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Matthew Barmmer
Matthew Barmmer

Emergency physician. EMS & tactical medicine. High-yield research for busy clinicians.

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
The Hallway Consult — Issue #19: Pediatric Sepsis Fluids, Arterial Lines in Shock, and Antibiotics-First Appendicitis

Aug 31, 2026

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4 min read

The Hallway Consult — Issue #19: Pediatric Sepsis Fluids, Arterial Lines in Shock, and Antibiotics-First Appendicitis

Three papers this week that all take aim at reflexive practice. The first asks whether balanced crystalloids are actually better than saline in pediatric septic shock when you finally run the big trial. The second challenges the assumption that every shocked patient needs an arterial line right away. The third gives the longest randomized follow-up yet on antibiotics-first treatment for uncomplicated appendicitis in adults. None of these papers says “stop thinking.” All three say “stop autopiloting.”

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #18: Septic Shock Fluids, ED Buprenorphine, and Late-Window Stroke

Aug 24, 2026

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5 min read

The Hallway Consult — Issue #18: Septic Shock Fluids, ED Buprenorphine, and Late-Window Stroke

Three trials this week that push on decisions you're making in your first hour. The first is the largest randomized trial of early septic shock resuscitation and it delivers a genuinely surprising result. The second tests whether a single injectable buprenorphine shot does a better job than a sublingual prescription for patients with OUD; the answer is more nuanced than either camp wanted. The third extends the thrombolysis window for non-LVO ischemic stroke to 24 hours, and the numbers moved.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #17: VTE Anticoagulation, Cancer PE Workup, and Preschool Wheeze

Aug 17, 2026

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4 min read

The Hallway Consult — Issue #17: VTE Anticoagulation, Cancer PE Workup, and Preschool Wheeze

Three papers this week that tighten decisions you're already making. The first settles — finally, with a real RCT — which DOAC you should be reaching for when you discharge a VTE patient. The second asks whether you can safely skip the CT on a cancer patient with suspected PE if the YEARS algorithm says you can. The third gives the azithromycin reflex for wheezing toddlers a fair shake, and it does not hold up.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #16: Migraine Fluids, SPG Block Dosing, and Difficult IV Access

Aug 10, 2026

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5 min read

The Hallway Consult — Issue #16: Migraine Fluids, SPG Block Dosing, and Difficult IV Access

Three common ED habits are up for audit. The first is the migraine liter hanging next to the NSAID as if fluid itself were analgesia. The second is the elegant-sounding sphenopalatine ganglion block, where more anesthetic turns out not to mean more durable relief. The third is the hard-stick patient, where a simple transillumination device may help more than most of us would have guessed — but only if we treat it as an early adjunct, not a magic wand.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #15: Cardiac Arrest Access, AI Chest X-Rays, and Trauma Ketamine

Aug 3, 2026

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5 min read

The Hallway Consult — Issue #15: Cardiac Arrest Access, AI Chest X-Rays, and Trauma Ketamine

In cardiac arrest, should IO really come before IV? On chest x-ray, does AI meaningfully help, or just shift the error pattern? And for trauma pain without a line, is intranasal ketamine actually the better non-IV route? Let’s get into it.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #14: Prehospital Whole Blood, Suspected PE in Pregnancy, and Video EMS Dispatch

Jul 27, 2026

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5 min read

The Hallway Consult — Issue #14: Prehospital Whole Blood, Suspected PE in Pregnancy, and Video EMS Dispatch

Whole blood in the field, PE workup in pregnancy, and what happens when dispatch can actually see the scene. Three questions the ED doesn't always get to ask — but should.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #13: Acetaminophen Overdose, TBI Osmotherapy, and Pediatric Appendicitis

Jul 20, 2026

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4 min read

The Hallway Consult — Issue #13: Acetaminophen Overdose, TBI Osmotherapy, and Pediatric Appendicitis

Three decisions that look simpler than they are. Can you stop NAC early in a low-risk acetaminophen overdose? Does hypertonic saline actually change meaningful outcomes in traumatic brain injury, or just make the ICP monitor look better? And in pediatric appendicitis, has antibiotics-first really caught surgery yet? Let's get into it.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #12: DOAC Bleeding, Agitation, and Pediatric DKA Fluids

Jul 13, 2026

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5 min read

The Hallway Consult — Issue #12: DOAC Bleeding, Agitation, and Pediatric DKA Fluids

Should you reverse anticoagulation in a GI bleeder — and with what? What do you actually reach for when someone is dangerously agitated? And when a child with DKA needs fluid, is normal saline still the best default? Let's get into it.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #11: Renal Colic, Acute AF, and Hip Fracture Pain

Jul 6, 2026

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4 min read

The Hallway Consult — Issue #11: Renal Colic, Acute AF, and Hip Fracture Pain

The EM literature, translated for your next shift.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #10: Oxygen Targets, HFNC vs NIV, and Chest Pain Scores

Jun 29, 2026

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5 min read

The Hallway Consult — Issue #10: Oxygen Targets, HFNC vs NIV, and Chest Pain Scores

Three topics that show up constantly in real emergency practice, and three places where the “standard” approach is a lot less settled than people think.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #9: Syncope, Ketamine and Procalcitonin

Jun 22, 2026

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2 min read

The Hallway Consult — Issue #9: Syncope, Ketamine and Procalcitonin

Three topics that live in every emergency physician's blind spot, not because they're rare, but because the old heuristics are imprecise. Who actually needs admission after syncope? Does ketamine dose matter for emergence agitation? And after a decade of promise, does procalcitonin finally earn a place in your antibiotic decisions? The data are in.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult Issue #8: Aspirin, Pediatric Fever, and the TBI Intubation

Jun 15, 2026

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4 min read

The Hallway Consult Issue #8: Aspirin, Pediatric Fever, and the TBI Intubation

The EM literature, translated for your next shift.Three things that come up constantly in the ED — and three sets of assumptions worth pressure-testing. Does the reflex aspirin actually help? Is the febrile toddler with no source still as scary as it used to be? And is ketamine really dangerous in the head-injured patient? Spoiler: the answers aren't what we used to teach.

Matthew Barmmer
Matthew Barmmer
Issue #007 — Heart Failure, Skin Infections, and the Chest Pain Workup

Jun 8, 2026

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3 min read

Issue #007 — Heart Failure, Skin Infections, and the Chest Pain Workup

The EM literature, translated for your next shift.Three things you deal with constantly in the ED — and all three have changed enough that the old reflexes are worth rechecking.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #6: Intubation, PE, and the Hypotensive Patient

Jun 1, 2026

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3 min read

The Hallway Consult — Issue #6: Intubation, PE, and the Hypotensive Patient

Three topics you’ve probably had on your mind this week — and one of them just got rewritten by a large randomized trial.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #5: Neurology & Stroke

May 25, 2026

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3 min read

The Hallway Consult — Issue #5: Neurology & Stroke

The brain can't wait. Neither can the evidence base — it changed again.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #4: Trauma & Hemorrhage Control

May 18, 2026

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3 min read

The Hallway Consult — Issue #4: Trauma & Hemorrhage Control

Bleeding kills faster than almost anything else. Here's what the evidence says about stopping it.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #3: Cardiac Emergencies

May 11, 2026

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3 min read

The Hallway Consult — Issue #3: Cardiac Emergencies

Your resus bay's busiest tenant. Here's what the literature says you should actually be doing.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #2: Sepsis & Infectious Disease

May 4, 2026

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3 min read

The Hallway Consult — Issue #2: Sepsis & Infectious Disease

The most over-bundled, under-nuanced diagnosis in emergency medicine. Let’s sort it out.

Matthew Barmmer
Matthew Barmmer
The Hallway Consult — Issue #1: Airway & Resuscitation

Apr 27, 2026

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4 min read

The Hallway Consult — Issue #1: Airway & Resuscitation

The stuff that actually keeps people alive. Let's talk about it.

Matthew Barmmer
Matthew Barmmer

The Hallway Consult

The EM literature, translated for your next shift.

© 2026 The Hallway Consult.
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