The Hallway Consult

The Hallway Consult

The EM literature, translated for your next shift.

The Hallway Consult — Issue #25: Cooling Duration After Cardiac Arrest, Post-Arrest Oxygen Targets, and Catheter-Directed Thrombolysis for PE

Oct 12, 2026

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5 min read

The Hallway Consult — Issue #25: Cooling Duration After Cardiac Arrest, Post-Arrest Oxygen Targets, and Catheter-Directed Thrombolysis for PE

This week's issue is about post-resuscitation and PE care getting more precise answers than we've had in years. Two large cardiac arrest trials each knock down a long-standing assumption — longer cooling, tighter oxygen control — and a third finally gives catheter-directed therapy for intermediate-high-risk PE the clean trial it's lacked. Three trials, three practices worth reconsidering before your next code or PE workup.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #24: Capillary Refill–Guided Resuscitation, Tenecteplase Before Thrombectomy, and Steroids for Pneumonia

Oct 5, 2026

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5 min read

The Hallway Consult — Issue #24: Capillary Refill–Guided Resuscitation, Tenecteplase Before Thrombectomy, and Steroids for Pneumonia

This week's issue is a study in restraint. A bedside sign everyone already checks gets a rigorous trial and comes back murkier than hoped. A drug that works brilliantly early in stroke gets tested later in the window and adds nothing. And an intervention with a mixed track record finally gets a clean, adequately powered answer — just not in the population you'd expect. Three trials, three different lessons about when more intervention helps and when it doesn't.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #23: Albumin in Septic Shock, TXA for Intracerebral Hemorrhage, and Peripheral Vasopressors

Sep 28, 2026

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5 min read

The Hallway Consult — Issue #23: Albumin in Septic Shock, TXA for Intracerebral Hemorrhage, and Peripheral Vasopressors

This week's issue covers three topics where the clinical intuition and the evidence don't quite line up — and where the gap matters for how you run your resuscitations. Albumin has been a compelling concept in sepsis for decades; TXA came to ICH with momentum from trauma; and peripheral vasopressors have been standard practice in some centers and forbidden in others. The data now helps sort all three.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #22: SEP-1 Bundle Evidence, Toddler's Fracture Immobilization, and Pediatric Appendicitis Scores

Sep 21, 2026

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5 min read

The Hallway Consult — Issue #22: SEP-1 Bundle Evidence, Toddler's Fracture Immobilization, and Pediatric Appendicitis Scores

This week's issue covers three topics that touch something most EM clinicians do on every shift: managing sepsis by the book, deciding how to splint the limping toddler, and choosing a score for the kid with belly pain. The thread connecting them is the same one that shows up in good medicine repeatedly — standard practice and evidence don't always overlap the way we assume they do.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #21: Minocycline for Acute Ischemic Stroke, CT Contrast and Nephrotoxicity, and Blood Pressure Targets in Acute SCI

Sep 14, 2026

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5 min read

The Hallway Consult — Issue #21: Minocycline for Acute Ischemic Stroke, CT Contrast and Nephrotoxicity, and Blood Pressure Targets in Acute SCI

Three papers this week that each push back against something we've been doing on intuition. The first tests a repurposed antibiotic in acute ischemic stroke with surprising results. The second makes a toxicological case that CT contrast hasn't been causing the kidney damage we thought it was. And the third takes the first randomized swing at blood pressure targets in acute spinal cord injury — and finds that the recommendation we've been following for a generation may not hold up. All three are worth reading before your next shift.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #20: Geriatric Head Injury Risk Factors, Trigger Point Injections for Low Back Pain, and Presyncope vs. Syncope

Sep 7, 2026

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5 min read

The Hallway Consult — Issue #20: Geriatric Head Injury Risk Factors, Trigger Point Injections for Low Back Pain, and Presyncope vs. Syncope

Three papers this week from your everyday waiting room. The first asks what actually predicts intracranial hemorrhage in the older adult who tripped and hit their head — and what doesn't. The second tests whether trigger point injections add anything meaningful to standard low back pain treatment in the ED. The third reframes a distinction we make instinctively but may not be making correctly: presyncope versus syncope, and whether the cardiac risk really differs between them. All three papers say something useful for tomorrow's shift.

Matthew Barmmer
Matthew Barmmer
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