Dr. Smith's ECG Blog

MAY 31, 2023

Opiates are associated with worse outcomes in Myocardial Infarction. Association of intravenous morphine use and outcomes in acute coronary syndromes: Results from the CRUSADE Quality Improvement Initiative. de Winter et al in N Engl J Med 359:2071-2073, 2008. See this case: A man his 50s with chest pain. Am Heart J.

EKG/ECG 96

EKG/ECG Outcomes Academics Wellness 96

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

Don't Forget the Bubbles

JANUARY 8, 2024

This led to her death at 19, an outcome ruled as homicide at inquest, indicating others’ contribution to her demise. Verbal de-escalation not only helps in avoiding the need for physical intervention but also fosters a therapeutic relationship, crucial for successful treatment outcomes in these sensitive situations. Mulraney, M.,

Research 105

Research Emergency Department Psychiatric Academics 105

EMDocs

SEPTEMBER 7, 2023

Fatal Poisoning Among Young Children from Diethylene Glycol-Contaminated Acetaminophen — Nigeria, 2008—2009”. Long-Term Renal and Neurologic Outcomes among Survivors of Diethylene Glycol Poisoning.” Upon review of the history, several of the patients had been exposed to a liquid acetaminophen-based teething medication.

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Poisoning CDC Administration Emergency Department 94

Sensible Medicine

JULY 17, 2023

And again, they reported no difference in outcomes. A year later, in 2008, COURAGE trialists published a follow-up paper looking at quality of life. The COURAGE investigators even carried out their study to ten years. You might wonder how PCI remained so popular after such a definitive study. Here is the key graph.

Shock 98

Shock Outcomes 98

EMDocs

MAY 11, 2024

Endovascular and Clinical Outcomes of Vertebrobasilar Intracranial Atherosclerosis-Related Large Vessel Occlusion. Salim Rezaie, “Thrombolysis in Acute Ischemic Stroke: Now We Have No Positive RCTs”, REBEL EM blog, July 27, 2020. Available at: [link]. Baek JH, Kim BM, Heo JH, et al. Front Neurol. 2019 Mar 19;10:215. 2019.00215.

Stroke 111

Stroke EMS EKG/ECG Radiology 111

PHEM Cast

DECEMBER 12, 2016

Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. Injury; 2008 (39): 967-969. Emergency thoracotomy in thoracic trauma: a review. Injury; 2006 (37): 1-19. Clay et al. World Journal of Emergency Surgery; 2006: 1:4. Rhee et al. J Am Coll Surg; 2000. J Am Coll Surg.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

Cook County EM Blog

MARCH 20, 2023

2008 Apr;3(1):27-33. Epub 2008 Feb 2. 2008 Jan;12(1):33-6. Latex paint-gun injuries of the hand: are the outcomes better? 2008 Dec;3(4):340-5. Epub 2008 May 28. High-pressure injection injury of the hand: an often underestimated trauma: case report with study of the literature. Hogan CJ, Ruland RT.

Fractures 52

Fractures Documentation/Coding Operations Research 52

PHEM Cast

APRIL 16, 2018

The outcomes from different resuscitative interventions in a haemorrhagic shock model in porcine model: From: Watts et al. Survival and neurological outcome after OOH TCA in pediatric & adult populations: a systematic review. 2008; 64: 9-14/ Ultrasound during TCA: Cureton et al. 2012; 73: 102-10. Grasner et al.

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

Dr. Smith's ECG Blog

FEBRUARY 8, 2015

There was a good outcome. We believe this represents a form of “toxicomythology” given the millions of doses of beta -blockers administered in the past to patients with hyperadrenergic states, and a paucity of evidence of adverse outcomes (12). The one exception ADDIN EN.CITE McCord 2008 1774 1774 17 McCord, J. Wells, P.J.

Seizures 52

Seizures Administration Outcomes Hospitals 52

Taming the SRU

JANUARY 29, 2024

Phlegmasia Cerulea Dolens in the Upper Extremity: A Case Report and Systematic Review and Outcomes Analysis. 2008 Aug;6(8):1262-6. Epub 2008 May 15. Greenberg J, Troutman DA, Shubinets V, Dougherty MJ, Calligaro KD. Vasc Endovascular Surg. 2016 Feb;50(2):98-101. Epub 2016 Feb 11. Bolitho DG, Elwood ET, Roberts F.

Emergency Department 94

Emergency Department Fractures Hospitals Operations 94

The Skeptics' Guide to EM

APRIL 16, 2022

Before we answer that question, let’s remind everyone that only a small number (2.8%) of interventions published in SRMA and relevant to emergency medicine have unbiased and strong evidence for improved outcomes ( SGEM#361 ). JAMA Feb 2009 looked at the ACC/AHA guidelines from 1984 to 2008. This is a broader problem in medicine.

Military 40

Military Operations Emergency Department Pediatrics 40

Northwestern EM Blog

FEBRUARY 14, 2022

The primary outcome of the study was the response in MAP three hours after the start of angiotensin II infusion. It showed improvement in blood pressure which is a clinically important parameter but not a patient-oriented outcome. NEJM 2008; 358(9): 877 – 87. Crit Care 2014; 18(5): 534. PMID: 25286986 Russell JA et al.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

Pediatric Emergency Playbook

AUGUST 1, 2017

J Med Genet 2008; 45:1. Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease? J Pediatr Gastroenterol Nutr 2008; 46:13. Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. 2008; 15-21. 2008; 22-28. Hirschsprung's disease.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Dr. Smith's ECG Blog

APRIL 17, 2023

Full case details and outcomes are below. Emergency providers need to instinctively recognize this ECG pattern in a patient with new chest pain! == KEY POINTS regarding D e W inter T Waves : In 2008 — Robert J. de Winter et al in N Engl J Med 359:2071-2073, 2008. Case 1: Case 2: Case 1: What do you think? See text ).

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EKG/ECG Documentation/Coding Emergency Department Psychiatric 52

ACEP Now

SEPTEMBER 3, 2024

These stakeholders are similarly shielded in court when adverse patient outcomes, such as negligent deaths, occur under their management or when the bought-out companies are challenged for anticompetitive business practices overseen by the PE firm. 7-9 The PE model then aims to sell acquired businesses for a profit within three to six years.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

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

PulmCCM

OCTOBER 30, 2023

IDSA cites multiple large observational studies showing no improvement in sepsis outcomes at many centers after SEP-1 implementation. In 2008, the U.S. incidence of VAP has remained stubbornly persistent : though it declined from 20 cases to 15 per 1000 ventilated patients 2008-2015, the rate then crept back up to 17 per 1000 in 2017.

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 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. 2017;18(5):835-845.

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

EMDocs

JANUARY 4, 2024

Whole bowel irrigation: 3 Not routinely performed and limited evidence to support improved outcome in general. 2008 Apr;51(4):412-5, 415.e1. Clinical characteristics and outcomes associated with bupropion overdose: a Canadian perspective. Can consider in massive overdose, especially of SR or XL formulations. Ann Emerg Med.

Seizures 94

Seizures EKG/ECG Poisoning Shock 94

The Skeptics' Guide to EM

JANUARY 27, 2018

Outcome: * Primary Outcomes: Reduction in peripheral IV catheters placed post-intervention and usage * Secondary Outcome: PIVC insertion cost (staff and consumables) This is an SGEMHOP episode, so we have the lead author on the show. days after, the intervention. Yes * Was the exposure accurately measured to minimize bias?

Emergency Department 40

Emergency Department Academics Outcomes Research 40

Dr. Smith's ECG Blog

MARCH 13, 2013

Aygul, 2008 ) STE or STD of 1 mm or more in anterior STEMI portended a worse prognosis (compared to no STE or STD), even after correcting for STE or STD elsewhere on the ECG, but only ST depression in aVR (“reciprocal to injury in the area of lead V7”) remains significant when corrected for all other ECG and clinical factors. Wong, 2012)" 1.

EKG/ECG 52

EKG/ECG Hospitals Outcomes Wellness 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

Yet this is rarely followed, and patient outcomes like this are the result once in a while. ECG changes in many of the cases I've seen are not “static” until reperfusion ( as had been initially reported in 2008 by deWinter et al. ). "

EKG/ECG 83

EKG/ECG Shock Documentation/Coding Academics 83

The Skeptics' Guide to EM

MAY 11, 2019

Omar et al (2008) showed just how safe laparoscopic appendectomies have become. Secondary Outcomes: “Length of stay during index hospitalization, cost of index hospitalization, number of follow-up visits required in the following year, and the total cost of appendicitis-associated care in the year after diagnosis. .

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

Emergency Medicine Ireland

OCTOBER 30, 2023

First up is the VASST trial, (Russel et al 2008 NEJM). Primary outcome here was kidney based rather than mortality. New Engl J Medicine 358 , 877–87 (2008). First up is the VASST trial, (Russel et al 2008 NEJM). A somewhat underwhelming start Second is the VANISH trial by Gordon et al, JAMA 2016. Nagendran 2019 in CCM.

Shock 52

Shock Sepsis Wellness Outcomes 52

PulmCCM

FEBRUARY 5, 2024

Fever in the ICU: Guideline Update The Society of Critical Care Medicine (SCCM) and the Infectious Diseases Society of America (IDSA) issued an interim update to their 2008 recommendations for the management of fever in the ICU. PulmCCM is not affiliated with SCCM or IDSA. °C oral measured multiple times).

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

ACEP Now

MAY 3, 2023

When she took the role in 2008, it was a newly created job tasked with expanding AARP’s approach to making health products and services available to its members from third party companies. Charlotte Yeh’s day-to-day work as the CMO of AARP Services, Inc.

EMS 52

EMS Outcomes Emergency Department Hospitals 52

PulmCCM

FEBRUARY 12, 2024

SCCM made its statement unilaterally, without the European Society of Intensive Care Medicine (ESICM), its partner on the 2008 and 2017 updates, or the American Thoracic Society (ATS). That could be because CIRCI is ill-defined, almost hypothetical. The new evidence prompted all three societies to issue new guideline updates.

Shock 52

Shock Administration Sepsis Fractures 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

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Comparative early and late outcomes after primary percutaneous coronary intervention in st-segment elevation and Non–St-segment elevation acute myocardial infarction (from the Cadillac trial). Stuckey, T., Zimetbaum, P. Tcheng, J. Guagliumi, G., Iwaoka, R. O’Neill, W. Lansky, A. & Griffin, J. Elsevier/Saunders. Belhassen, B., Rozovski, U.,

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EKG/ECG Documentation/Coding Wellness Emergency Department 131

PulmCCM

SEPTEMBER 4, 2024

Might this novel measure predict outcome in critically-ill patients [ @ross_prager ]? Parkin WG, Leaning MS, (2008) Therapeutic control of the circulation. Best, JE Please enjoy other posts in this series, now over a decade running! Subscribe now References 1. Critical care medicine 12: 107-112 3. J Clin Monit Comput 22: 391-400 4.

Ultrasounds 84

Ultrasounds Operations Research Outcomes 84

Taming the SRU

AUGUST 30, 2023

A 2008 review in the International Journal of Medicine on spinal epidural abscess (SEA) agreed that inflammatory markers (specifically ESR and CRP) are generally sensitive in the diagnosis of SEA, but are not specific. 2008 Aug;75(8):557-66. Notably, up to 40% of patients with native vertebral osteomyelitis had a normal WBC [33-34].

Infectious Diseases 89

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

The Skeptics' Guide to EM

FEBRUARY 24, 2018

The second, the larger CORTICUS study, published in the NEJM in 2008 found no benefit of the use of corticosteroids compared to placebo. While the primary outcome showed no difference between glucocorticoid treatment and placebo, there was also no secondary mortality benefit observed.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

Advanced Emergency Nursing from AENJ

APRIL 29, 2015

The association between hyperoxia and patient outcomes after cardiac arrest: analysis of a high-resolution database. The impact of oxygen and carbon dioxide management on outcome after cardiac arrest. Emergence Phenomena blog. Scutella, M., Pullalarevu, R., Vaghasia, N., Trzeciak, S., & Dezfulian, C. cited in : Pourmand, A.

Resuscitation 40

Resuscitation Pediatrics Administration Emergency Nursing 40

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. 2008) Shprecher, Schwalb, Kurlan. Lancet Neurol. Marmarou, Young, Aygok. Neurosurg Focus. Marmarou et al. Neuroradiology. Normal Pressure Hydrocephalus: Diagnosis and Treatment. Wallace et al.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Sensible Medicine

SEPTEMBER 29, 2023

2008 Feb;117(6):743-53. The impact of the use of the Early Warning Score (EWS) on patient outcomes: a systematic review. General Cardiovascular Risk Profile for Use in Primary Care. Circulation. Available from: [link] [2] Alam N, Hobbelink EL, van Tienhoven AJ, van de Ven PM, Jansma EP, Nanayakkara PW. Resuscitation.

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Research Hospitals Academics Emergency Department 60