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Journal Feed Weekly Wrap-Up

Journal Feed
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.
Follow Dr. Clay Smith at @spoonfedEM, and sign up for email updates here.

#1: Discharging Delirium Is Dangerous

Spoon Feed —
Older adults discharged from the ED with delirium had almost 3 times the risk of 30-day mortality compared to those discharged without delirium.

Source
Outcomes of Older Adults With Delirium Discharged From the Emergency Department. Ann Emerg Med. 2025 Nov;86(5):484-495. doi: 10.1016/j.annemergmed.2025.02.003. Epub 2025 Mar 12. PMID: 40072382; PMCID: PMC12353625.

#2: Hyperkalemia – Can We Use Succinylcholine for RSI?

Spoon Feed —
This retrospective cohort study found no 24-hour mortality difference when intubating hyperkalemic patients (K > 5.5mmol/L) with succinylcholine versus rocuronium for RSI.

Source
Hyperkalemic emergency department patients intubated with rocuronium or succinylcholine: Retrospective study of clinical outcomes. Am J Emerg Med. 2025 Dec 2;100:154-164. doi: 10.1016/j.ajem.2025.11.030. Epub ahead of print. PMID: 41380422.

#3: Febrile Neonates Under 28 Days – Is PECARN Rule Safe?

Spoon Feed —
In a large international cohort of well-appearing febrile infants ≤28 days old, the updated PECARN rule had high sensitivity and negative predictive value for invasive bacterial infection, with no missed cases of bacterial meningitis, supporting selective avoidance of routine lumbar puncture in low-risk neonates.

Don’t miss Dr. Josh Belfer’s interview with lead author Dr. Burstein and senior author Dr. Kuppermann on his blog HipPEMcrates.com.

Source
Prediction of Bacteremia and Bacterial Meningitis Among Febrile Infants Aged 28 Days or Younger. JAMA. 2025 Dec 8:e2521454. doi: 10.1001/jama.2025.21454. Epub ahead of print. PMID: 41359314; PMCID: PMC12687207.

#4: Slow and Steady – Be Careful with ICH BP Control

Spoon Feed —
In this retrospective multicenter study, both early, overly rapid systolic blood pressure (SBP) reduction after intracerebral hemorrhage (ICH) and overshooting SBP targets (<120 mmHg) were linked with worse functional outcomes at discharge.

Source
Early Intensive Blood Pressure Reduction After Intracerebral Hemorrhage Is Associated With Worse Functional Outcome: The Risk of Overshooting Blood Pressure Goals. Ann Emerg Med. 2025 Dec 9:S0196-0644(25)01303-4. doi: 10.1016/j.annemergmed.2025.10.009. Epub ahead of print. PMID: 41369631; PMCID: PMC12757810.

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