardiac monitors don’t show ST deviations very well (Dr. Smith’s ECG Blog, 2022)

Hospital Medicine

• Things We Do For No Reason — Treating Asymptomatic Fevers (PDF)
  • Treat fever with antipyretics only for fever-related symptoms (headache, chills, myalgia, or in peds: irritability, malaise, poor PO).
  • In sleeping or asymptomatic hospitalized patients, the risks outweigh the benefits.
• Successful Hospitalization of Patients with No Discernible Pathology — parody (PDF)
  • Admit if: (family member + suicide-to-nursing-staff ratio) > 1.0; age + BUN > 100; consultant being unreasonable.

Procedures

• Procedural Sedation and Analgesia in the Emergency Department (EB Medicine, 6/2022 PDF)
• Managing Patients with Acute Visual Loss (2022, PDF)
• Managing Elbow Dislocations (2022, PDF)

Neurology

• Drugs that Aggravate Myasthenia Gravis (PDF)

Evidence-Based Medicine

• Why I’ve Lost Faith in p-values (Steve Luck, 2018) — Part 1, Part 2
• Statistical tests, P values, confidence intervals, and power: a guide to misinterpretations (Greenland et al, 2016 PDF)
• The Difference Between “Significant” and “Not Significant” is not itself Statistically Significant (Gelman & Stern, 2006 PDF)
• Why Most Published Research Findings Are False (Ioannidis 2005, PDF)
• Confidence intervals rather than P values (Gardner & Altman 1986, PDF)
• The Fragility Index (First10EM)
• Leaf Plot — pre-test vs post-test probability
• Reference Collection — pushback against common statistical myths

Health Policy / Systems

• The Incidental Economist — peer-reviewed and journalistic health policy.
• BMJ Student