EM Updates

MARCH 24, 2021

The age of VL was ushered in by the 2001 Glidescope, which simultaneously introduced two technologies: video (putting a camera at the end of the blade and projecting the image onto a screen), and hyperangulated geometry (blades with a much steeper curve that are designed not to move the tongue out of the way, but to advance around the tongue).

Operations 52

Operations Airway Management EMS Wellness 52

Pediatric EM Morsels

JULY 21, 2023

We had just received a young child from EMS who was post-ictal with decreased mentation. Orso 2020] One pediatric study in this systematic review, and the intubated patients had worse outcome than non-intubated Early airway protection = lower rates of complications (in TRAUMA), but this is not always true with medical patients.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Pediatric EM Morsels

JULY 28, 2023

Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. 2001 Jan 25;344(4):264-9. 13406 The post Cerebral Edema and Diabetic Ketoacidosis: Rebaked appeared first on Pediatric EM Morsels. Is your patient hyperglycemic, acidotic, with ketonuria? Then we’ve likely got DKA.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

RebelEM

MAY 29, 2023

Without larger studies and a patient centered outcome, the addition of methylene blue within 24 hours of septic shock should still not be part of a general approach but rather an adjunct in specific circumstances (i.e. NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9% 95% CI 15.4 NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9%

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

PulmCCM

APRIL 18, 2024

Video laryngoscopy was introduced in 2001 as a technique for orotracheal intubation. This outcome measure was less robust than intubation attempts, because the “failure” definition included simply switching devices, which the intubator was permitted to do at any time for any reason.

Airway Management 98

Airway Management Operations EMS Research 98

RebelEM

AUGUST 14, 2023

This varies from the 2001 definition, which used SIRS criteria and was thought to overly focus on inflammation. Secondary Outcome Results: ICU mortality: placebo 20.0% The primary outcome was patient oriented. Many of the secondary outcomes were changed well after most of the data was acquired. vs. XBJ 14.4%

Sepsis 98

Sepsis Outcomes Administration EMS 98

RebelEM

AUGUST 7, 2023

Outcome of delirium in critically ill patients: systematic review and meta-analysis. Over half the patients (540) were hypoactive delirium and we typically don’t see a benefit in treating these patients with antipsychotics The median daily dose of haloperidol given was 8.3mg over 3.6 N Engl J Med. 2022 Dec 29. N Engl J Med.

Outcomes 52

Outcomes Hospitals EMS Administration 52

EB Medicine

OCTOBER 1, 2018

Optimal management of septic patients has been a source of intense research, stemming from the landmark study by Rivers in 2001. Then in 2001, sepsis-2 was introduced. The CMS metrics are slightly different from the 2001 sepsis guidelines also. Jeremy, can you give us a little historical context there? Jeff : Yes it has!

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EB Medicine

DECEMBER 4, 2019

Physicians reportedly respond 44% of the time, followed by nurses at 20% and EMS providers at about 4%. Even in cases where EMS was requested, patients were only transported 37% of the time and of those, only 8% were actually admitted for further work up. Nachi: I think that covers the main pathologies you may encounter. of cases.

Dehydration 40

Dehydration EMS Wellness Burns 40

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. Jeff: It’s also worth noting that cannabis is known to cause adverse outcomes on babies such as low birth weight and more frequent perinatal ICU placement.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. 2001 Oct;27(10):1606-13. N Engl J Med. 1989 May 18;320(20):1312-6.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

Dr. Smith's ECG Blog

APRIL 8, 2015

Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. These premonitory symptoms were negative predictors of adverse outcomes in EGSYS. Abnormal ECG – looks for cardiac syncope. Hemoglobin less than 10 (SF rule) 6. Syncope with Exertion (EGSYS) 7. S yncope while supine (EGSYS) 8.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

RebelEM

NOVEMBER 11, 2024

4 The 2023 ACORN Trial ( covered here on REBEL EM ) randomized 2,511 patients requiring antipseudomonal coverage to receive either cefepime or piperacillin-tazobactam. Variations in compliance could have impacted patient outcomes. In 2021, Buckley et. 3 The same year, Ross et. address in the article discussed below.

Sepsis 113

Sepsis Outcomes Administration Shock 113

EMDocs

JANUARY 20, 2025

2001 12 found similar results among a cohort of critically ill patients. One of the hallmarks of sepsis care, based on the Rivers 2001 17 trial and still recommended by the latest SCCM guidelines is early detection of sepsis and initiation of early resuscitation. 9 In terms of assessing volume status in general, Joseph et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

EMDocs

NOVEMBER 25, 2024

Vision loss carries a high degree of morbidity and is associated with higher all-cause mortality, 4 and it is our role as emergency providers to recognize potentially reversible causes of such adverse outcomes. 0000000000000483 Opoku NO, Bakajika DK, Kanza EM, et al. 7 Approximately 14.6 million from partial or complete blindness.

Infectious Diseases 73

Infectious Diseases Emergency Department EMS Administration 73