PulmCCM

APRIL 1, 2024

Physical therapy is probably under-provided to critically ill patients, and improving this might improve outcomes for many. That could (and should) change if improved functional outcomes, persisting for months after hospital discharge, are ever confirmed in large, well-conducted trials.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

Pediatric EM Morsels

JULY 21, 2023

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. A practical scale. PMID: 4136544.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

RebelEM

MAY 29, 2023

It also reduced length of stay in ICU and hospital without adverse effects. What They Did: Single-center, parallel, double blind, randomized controlled trial performed in a medical-surgical ICU (Mexico) Both groups received: Adjunctive vasopressin initiated at a dose of 0.03 NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9%

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

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% vs. Secondary Outcome Results: ICU mortality: placebo 20.0% 001) Hospital mortality: Placebo 22.8% The primary outcome was patient oriented.

Sepsis 98

Sepsis Outcomes Administration EMS 98

ACEP Now

SEPTEMBER 3, 2024

Hahnemann University Hospital in Philadelphia closed in 2019, a year and a half after it was acquired along with St. Christopher’s Hospital for Children by private equity (PE) firm Paladin Healthcare Capital for 170 million dollars. Christopher’s was able to find a buyer prior to bankruptcy but Hahnemann could not.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

ACEP Now

APRIL 9, 2025

When I was an inpatient pharmacy manager in 2013, my hospital was visited by the California Department of Public Health (CDPH), concerned about droperidol and ECG monitoring, or rather, lack thereof. On December 4, 2001, the FDA issued a boxed warning fordroperidol, noting an association with QT prolongation and torsade des pointes (TdP).

Emergency Department 52

Emergency Department Administration EKG/ECG Resuscitation 52

ACEP Now

JULY 7, 2023

Her last hospitalization was one month ago for a similar wound, at which time she received intravenous antibiotics and was subsequently discharged. Many of these infections require hospitalization with intravenous antibiotics and surgical debridement. 10 The wounds are purulent and often polymicrobial. Forensic Sci Int. 2014;240:1-8.

Forensics 98

Forensics Airway Management Emergency Department Administration 98

RebelEM

AUGUST 7, 2023

The authors of the AID-ICU study aim to determine whether haloperidol leads to a significantly greater number of days alive and out of the hospital at 90 days than placebo in ICU patients with delirium. Paper: Andersen-Ranberg NC,et al; AID-ICU Trial Group. Haloperidol for the Treatment of Delirium in ICU Patients. N Engl J Med. 2022 Dec 29.

Outcomes 52

Outcomes Hospitals EMS Administration 52

Stop and Think

OCTOBER 8, 2024

Consider heart failure hospitalization. The problem is that in some trials, hospitalization for heart failure represents only a small fraction of total hospitalizations. Yes, hospitalizations for heart failure are 29% lower with the drug. Yes, hospitalizations for heart failure are 29% lower with the drug.

Hospitals 73

Hospitals Academics Outcomes 73

Mind The Bleep

OCTOBER 17, 2024

I am a GP at a large practice based in a town in southwest Scotland, and I also work as a doctor in the Emergency Department in our local district general hospital. BASICS responders have additional skills and can provide pre-hospital emergency care to patients delivering time-critical interventions to improve outcomes.

Ambulance Services 52

Ambulance Services Hospitals Anaphylaxis Wellness 52

PulmCCM

OCTOBER 9, 2023

Intensive blood glucose control in the ICU: Try, try again (TGC-FAST trial) Hyperglycemia is associated with worse outcomes in the ICU (and in medical patients generally), so correcting it must improve outcomes … right? ICU lengths of stay (the primary outcome) were identical between groups. and many other countries.

Shock 52

Shock Outcomes Hospitals Wellness 52

All Ohio EM

SEPTEMBER 16, 2019

By Mike Pallaci, DO Research Question: Does rapid lowering of blood pressure improve the outcome in patients with intracerebral hemorrhage? The primary outcome was determined for 2794 of these; 45 patients (1.6%) lost to follow-up. How Many Patients: The investigators enrolled 2839 patients.

Stroke 40

Stroke Outcomes Research Hospitals 40

EB Medicine

OCTOBER 1, 2018

For those listening, my hospital probably looks a little bit like yours. Roughly half of in-hospital mortality is associated with septic in some fashion. clearly this is an important topic if it warrants it’s own chair at a major hospital in NYC. Then in 2001, sepsis-2 was introduced. We like it that way. 3 Criteria.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EB Medicine

DECEMBER 4, 2019

Nachi: AEDs are also required and have been since 2001 and amazingly when a shock was delivered in flight, 40% survived to hospital discharge with a good outcome. Nachi: The Good Samaritan law provides legal protection to medical providers who perform their services in response to medical emergencies outside of the hospital.

Dehydration 40

Dehydration EMS Wellness Burns 40

PulmCCM

FEBRUARY 17, 2025

hospitals each year. How do physicians and providers decide to stop CPR after in-hospital cardiac arrest—and how should they? This allows for flexibility in treating individual patients, but also results in wide variability in the observed duration of CPR after in-hospital cardiac arrests. who died) was 21 minutes.

CPR 112

CPR Hospitals Resuscitation Documentation/Coding 112

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. 10) Jubran A.

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. Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to general hospital: the EGSYS score.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

RebelEM

NOVEMBER 11, 2024

Outcomes: Primary outcome: All-cause mortality within 90 days of ED presentation Secondary outcomes: Organ-failure-free days at 28 days, that is how many days in the first 28 after arriving in the ED not requiring mechanical ventilation, vasopressors, or dialysis. Variations in compliance could have impacted patient outcomes.

Sepsis 113

Sepsis Outcomes Administration Shock 113

Don't Forget the Bubbles

MARCH 3, 2025

Royal Manchester Childrens Hospital (RMCH) is a tertiary and major trauma centre in the North-West of England. Most studies in this review used quasi-Poisson regression with a general additive model to analyse the association between air pollution and respiratory-related hospital visits. Approximate annual attendance is 50,000.

Hospitals 88

Hospitals Emergency Department Research Forensics 88

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

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S.,

Psychiatric 89

Psychiatric Seizures Emergency Department Pediatrics 89

Taming the SRU

JUNE 12, 2023

In 2008, this led to greater than 316,000 emergency department (ED) visits and about 9,500 hospitalizations [1]. Although not every person seeks health care for these injuries, the majority of those that do end up in the emergency department. Sterile versus nonsterile gloves for repair of uncomplicated lacerations in the emergency department.

Infectious Diseases 103

Infectious Diseases Emergency Department Administration Academics 103