Emdocs iconEmdocsSep 12, 2026 ~2 min source read

Journal Feed Weekly Wrap-Up: Hypothermia Duration, Ramping for Intubation, and Outpatient PE

Three recent literature items summarized: a randomized trial on how long to keep post-arrest patients at 33°C, a systematic review of patient positioning for ED intubation, and a single-center study on discharging low-risk pulmonary embolism patients from the ED.

Journal Feed Weekly Wrap-Up

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Useful takeaways from this story.

ICECAP randomized trial: extending targeted temperature management at 33°C after out-of-hospital cardiac arrest did not improve survival with good neurologic outcome.

Systematic review of ED intubations found non-supine positioning (ramped or other) is likely non-inferior or possibly superior to supine for first-pass success.

Single-center Canadian retrospective study reported safe discharge of selected low-risk pulmonary embolism patients diagnosed in the ED.

1) Duration of therapeutic hypothermia after OHCA (ICECAP trial)

What happened: The ICECAP randomized clinical trial compared different durations of targeted temperature management at 33°C following OHCA. The primary outcome reported was survival with good neurologic outcome.

What it found: Extending the duration of therapeutic hypothermia at 33°C did not improve survival with good neurologic outcome. The trial is published in JAMA (2026) and includes trial identifiers in the original source listing.

2) Positioning for emergency department intubation: ramping vs supine

What happened: A systematic review evaluated whether non-supine positioning (including ramped positioning) is preferable when intubating patients in the ED, focusing on first-pass success and related outcomes.

What it found: Non-supine positioning during ED intubation is likely either non-inferior or superior to supine positioning regarding first-pass success. The review appears in Emerg Med J (2026).

Practical takeaway: Ramped or other non-supine positions can be considered as reasonable alternatives to standard supine positioning when preparing for ED intubation. Choose positioning based on the clinical situation, provider experience, and an airway plan that accounts for anticipated difficulty, rather than assuming supine is always best.

3) Outpatient management of select pulmonary embolism patients

What happened: A single-center retrospective Canadian study examined safety of discharging selected low-risk PE patients diagnosed in the ED.

What it found: Discharging select low-risk patients with PE was safe in this cohort. The study is reported in CJEM (2026).

How to use this summary in your practice

  • For airway positioning: consider ramped or alternative non-supine positions when they may improve laryngeal view or first-pass conditions, but keep a structured airway plan and backup strategies.
  • For PE disposition decisions: apply low-risk criteria, confirm outpatient anticoagulation and follow-up, and document shared decision-making when choosing outpatient management.

Sources cited in the wrap-up: ICECAP randomized clinical trial (JAMA, 2026), systematic review on non-supine positioning for ED intubation (Emerg Med J, 2026), and single-center safety study on outpatient PE management (CJEM, 2026).

More context around this story.

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