Emergency Medicine Ireland

OCTOBER 30, 2023

Well, that time has come and it’s time to run through vasopressin. Well this is where the fun beings. 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). How does it work? Nagendran 2019 in CCM.

Shock 52

Shock Sepsis Wellness Outcomes 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). Wells, P.J. Wells, P.J. This would treat both SVT or sinus tachycardia.

Seizures 52

Seizures Administration Outcomes Hospitals 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. Some institutions developed a tier-based system for outpatient imaging as well which was updated in real-time. West J Emerg Med.

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

Dr. Smith's ECG Blog

APRIL 17, 2023

Full case details and outcomes are below. 4) There is well formed J-point notching. He also stated he "just didn't feel well" starting about 14 hours prior to presentation, but the chest pain was only noticed about 2 hours prior to presentation. de Winter et al in N Engl J Med 359:2071-2073, 2008. See text ).

EKG/ECG 52

EKG/ECG Documentation/Coding Emergency Department Psychiatric 52

EMDocs

JANUARY 4, 2024

3 Bupropion blocks the reuptake of dopamine and norepinephrine, as well as antagonizes acetylcholine at nicotinic receptors. Whole bowel irrigation: 3 Not routinely performed and limited evidence to support improved outcome in general. 2008 Apr;51(4):412-5, 415.e1. Ann Emerg Med. doi: 10.1016/j.annemergmed.2007.06.004.

Seizures 94

Seizures EKG/ECG Poisoning Shock 94

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

DECEMBER 27, 2023

Brief aside: "Early repolarization" is a frequently proclaimed and poorly understood electrocardiographic phenomenon which mostly serves to reassure clinicians that not all ST elevations are ischemic (something readers of this blog know well). linking the finding with long term risk of idiopathic ventricular fibrillation. Stuckey, T.,

EKG/ECG 131

EKG/ECG Documentation/Coding Wellness Emergency Department 131

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

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

Dr. Smith's ECG Blog

MARCH 13, 2013

There is reciprocal ST depression in I, II, aVL and V4-V6, as well as some very subtle STD in posterior leads V8 and V9 (which also have very low QRS voltage) Here is his initial ECG, which the tech recorded as a 15-lead ECG (the doctors were not sure why): Thus, there is a rightward, anterior, and slightly superior ST axis. Wong, 2012)" 1.

EKG/ECG 52

EKG/ECG Hospitals Outcomes Wellness 52

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. Some people do really, really well as they age, and other people don’t,” Dr. Yeh said.

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. 3 days).

Shock 52

Shock Administration Sepsis Fractures 52

The Skeptics' Guide to EM

FEBRUARY 24, 2018

There is a certain subset of patients in septic shock whose adrenal axis functions well enough to support them in a state of health but are unable to support them in a state of unwell. The second, the larger CORTICUS study, published in the NEJM in 2008 found no benefit of the use of corticosteroids compared to placebo.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

Sensible Medicine

SEPTEMBER 29, 2023

The promise is that well-constructed and validated prediction models will lead to diseases being diagnosed earlier and treatment for the right patients, in the right place, at the right time. In some cases, models that appear to perform well may pose risks to patients if used to make clinical decisions. 2008 Feb;117(6):743-53.

Research 60

Research Hospitals Academics Emergency Department 60

Taming the SRU

MARCH 14, 2023

He appears well and is triaged to an ESI 4. She was doing well, but recently has had the “stomach flu” with a couple weeks of abdominal pain, nausea and vomiting. Estimated incidence of normal pressure hydrocephalus and shunt outcome in patients residing in assisted-living and extended-care facilities. Lancet Neurol. Amer J Rad.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. 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.

Infectious Diseases 89

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

Dr. Smith's ECG Blog

MARCH 6, 2019

There is a new Q-wave in aVL, with STE and large T-wave as well. She requires maximal medical management per all current guidelines (including heparin and P2Y12 inhibitor per cardiology), as well as consideration for emergent cath in the case of persistent ischemia. The patient did well. V2 still has STE and hyperacute T-waves.

EKG/ECG 52

EKG/ECG Outcomes Hospitals Wellness 52

Dr. Smith's ECG Blog

OCTOBER 6, 2023

Thus, this ECG predicts poor myocardial perfusion and poor outcome. de Winter et al in N Engl J Med 359:2071-2073, 2008. Small vessel occlusion is measured by "blush" on the angiogram, and codified by TIMI Myocardial Perfusion (TMP) Grading. Figure-1: The de Winter T Wave Pattern , as first described by Robbert J.

EKG/ECG 66

EKG/ECG Academics Shock Outcomes 66

Don't Forget the Bubbles

JUNE 10, 2024

Baby A, a preterm infant, appears to be faring well for the moment—requiring minimal respiratory support, on full feeds, without IV access, and generally in an okay condition. Welcome to your first day with the neonates! Upon arriving for your initial shift, you set down your bag, and shortly after, you’re asked to evaluate Baby A.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Sensible Medicine

SEPTEMBER 29, 2023

The promise is that well-constructed and validated prediction models will lead to diseases being diagnosed earlier and treatment for the right patients, in the right place, at the right time. In some cases, models that appear to perform well may pose risks to patients if used to make clinical decisions. 2008 Feb;117(6):743-53.

Research 40

Research Hospitals Academics Emergency Department 40

Dr. Smith's ECG Blog

OCTOBER 3, 2018

The medic was very worried about the concordant STE and T-wave in aVR, and the downsloping concordant ST depression in II, III, aVF, as well as V5 and V6. The only possibilities are accelerated idioventricular rhythm and paced rhythm. When he showed it to me, I said "Ouch, looks like an acute coronary occlusion. What happened?"

EKG/ECG 52

EKG/ECG Emergency Department Research Outcomes 52

EB Medicine

MAY 3, 2019

Jeff: And finally, how many of you wish there was a clearly outlined evidence-based approach to managing such patients to improve care and outcomes? 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.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

EB Medicine

JULY 8, 2019

Jeff: Well that’s kind worrisome. From the 80’s to 2008, the worldwide prevalence of obesity nearly doubled! Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in. Vitamin D, B12, Calcium, foate, iron, and thiamine deficiencies are all well documented complications.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Dr. Smith's ECG Blog

OCTOBER 6, 2018

The patient did well at least in the short term. Angiographic and clinical outcomes among patients with acute coronary syndromes presenting with isolated anterior ST-segment depressions. JACC 51(3):307-14; January 22, 2008. EF was 55%. The recommended value for V2 and V3 is now 1.5 mm for women, 2.0 mm for men under age 40.

EKG/ECG 40

EKG/ECG Seizures Documentation/Coding Outcomes 40

Don't Forget the Bubbles

JUNE 5, 2023

Outcomes of the PREFER pre-post intervention study. These are the preferable contraceptive choice, so this point appears to have been well communicated in the video. This study examined the developmental outcomes of 12 months olds from a “pandemic” cohort of babies ( 309 babies ). Mazza D, Buckingham P, McCarthy E, Enticott J.

Outcomes 124

Outcomes Research Wellness Documentation/Coding 124

Don't Forget the Bubbles

AUGUST 21, 2023

The baby’s parents tell you that the baby hasn’t been feeding well for a few days and today has been very sleepy. What are the long-term outcomes for children with dilated cardiomyopathy? Outcomes at 1 year seem to be influenced by the severity of illness at presentation. Female sex and younger age favour better outcomes.

Pediatrics 98

Pediatrics Outcomes Research Sepsis 98

EMDocs

JANUARY 20, 2024

The most common findings on ECG are ST elevation , most often in the anterior precordial leads, as well as sinus tachycardia and QT interval prolongation. Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy. 2008 Mar;155(3):408-17. Troponin and B – type natriuretic peptide are often elevated. J Neurosurg.

EMS 102

EMS Fluid Resuscitation Shock EKG/ECG 102

RebelEM

MAY 15, 2024

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 98

Infectious Diseases Administration Sepsis Anaphylaxis 98

EMDocs

OCTOBER 23, 2023

She had been feeling well until yesterday when she had a follow-up with her surgeon, at which time she reported that they performed an internal exam and inserted a ‘medication disk’ into her vagina. The patient is noted to be mildly tachycardic as well as febrile. BJOG 2008; 115:1473. 2020 Sep;127(10):1269-1279.

OB/GYN 95

OB/GYN Operations EMS Ultrasounds 95

The Skeptics' Guide to EM

APRIL 3, 2021

He was last seen well when going to bed at 10pm the night before. Of the 13, eleven failed to show benefit for their primary outcome and four were stopped early due to harm or futility. Only two RCTs claimed benefit for their primary outcome. Those were ECASS-3 in 2008 and the NINDS trial from 1995. THAWS RCT Substudy.

Stroke 52

Stroke Research Outcomes Emergency Department 52

ACEP Now

AUGUST 1, 2023

It was submitted in 2008 to the National Quality Forum (NQF), which convenes external groups to endorse measures. What’s clear from the emerging data: our experience as clinicians as well as our patients’ is that the system is unraveling. ED crowding and boarding are causing patient experiences and outcomes to worsen.

Military 98

Military Emergency Department Hospitals Leadership 98

EB Medicine

FEBRUARY 1, 2019

Gabrielle Procopio, a PharmD, have done a fantastic job parsing through the literature, which included over 500 abstracts, 89 full text articles, guidelines from ACEP and the American Academy of Neurology, as well as canadian and european neurology guidelines, to summarize the best evidence based recommendations for you all.

Emergency Department 40

Emergency Department Stroke Outcomes Ultrasounds 40

EMDocs

NOVEMBER 4, 2024

She denies any trauma, swelling, or redness in the joints, as well as fever or weight loss. A comprehensive, patient-centered approach to pain management ensures effective treatment across these diverse pain syndromes, ultimately improving patient outcomes. Cause and outcome of atypical chest pain in patients admitted to hospital.

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Emergency Department Fractures Burns EMS 105

Dr. Smith's ECG Blog

JANUARY 31, 2025

al in 2008, and is eponymously named after the main author. Peak troponin may be very high following rapid reperfusion. __ Smith : This is a classic case and well managed, as it should be. This ECG and patient outcome is a reminder of why it is so important to recognize this ECG pattern. Sadly, he could not be resuscitated.

EKG/ECG 114

EKG/ECG Ambulance Services Outcomes Resuscitation 114

PulmCCM

MARCH 7, 2025

Ranganathan et al reviewed the outcomes for 429,691 patients undergoing commonly performed surgeries on Friday or Monday (or Tuesday after a holiday weekend) in multiple hospitals in Ontario, Canada, from 2007 to 2019. between 2008 and 2011, patients in the U.K. Don’t look at that. Aylin et al BMJ 2013) But that was in the U.K.,

Outcomes 116

Outcomes Hospitals Operations Radiology 116

Sensible Medicine

JULY 28, 2023

Owing to a collaboration with the Wuhan University Medical School, I had visited Wuhan in 2008 and 2017. I had pored over a website, recommended by my gastroenterologist, on which IBD docs reported their patients’ COVID outcomes stratified by their medication. 2 These contacts and experiences added to my anxiety.

Hospitals 95

Hospitals PPE Urgent Care Academics 95