The Skeptics' Guide to EM

SEPTEMBER 11, 2021

He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP). Defibrillation is the treatment of choice in these cases but does not often result in sustained ROSC ( Kudenchuk et al 2006).

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

PHEM Cast

APRIL 10, 2016

The control group received many similar treatments as the ‘intervention’ group (just not full protocolised EGDT) highlighting that with good sepsis care (fluid resuscitation, close monitoring, early appropriate antibiotic administration), mortality can be reduced. 2006 Jun 3;332(7553):1295–8. 2006 Jun 3;332(7553):1299–303.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Downeast Emergency Medicine

JULY 17, 2021

2006 Aug; 48(2): 173-81.[ Pain was assessed 20 minutes following administration and if pain persisted, a second dose of the original medication was given. American Journal of Emergency Medicine. 2020 Feb; 38 (2): 165-172.[ Pubmed ] 3. Ann Emerg Med. Pubmed ] Additional reading 4. Berger, et al.

Emergency Department 52

Emergency Department Wellness Administration EMS 52

RebelEM

JANUARY 23, 2023

2006) “Management of acute allergic reactions and anaphylaxis in the Emergency Department between 1993-2003,” Journal of Allergy and Clinical Immunology , 117(2). The effectiveness of IV cetirizine was determined to be statistically non-inferior. Multicenter study of emergency department visits for food allergies. J Allergy Clin Immunol.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2006; 26:1485-1500. 2006; 22:1021-1024. Plasma levels of lidocaine following nebulized aerosol administration. Pediatr Rev. 1988; 9(7):219-226. Malrotation with Midgut Volvulus Applegate KE. Intestinal Malrotation in Children: A Problem-Solving Approach to the Upper Gastrointestinal Series. Radiographics. Kapfer SA, Rappold JF.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

PulmCCM

OCTOBER 16, 2023

A 2006 analysis showed much lower rates of CLABSI with PICC lines, compared to conventional central venous catheters (0.5 These measures have dramatically increased hospital administrators’ attention to CLABSI rates, and have likely had an effect of reducing actual rates of CRBSI. per 1,000 catheter-days).

CDC 52

CDC Hospitals Ultrasounds Documentation/Coding 52

Pediatric Emergency Playbook

MAY 1, 2017

Also, newborns have a double-whammy administrative load. 2006 Jun;11(3):214-24. Newborns are terrible at answering emails. There is a lot of unread unconjugated bilirubin is floating around. The liver and spleen are just not able to keep up. The infant’s gut is relatively sterile, so no admin assistance there. Pediatrics. Pediatrics.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

EMDocs

NOVEMBER 16, 2024

In stable patients, fluid/tissue cultures should be obtained prior to administration of antibiotics. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006 Feb-. An 80-year-old man with a history of hip arthroplasty presents by ambulance after falling at home. Hospitals, 2018. 2021 Aug 31. Statistical Brief #281.

EMS 98

EMS Dislocations Fractures Operations 98

RebelEM

MAY 15, 2024

Early administration of antibiotics is the only factor known to reduce this mortality. Early administration of antibiotics is the only factor known to reduce this mortality. 2006 May 15;106(10):2258-66. Cohort Study of the Impact of Time to Antibiotic Administration on Mortality in Patients with Febrile Neutropenia.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

EMDocs

FEBRUARY 7, 2024

22 Regardless of one’s ethical stance on the issue, increases in strike frequency will pose challenges to health systems, while also putting pressure on administrators to offer better support to workers. 2006 Apr;36(2):331-54. One study found that labor unionization among U.S. Why does it matter? BMC Medical Ethics. 2013 Dec;14:1-0.

Hospitals 98

Hospitals Research Patient Safety Wellness 98

Don't Forget the Bubbles

NOVEMBER 29, 2023

Even though sedation after endotracheal intubation (ETI) reduces the risk of self-extubation, uncontrolled pain, and awakening awareness, several small single-centre studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED).

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

EMDocs

JUNE 12, 2024

Two randomized controlled trials by Moore et al found that prehospital plasma administration in trauma patients is associated with hypoCa (53% vs 36%). Prehospital Ca administration reduces risk of hypoCa on arrival (70% vs. 28%). Make Ca administration a part of your massive transfusion protocol. Emerg Med J.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 105

ALiEM

NOVEMBER 15, 2023

Urine discoloration is seen after administration as seen in ALiEM Toxicology Visual Pearl: Discolored Skin and Urine [9]. 2006 ;118(5):2146-58. PREFERRED: Hydroxocobalamin (more favorable safety profile) Binds to cyanide, forming cyanocobalamin (i.e., Christopher Holstege, Bryan Judge, and Louise Kao. Pediatrics.

Poisoning 67

Poisoning Pediatrics Seizures Administration 67

Taming the SRU

JULY 2, 2023

An abrupt increase in end-tidal is an indicator of the return of spontaneous circulation (however this can also represent recent administration of bicarbonate). 2006): e1170-e1178. Annals of emergency medicine 63.2 2014): 247-258. Lightdale, Jenifer R., Pediatrics 117.6

Emergency Department 88

Emergency Department Pediatrics CPR Administration 88

Dr. Smith's ECG Blog

NOVEMBER 2, 2015

A prospective analysis of consecutive adult patients presenting to an urban/suburban two paramedic ambulance service fromJuly 15, 2006, to August 15, 2007, who have diagnostic ECGs for STEMI. Prehospital ECGs diagnostic for STEMI can normalize or become nondiagnostic after NTG administration or due to spontaneous reperfusion or evolution.

EKG/ECG 52

EKG/ECG Ambulance Services Administration 52

Don't Forget the Bubbles

DECEMBER 16, 2024

Depending on the individuals circumstances, this may involve either the administration of the MMR vaccine within 72 hours of exposure or intravenous immunoglobulin within six days. Although post-exposure prophylaxis is recommended in cases of measles, these interventions have limited effectiveness, making surveillance a priority. 2024 Oct 15.

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59

EMDocs

APRIL 22, 2024

The Accu-Chek was 214, and there was no response to empiric Narcan administration. 4, 2006, pp. Advanced cardiac life support (ACLS) had been initiated and on arrival at the ED, the patient was found to have Pulseless Electrical Activity (PEA). Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Chest , vol. doi: 10.7759/cureus.28481.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

Advanced Emergency Nursing from AENJ

MAY 27, 2015

Dolan, LA Times] Administrators often insist that the hospital be a “weapons-free” zone (as if there was any protection in that), that guards are often unarmed –perhaps with just a radio and a flashlight, and often wearing a “friendly” blazer rather than a uniform of obvious authority. Updated: January 1, 2006). Miri Halperin. (27/10/2013).

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40

EB Medicine

SEPTEMBER 1, 2018

Both are at the University of Florida Jacksonville, and they reviewed a total of 120 articles from 2006-2017, in addition to reviews from both Cochrane and Dare. As some background, from 2006-2015 there were almost 66,000 reported snake exposures and 31 deaths from snake envenomation in the US. Jeff: What a team! Jeff: What a team!

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

Taming the SRU

MARCH 31, 2023

Yates Anaphylaxis Pathophysiology Type 1 Hypersensitivity Reaction IgE-mediated Mast-cell degranulation of vasoactive materials Reaction occurs in minutes Clinical Definition: Acute onset of illness with involvement of the skin, mucosal tissue or both + one of the following Respiratory compromise Reduced BP Or, acute onset of illness with at least (..)

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

" The impact of this paper led to massive government regulation, grants, and reorganization of many local ambulance groups to Emergency Medical Services under administrative authorities and with shifts to contracted operators or public agencies such as fire departments who welcomed additional service justification and operating funds.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

EB Medicine

MAY 3, 2019

Jeff: If those figures seem a bit high, another CDC study found that in a general population survey of a quarter million people between 2006-2008, 9% met the criteria for major depression. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006. (US Current depression among adults United States, 2006 and 2008.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

EB Medicine

OCTOBER 1, 2018

In one study, every hour of delayed abx administration was associated with an 8% increase in mortality. Current guidelines recommend that broad spectrum antibiotics be administered within the first hour of presentation for those with sepsis or septic shock, ideally with blood cultures being drawn beforehand.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

NOVEMBER 4, 2024

Prophylactic Administration of Diphenhydramine to Reduce Neuroleptic Side Effects in the Acute Care Setting: A Systematic Review and Meta-Analysis. 2006 Jun;26(6):684-90. Prophylactic Administration of Diphenhydramine to Reduce Neuroleptic Side Effects in the Acute Care Setting: A Systematic Review and Meta-Analysis.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

Pediatric Emergency Playbook

JANUARY 1, 2017

CRIES is a 10-point scale, using a physiologic basis similar to APGAR: Crying; Requires increased oxygen administration (distress and breath-holding); Increased vital signs; Expression; and Sleeplessness ( Krechel 1995 ). Once the pain is controlled, less frequent administration of medications, with frequent reassessments, are indicated.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Administrative data from an integrated health system of 11 Southern California EDs were used to identify cardiac outcomes after ED presentation for syncope from January 1, 2002, to December 31, 2005. Population-based data on patterns and predictors of cardiac outcomes may improve decision-making. Quinn et al.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EMDocs

JANUARY 20, 2025

Since then, at least three separate meta-analyses 20-22 have found that on the whole, a restrictive fluid administration approach (variously defined) is at least as effective and possibly better than a liberal approach. It may be reasonable to consider IV fluid administration in patients with moderate dehydration or prolonged vomiting.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

EMDocs

NOVEMBER 25, 2024

6 Worldwide ongoing mass drug administration (MDA) with ivermectin, a public health measure made possible via mass donations from Merck, significantly reduces the burden of infection and associated ocular disease. 2006) River Blindness: A Success Story under Threat? 7 Approximately 14.6 million from partial or complete blindness.

Infectious Diseases 73

Infectious Diseases Emergency Department EMS Administration 73

Taming the SRU

JUNE 12, 2023

There are multiple factors to consider when managing dog and mammalian bites in the ED, including closure, prophylactic antibiotic administration, and rabies post-exposure prophylaxis. In 2006, only 79 dogs were found to have rabies in the United States [14]. Let’s take a deeper dive into the evidence. To close or not to close?

Infectious Diseases 103

Infectious Diseases Emergency Department Administration Academics 103

Don't Forget the Bubbles

JULY 5, 2023

It has been routine practice in the UK since 2006. Older children and adults usually present with ACS 2-3 days after hospitalisation due to pulmonary infarction (in situ sickling), hypoventilation due to rib infarction (which may be exacerbated by recent narcotic administration) or fat embolism. How is sickle cell disease diagnosed?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126