The Resus Room June 2024; papers of the month
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Jun 1, 2024 This podcast delves into the significance of three key papers from June 2024. They discuss the prevalence of radiological abnormalities in first episode psychosis and the need for MRI in initial assessment. Additionally, they compare the effectiveness of physician gestalt vs. screening tools for predicting sepsis in critically ill patients. Lastly, they explore the impact of gastric distension on resuscitation outcomes post-cardiac arrest.
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Clinically Relevant MRI Findings Are Not Rare
- A meta-analysis found 5.9% of first-episode psychosis patients had clinically relevant MRI findings that changed management.
- The authors recommend MRI as part of initial assessment due to potential serious consequences of missed lesions.
Coordinate Imaging With Psychiatric Assessment
- Do prioritise timely psychiatric involvement while balancing need for neuroimaging and potential sedation delays.
- Aim to coordinate medical workup and psychiatric assessment to avoid unnecessary admissions and delays.
Most Abnormalities Aren't Tumours
- White matter hyperintensities were the most common abnormality, but brain tumours were rare (NNT ~1000).
- The pool of radiological abnormalities (~26%) mainly included findings that may not be immediately actionable.