Dr. Sara Hevesi and Dr. Maria Kaisler
Dr. Hevesi is a consultant at Mayo Clinic in Rochester, MN. Dr. Kaisler is a PGY-3 and chief resident at Mayo Clinic Emergency Medicine Residency in Rochester, MN.
The inaugural Mayo EM residency journal club met for the first time on July 13th, hosted by Dr. Sara Hevesi and her husband Mario (an Orthopedic Surgery resident at Mayo). We reviewed an Academic Emergency Medicine paper titled “Out-of-Hospital Spinal Immobilization: Its Effect on Neurologic Injury” from 1998 and an EM:RAP chapter from April 2020 titled “Pediatric Pearls - Pediatric C-Spine Clearance.” Due to COVID, a small group met at Dr. Hevesi’s house and the rest of the participants joined via Zoom. In addition to the residents and faculty from Mayo Rochester we also had several EMS faculty join from Mayo Arizona.
The bottom line from the AEM paper was that spinal immobilization did not affect outcomes in the only large-scale study of its kind to date. This was a unique paper in that it compared patient outcomes from a country where immobilization is not used (Malaysia) with a country where immobilization is used. Highlights from the EM:RAP lecture were that in pediatric patients, their C spine can often be cleared with plain films alone as long as there is a low clinical suspicion (adequately restrained in a car seat, moving neck without pain, no neurologic deficits). They also gave good clinical pearls about allowing the child to “clear themselves” by keeping the (often ill-fitting) C collar on until they are moved out of the trauma bay, warm and calm near parents and watch to see if they move their neck on their own.
Mario grilled a large selection of brats and burgers from Greg’s Meats and Ricky and Maria were able to put aside their extreme hatred of the other’s college football team to emerge victorious at corn hole. Look for another post covering August journal club where we reviewed the evidence behind using tPA for ischemic strokes with the involvement of our Pharmacy colleagues..
Special thanks to Dr. Joe Walter and the crew over at Regions Rap (https://regionsrap.com/) who were gracious enough to share the scoring tool they use for their Journal Club!