The Skeptics' Guide to EM

DECEMBER 14, 2024

The 2005 International Pediatric Sepsis Consensus Conference (IPSCC) criteria were established based on expert consensus and used for diagnosis. A medical trainee you are working with asks, He looks really sick. Is this pneumonia or could this be sepsis? Background: Pediatric sepsis is a major global health concern, causing an estimated 3.3

Sepsis 103

Sepsis Shock Pediatrics Hospitals 103

ACEP Now

MARCH 10, 2025

His highest attained rank was in the Makushita division in 2005, the third highest of six sumo divisions. Ikigai and subsequent health and wellbeing among Japanese older adults: longitudinal outcome-wide analysis. Satonofuji Hisashi has been a career sumo wrestler since 1996. He is no champion wrestlerin fact, he is far from it.

Academics 85

Academics Wellness CPR Hospitals 85

RebelEM

JANUARY 24, 2024

Wallace 2011 ) If addressed early and appropriately, most patients have good self-reported long-term outcomes regardless of the treatment modality Links Orthobullets: Achilles Tendon Rupture Resources: Sheth U et al. 2005; 39(11): 838-42. Sports Med. 1998; 25(2): 79-100. PMID: 9519398 Kayser R et al. Br J Sports Med. Coll Antropol.

Operations 101

Operations Ultrasounds Fractures Outcomes 101

PulmCCM

MAY 24, 2024

Actuarially speaking, outcomes after severe intracerebral hemorrhage (ICH) occurring deep in the brain range from very bad to terrible. Although the SWITCH trial was arguably ‘97% positive’, its results further emphasize this hard reality.

Outcomes 52

Outcomes 52

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 4, 8 Paper: Dahyot-Fizelier, C.,

CDC 122

CDC Radiology Radiology Head Injuries 122

Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

American Journal of Emergency Medicine 2005; 23(3):279-287. Smith : "What was the outcome?" The fact that this is syncope makes give it a far lower pretest probability than chest pain, but it was really more than syncope, as the patient actually underwent CPR and had hypotension on arrival of EMS. They of course opened and stented it.

EMS 114

EMS CPR EKG/ECG Wellness 114

ACEP Now

JULY 11, 2024

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. Front Public Health. 2020:8;279. doi:10.3389/fpubh.2020.00279. 2020.00279. 2008.03.033.

Emergency Department 98

Emergency Department Psychiatric Outcomes Wellness 98

PHEM Cast

DECEMBER 12, 2016

EMJ; 2005: 22-24. Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. pdf Equipment required for resuscitative thoracotomy: Surface anatomy: Appearance of pericardial clot A foley catheter being used to fill a cardiac wound – note how easily this could be pulled out.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

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 99

Stroke Outcomes EMS Seizures 99

Sensible Medicine

MARCH 19, 2024

Most guidelines f ocus on the management of single conditions because studies are usually designed to isolate the effect of a single intervention on a single condition outcome. In 2005, the average primary care physician would need 18h/day to follow recommendations for chronic disease and preventive care.

Research 143

Research Outcomes 143

Stop and Think

OCTOBER 8, 2024

The puzzle : older trials found big gains in major outcomes (death) and newer trials struggle to show incremental gains in composite endpoints, such as one of many causes of hospitalization. Yes, hospitalizations for heart failure are 29% lower with the drug. This endpoint represents only 10% of total hospitalizations.

Hospitals 73

Hospitals Academics Outcomes 73

PulmCCM

JANUARY 22, 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 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Dr. Smith's ECG Blog

AUGUST 9, 2024

Opioids associate with worse outcomes in myocardial infarction , probably because they eliminate the pain signal that informs the clinician of the urgency of revascularization. Association of intravenous morphine use and outcomes in acute coronary syndromes: Results from the Crusade Quality Improvement Initiative. Do not treat AIVR.

EKG/ECG 107

EKG/ECG EMS Emergency Department Wellness 107

PHEM Cast

APRIL 16, 2018

The outcomes from different resuscitative interventions in a haemorrhagic shock model in porcine model: From: Watts et al. EMJ; 2005: 22-24. Survival and neurological outcome after OOH TCA in pediatric & adult populations: a systematic review. Ultrasound during TCA: Cureton et al. 2012; 73: 102-10. Phil Trans R Soc.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

RebelEM

MARCH 13, 2023

Nevertheless, mortality of prehospital traumatic cardiac arrest (TCA), and survivability with good neurologic outcome, remain the gold standards of trauma care in and out of the hospital and are effectively the criterion by which we measure outcomes in the trauma literature. Discussion: Dead On Scene: The 96.2% mortality rate and 43.5%

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52

The Skeptics' Guide to EM

JANUARY 29, 2020

Characteristics that indicate when a patient more likely to have an outcome, what we call prognostic factors, need to be accounted for when assessing the effectiveness of a treatment. May 2005. Randomization, statistics, and causal inference. Epidemiology Nov 1990 * Stephen Sean. Applied Clinical Trials.

EMS 52

EMS Outcomes 52

Taming the SRU

SEPTEMBER 8, 2023

2005 May;41(5):1179-97. 2005 Mar;42(3):365-70. Prognosis of acute severe autoimmune hepatitis (as-AIH): The role of corticosteroids in modifying outcome.” LaFollette is co-editor of TamingtheSRU.com References General Information: Polson J, Lee WM; American Association for the Study of Liver Disease. Hepatology. PMID: 15841455.

Radiology 59

Radiology Radiology Ultrasounds EMS 59

The Skeptics' Guide to EM

FEBRUARY 26, 2019

” Hoffman and Cooper Another issue we discussed was the outcome measure of mRS or in the case of IST-3, the Oxford Handicap Score (OHS) which is very similar to the mRS. Previous research has shown the mRS to have poor inter-rater reliability ( Wilson et al Stroke 2005 ) and issues with validity ( Zhao et al Cerebrovasc Dis 2010 ).

Stroke 52

Stroke EMS Research Outcomes 52

The Skeptics' Guide to EM

MARCH 6, 2021

Background: Epistaxis is a common Emergency Department (ED) complaint with over 450,000 visits per year and a lifetime incidence of 60% ( Gifford 2008 , Pallin 2005 ). You administer phenylephrine topically, reapply pressure and, consider the use of tranexamic acid (TXA).

EMS 52

EMS Emergency Department Outcomes 52

The Skeptics' Guide to EM

JULY 9, 2022

Another reanalysis was done by Kwiatkowski et al 2005 that also confirmed that the baseline imbalance in the NINDS trial did not account for the better outcome of tPA-treated patients. This committee’s findings supported the use of tPA in less than three hours ( Ingall et al 2004). What are your thoughts on this commissioned report?

Stroke 52

Stroke Emergency Department EMS Outcomes 52

Pediatric Emergency Playbook

OCTOBER 1, 2017

2005; 29: 493–500. Outcomes of Children Bridged to Heart Transplantation With Ventricular Assist Devices: A Multi-Institutional Study. Groves DA, Brown VJ. Vagal nerve stimulation: a review of its applications and potential mechanisms that mediate its clinical effects. Neuroscience and Biobehavioral Reviews. 2015; 4, Art. J Emerg Med.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

EMDocs

OCTOBER 30, 2023

Background and Context Contrast-enhanced computed tomography (CECT) is of paramount importance in the emergency department (ED) due to its indispensable role in facilitating precise diagnostic outcomes. 3 A study of CT use trends in the ED has shown increasing use of CTs by almost 60% from 2005 to 2013. West J Emerg Med.

Radiology 99

Radiology Radiology Emergency Department Hospitals 99

Pediatric Emergency Playbook

AUGUST 1, 2017

Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease? J Pediatr 2005; 146:787. J Pediatr Surg 2005; 40:197. Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. 2005; 40:1848-1851. J Med Genet 2008; 45:1. Hirschsprung's disease.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

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

RebelEM

JANUARY 19, 2023

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.

Outcomes 52

Outcomes Hospitals Research EMS 52

ACEP Now

MAY 10, 2024

External auditory canal foreign body extraction outcomes. Epidemiological trends and outcomes of children with aural foreign bodies in Singapore. Epidemiological trends and outcomes of children with aural foreign bodies in Singapore. 2005; 46(4):172-8. Ann Oto Rhinol Laryngol. 2017;126(11):755-761. Am J Otolaryngol.

Pediatrics 52

Pediatrics Emergency Department Poisoning Outcomes 52

The Skeptics' Guide to EM

NOVEMBER 2, 2019

Poolman et al ( Cochrane 2005 ) did a SRMA and pooled together five studies with a total of only 252 patients. Most of the studies were of poor quality and functional outcome was not used in any of the studies. This is typically defined as a minimally displaced closed fracture with angulation up to 70 degrees.

Fractures 40

Fractures EMS Emergency Department Outcomes 40

PEMBlog

AUGUST 20, 2024

2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. And of course, there needs to be more data on outcomes in pediatrics. Future prospective studies should focus on outcomes across a broad array of pediatric patients. Stratton, M., & Edmunds, K. Circulation.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

Taming the SRU

AUGUST 30, 2023

Significantly elevated CRP (>122mg/L) and PCT (>0.5ng/mL) levels are predictors of bad outcomes, and are useful for tracking therapy progress, but are not specific enough to rule-in infectious endocarditis [38-39]. 2005 Nov;6(11):1045-56. 2005 Feb 15;53(1):33-8. PMID: 28778870; PMCID: PMC6071487. J Zhejiang Univ Sci B.

Infectious Diseases 89

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

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. N Engl J Med. 2002;346(8):549-56.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

Taming the SRU

NOVEMBER 14, 2023

Complications of auricular hematoma drainage include pain, paresthesia, bleeding, infection, poor cosmetic outcome, scar formation, and re-accumulation of hematoma after the procedure. 2005 Jan;119(1):27-31. Treatment - How to Drain Auricular hematomas are treated with evacuation and compression to prevent re-accumulation of hematoma.

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

Taming the SRU

OCTOBER 23, 2023

Discrimination between an IUP and an interstitial pregnancy is critical as interstitial pregnancies can have devastating outcomes. The Lancet, Volume 366, Issue 9485, 2005, Pages 583-591, ISSN 0140-6736, [link]. Tubal Ectopic Pregnancy. ACOG Practice Bulletin No. Obstet Gynecol 2018. Available from: [link] 2 - Cynthia M Farquhar.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

RebelEM

JANUARY 23, 2023

Health care professional involved in patient management and outcome assessment was completely blinded. 2005 Sep;116(3):643-9. The effectiveness of IV cetirizine was determined to be statistically non-inferior. Epub 2010 Feb 8. PMID: 20146728. Clark S, Long AA, Gaeta TJ, Camargo CA Jr. J Allergy Clin Immunol. PMID: 16159637.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Dr. Smith's ECG Blog

MARCH 6, 2019

I believe this is by far the most common outcome for this patient around the world in 2019. Just because none of them had a disastrous outcome in a small, highly monitored study population does not mean they won't have bad outcomes in normal practice. No other clinical outcomes were reported. Schomig et al. Ownbey et al.

EKG/ECG 52

EKG/ECG Outcomes Hospitals Wellness 52

Taming the SRU

FEBRUARY 19, 2024

This has been the central question of many research projects with variable outcomes. Crit Care Med 2005; 33: 1276 –1280 6. Additionally, environmental factors such as movement, noise, vibrations can make these readings less accurate. But are they good enough? Galluccio, S. Finnis, M. E., & Chapman, M.

Shock 59

Shock Resuscitation Ultrasounds Research 59

Taming the SRU

MARCH 14, 2023

Estimated incidence of normal pressure hydrocephalus and shunt outcome in patients residing in assisted-living and extended-care facilities. Neurosurg Focus. Marmarou et al. Diagnosis and management of idiopathic normal-pressure hydrocephalus: a prospective study in 151 patients. J Neurosurg. Nakajima et al.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

PHEM Cast

SEPTEMBER 6, 2017

trauma 2004) showed that end-tidal CO2 may be of value in predicting outcome from major trauma (19). Qvigstad et al showed in again in Resuscitation in 2013, confirming inter-individual variation in effectiveness of CPR using ETCO2 as a surrogate for CO Trauma Deakin et al. (J.

CPR 52

CPR Resuscitation Operations Shock 52