EMDocs

JANUARY 29, 2024

Finally, anticipating and addressing known complications such as seizures, increased intracranial pressure, or cerebral edema with appropriate measures, including antiepileptic drugs or osmotic agents, is essential for improving patient outcomes. Lowering the MAP may mitigate these risks and possibly improve outcomes. doi: 10.1161/01.str.0000014509.11540.66.

Stroke 101

Stroke Outcomes EMS Seizures 101

The Skeptics' Guide to EM

MAY 19, 2019

Civil Monetary Penalties Resulting from Violations of the Emergency Medical Treatment and Labor Act (EMTALA) Involving Psychiatric Emergencies, 2002 to 2018. Civil Monetary Penalties Resulting from Violations of the Emergency Medical Treatment and Labor Act (EMTALA) Involving Psychiatric Emergencies, 2002 to 2018.

Psychiatric 40

Psychiatric Academics Emergency Department Hospitals 40

The Skeptics' Guide to EM

NOVEMBER 16, 2019

You call your hyperthermia team to initiate targeted temperature management (TTM), which in your hospital means 33C for 24 hours followed by slow rewarming for 24 hours. This has been or out-of-hospital cardiac arrests (OHCA). It showed cooling patients to 33C was not superior to 36C for the primary outcome ( SGEM#82 ).

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia EMS Research Documentation/Coding 40

The Skeptics' Guide to EM

JUNE 24, 2017

Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline). Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline).

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia CPR Resuscitation EMS 40

PHEM Cast

APRIL 21, 2021

The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. Anesthesia and Analgesia, 2002; 94; S-123. The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis. J Trauma 2003; 54:444-453 Mort TC.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

PulmCCM

JANUARY 24, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

Taming the SRU

JANUARY 29, 2024

Hospital Course The patient was initiated on a therapeutic heparin drip in the emergency department with vascular surgery consultation. She had improvement of the swelling in her left arm with return of sensation and function during her five-day hospital course. 2002 Feb 25;162(4):401-4. Vasc Endovascular Surg. Ann Plast Surg.

Emergency Department 94

Emergency Department Fractures Hospitals Operations 94

ACEP Now

APRIL 3, 2024

Early work on TTM in 2002 showed benefit to cooling to 33 degrees Celsius, which subsequently influenced international resuscitation guidelines to recommend mild hypothermia at 32 degrees to 34 degrees Celsius in 2005. 5,6 In 2021, the TTM2 trial was published. degrees Celsius for 72 hours.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

Don't Forget the Bubbles

FEBRUARY 26, 2024

Evidence (although limited) suggests using HFNC can delay the initiation of NIV and result in longer intensive care and hospital stays. 2002 Apr 1;3(2):181-4. Outcomes of paediatric critical care asthma patients. How does bi-level positive pressure ventilation work? Pediatric Critical Care Medicine. 2007 Jan 1;25(1):6-9.

Pediatrics 72

Pediatrics Research Documentation/Coding Outcomes 72

Taming the SRU

AUGUST 30, 2023

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. 2002 Jan 2;287(1):92-101. . + Procalcitonin (PCT) Etiology: PCT was first discovered in 1984. days (secondary endpoint) [51].

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

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

MAY 25, 2023

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

EMDocs

MAY 15, 2024

Consider risk factors for multi-drug resistant microbes: Recent IV antibiotics Hospitalization within 90 days. COVID-19 and ACS COVID increases the risk of hospitalization, pneumonia, pain, and ACS in SCD patients. Causes and outcomes of the acute chest syndrome in sickle cell disease. Published January 2002.

Blood Transfusions 104

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 104

EMDocs

MAY 28, 2024

Consider risk factors for multi-drug resistant microbes: Recent IV antibiotics Hospitalization within 90 days. COVID-19 and ACS COVID increases the risk of hospitalization, pneumonia, pain, and ACS in SCD patients. Causes and outcomes of the acute chest syndrome in sickle cell disease. Published January 2002.

Blood Transfusions 98

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 98

ACEP Now

MAY 9, 2024

The procedure has soared in popularity as beauty standards have shifted and cosmetic surgery has become increasingly transparent on social media platforms, with reported cases in the United States increasing from 614 in 2002 to 61,387 by 2021, a nearly 10,000 percent increase. These questionable practices led to a rash of bad outcomes.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Don't Forget the Bubbles

JULY 26, 2023

This has been trialled (out of hospital) in known children with SVT. Upside-down position for the out of hospital management of children with SVT, Bronzetti et al, International Journal of Cardiology 2017 this showed that a modified position (upside down) improved cardioversion rates from 33% to 67%.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

ACEP Now

MAY 8, 2023

1,2 With such enormous popularity it is no surprise that each year there are 56,000 emergency department (ED) visits, 2,600 hospitalizations, and 500 deaths in the U.S. Normal serum AST and ALT levels alone are not predictors of outcome. Dr. Helman is an emergency physician at North York General Hospital in Toronto. Hepatology.

Poisoning 52

Poisoning Outcomes Administration EMS 52

PHEM Cast

APRIL 18, 2016

All things Pre Hospital Ketamine – Minh Le Cong Key point: patients remember if you manage their pain well. Hauwald, 2002 A co-operative patient does not require immobilization unless their conscious level deteriorates. We have also recorded a three interviews already which will feature in future podcasts.

Fractures 40

Fractures Operations Administration Shock 40

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

PEMBlog

OCTOBER 31, 2024

every year, leading to emergency department visits and hospitalizations. The trial found that LGG did not significantly improve outcomes compared to placebo. We found that probiotics did not improve patient outcomes when compared to placebo. 2018 Nov 22;379(21):2002-2014. N Engl J Med. doi: 10.1056/NEJMoa1802598.

Outcomes 105

Outcomes Pediatrics Emergency Department Research 105

Broome Docs

DECEMBER 22, 2024

This month we cover a few out-of-hospital arrest trials. A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest. Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest. Which is better in out of hospital cardiac arrest: IV or IO? Favourable neurologic outcomes were seen in 2.7%

Blood Transfusions 52

Blood Transfusions Hospitals Outcomes Emergency Department 52

Taming the SRU

JULY 24, 2024

jarrell and kimmel Violence is a social determinant of health Direct injury Vicarious trauma Cardiovascular health Psychological health Birth outcomes Risky sexual behavior Substance use Socioeconomic health The link between violence and direct injury is obvious, however there is evidence linking exposure to violence to other health consequences.

Domestic Violence 52

Domestic Violence Leadership Ultrasounds Academics 52

EMDocs

JANUARY 20, 2025

13 While there is good data that early antibiotics for patients in septic shock reduce mortality 18-19 the role of early and aggressive volume resuscitation and its impacts on patient-centered outcomes remain unclear. 2024, 33 use of ultrasound may lead to a reduction in mortality, less volume of fluids given, and decreased hospital stay.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

JANUARY 1, 2024

The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). Outcomes From a Randomized Clinical Trial. Two-Year Autism Risk Screening and 3-Year Developmental Outcomes in Very Preterm Infants.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

March, 2002) Emergency Care Essentials: 'Nasal Intubation Strategies'. 2014;46(6):814-820 on Medscape.com. ** Example trauma case report requiring airway control; the decision process, algorithms, and alternatives, outcome. doi:10.4103/2229-5151.128014 ** Broad review of the spectrum of current out-of-hospital airway management.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40

PulmCCM

FEBRUARY 26, 2024

Read in JAMA Covid Update: Two new drugs for mild-moderate symptoms; Fluvoxamine RCT; Covid “brain fog” Paxlovid improves outcomes for the elderly and other people at high risk for severe Covid, but the best available data suggest it doesn’t meaningfully help healthier, younger people. anytime soon.

Stroke 40

Stroke Psychiatric CDC Hospitals 40

EMDocs

MARCH 14, 2024

Studies have shown that insured adults have better health outcomes and service utilization patterns compared to uninsured controls— including improved chronic disease (e.g Studies have shown that insured adults have better health outcomes and service utilization patterns compared to uninsured controls— including improved chronic disease (e.g

Administration 105

Administration Outcomes Burns Operations 105

Don't Forget the Bubbles

FEBRUARY 24, 2025

Two-month-old Isla presents to their local hospital following a prolonged apnoea at home. However, our true success is measured by how effectively we share knowledge, foster understanding, and improve patient outcomes. This reduction is consistently associated with improved outcomes in infants with severe pertussis.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59