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Glasgow Coma Scale in Children

Pediatric EM Morsels

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.

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SGEM #425: Are You Ready for This? Pediatric Readiness of Emergency Departments

The Skeptics' Guide to EM

Her research focuses on prehospital care of children with anaphylaxis. […] The post SGEM #425: Are You Ready for This? Her research focuses on prehospital care of children with anaphylaxis. She is nationally known for her work as an EMS researcher and educator. JAMA Netw Open. JAMA Netw Open. But does that always happen?

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Blood Pressure Management in Neurologic Emergencies: What Does the Evidence Say?

EMDocs

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 99
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Problem Drinking Remains a Big Problem

ACEP Now

This medication has limited outcomes data and multiple contraindications. On the other hand, naltrexone and acamprosate are well-tolerated, affordable medications with promising outcomes data for harm reductions and, in some cases, abstinence. Alcohol’s effects on health: research-based information on drinking and its impact.

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Improving Care for Patients with a Non-English Language Preference (NELP)

EMDocs

Certified interpreter use can improve communication and patient outcomes. Rockville: Agency for Healthcare Research and Quality. Conducting research regarding best practices for improving health outcomes for NELP patients. Pearls NELP patients have worse health outcomes despite widespread language-access policies.

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SGEM#284: Might as Well Jump, but We would Recommend a Parachute

The Skeptics' Guide to EM

Despite the near universal application, a systematic review from 2003 ( Smith and Pell, BMJ ) found no RCTs of parachute intervention. After years of trying to organize a trial, researchers were finally able to recruit some volunteers to jump out of a plane with a parachute or backpack.

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The RAMPP Trial: Randomised Ambulatory Management of Primary Pneumothorax

RebelEM

If aspiration is unsuccessful based on the criteria above → Chest tube is inserted (size 8-14Fr) and admitted to the hospital. Outcomes: Primary Outcome: Total length of hospital stay up to 30 days after randomization, including initial hospital stay and readmissions. Investigators asked a patient-oriented research question.