The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Intravenous drug administration during out-of-hospital cardiac arrest: A randomized trial. JAMA 2009 * Jacobs et al. There have been a number of papers published since OPALS that support the findings of not using ACLS drugs like epinephrine for OHCA: * Olavseengen et al.

CPR 52

CPR Academics Resuscitation Hospitals 52

Don't Forget the Bubbles

MAY 29, 2023

Academy of Management Learning & Education [Internet] 2009: 8:2:301–303. JONA: The Journal of Nursing Administration. [Review of Cultivating Communities of Practice: A Guide to Managing Knowledge, by Wenger E, McDermott R, Snyder WM]. Available at [link] Credland NJ, Whitfield C. Emergency Medical Journal [Internet] 2022;39;52-56.

Leadership 98

Leadership Patient Safety Academics Research 98

Critical Care Now

APRIL 21, 2022

Clin Infect Dis 2009; 49:433-7. Sustained low-efficiency dialysis in the ICU: Cost, anticoagulation, and solute removal. Kidney Int 2006;70:963-968. Mushatt D, Mihm L, Dreisbach A, et al. Antibiotic dosing in slow extended daily dialysis. Bogard K, Peterson N, Plumb T, et al. Crit Care Med 2011; 39:3 PEER Reviewed by Dr.

Burns 52

Burns Administration Outcomes Hospitals 52

The Skeptics' Guide to EM

MARCH 7, 2020

Background: Many hospitals had their health care workers fitted with N95 masks in response to the 2009 H1N1 pandemic. You wonder about the evidence supporting the initiative and if there is any recent evidence surrounding N95 masks usage for preventing health care workers getting acute respiratory illnesses.

Emergency Nursing 40

Emergency Nursing PPE Emergency Department Administration 40

EMDocs

OCTOBER 21, 2023

15 Treatment: Several treatment modalities have been described for BAO, including intravenous thrombolysis (IVT) which involves systemic administration of agents such as TNK or tPA, intra-arterial thrombolysis (IAT) via microcatheter at thrombus site, or mechanical endovascular thrombectomy (EVT). Lancet Neurol 2009; 8:724-730.

EMS 97

EMS Stroke Outcomes Hospitals 97

Pediatric Emergency Playbook

AUGUST 1, 2017

2009; 197:211-215. 2009 Jun;123(6):1548-55 Chinn WM, Zavala DC, Ambre J. Plasma levels of lidocaine following nebulized aerosol administration. Evid Based Rev Surg. 2013;216(3):501-505. Petroianu A. Diagnosis of acute appendicitis. Int J Surg. 2012; 10:115-119. Mazeh H et al. Amer J Surg. Puig S et al. Semin Roentgenol.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

PulmCCM

OCTOBER 16, 2023

per 1,000 central-line days between 2001 and 2009. These measures have dramatically increased hospital administrators’ attention to CLABSI rates, and have likely had an effect of reducing actual rates of CRBSI. As effective practices spread (and changes in reporting occurred), nationwide rates of CLABSI in the U.S.

CDC 52

CDC Hospitals Ultrasounds Documentation/Coding 52

Pediatric Emergency Playbook

MAY 1, 2017

Also, newborns have a double-whammy administrative load. 2009; 124(4):1193-6. 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 in Review.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Pediatric EM Morsels

JULY 28, 2023

Risk Factors that seem to stay consistent: Administration of Bicarb for correction of acidosis has been shown to be associated with cerebral edema and DOES persist after correcting for severity of DKA! 2009 Apr;10(2):155-7. Diabetes Ther. 2010 Dec;1(2):103-20. PMID: 22127748. PubMed] [Read by QxMD] Morales AE1, Daniels KA.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

Don't Forget the Bubbles

MARCH 31, 2025

However, excessive fluid administration can lead to fluid overload, which has been linked to worse clinical outcomes. It reinforces key principles in managing sepsis, including early recognition and rapid administration of antibiotics, balanced fluid resuscitation, early use of vasopressors, and steroid therapy for refractory shock.

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

ACEP Now

APRIL 14, 2025

The Substance Abuse and Mental Health Services Administration (SAMHSA) permitted all patients 14-28 days of take-home doses, allowed for prescription continuation via telehealth, and set limits of the frequency of in-person random drug testing permitted. 2009 Jul 8;(3):CD002209 3. Centers for Disease Control and Prevention. 2015 Mar 8.

Research 52

Research Infectious Diseases Hospitals Administration 52

EMDocs

FEBRUARY 7, 2024

healthcare workers previously remained low and relatively stagnant between 2009 and 2021. 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. Frequency : In the U.S., months since 2022.

Hospitals 97

Hospitals Research Patient Safety Wellness 97

EMDocs

SEPTEMBER 7, 2023

2 Administration of an alcohol dehydrogenase (ADH) inhibitor, such as fomepizole, is recommended in suspected or known DEG poisoning. Fatal Poisoning Among Young Children from Diethylene Glycol-Contaminated Acetaminophen — Nigeria, 2008—2009”. 6, 8 July 2009, pp. References: Abubukar et al. Schier, Capt. Nelson, et al.

Poisoning 91

Poisoning CDC Administration Emergency Department 91

EMDocs

JUNE 25, 2024

For large burns, consider albumin to lower total volume administration and improve urine output. It may interfere with lab tests (obtain labs prior to administration). National Burn Repository 2019 Update, Report of data from 2009–2018. Fluid choice: If traumatic injury and bleeding, administer blood products. link] (2019).

Burns 96

Burns Fluid Resuscitation Resuscitation Poisoning 96

Pediatric EM Morsels

MAY 24, 2024

In 2009, more than 9,000 children died from accidental injuries. Today we tackle low risk intra-abdominal injury , to find those children in which less may be more. Low Risk Inta-Adbominal Trauma: Pediatric Trauma is Dangerous! Unintentional injuries are the leading cause of death in children. Every hour, 1 child dies from an injury.

Pediatrics 164

Pediatrics Blood Transfusions EMS Fractures 164

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. Cohort Study of the Impact of Time to Antibiotic Administration on Mortality in Patients with Febrile Neutropenia. Radiologypics, P. 2014, November 10).

Infectious Diseases 98

Infectious Diseases Administration Sepsis Anaphylaxis 98

PEMBlog

MAY 24, 2023

Marianne Gausche-Hill New England EMSC: New England Regional Behavioral Health Toolkit Disclaimer The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. 2009 Nov;27(4):655-67, ix. 2009 Jun;21(3):196-202. doi: 10.1016/j.emc.2009.07.003.

Emergency Department 59

Emergency Department Pediatrics Psychiatric Administration 59

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

DECEMBER 18, 2023

Therefore, delayed initiation of vasopressors poses a greater risk for harm than potential extravasation or local tissue ischemia from peripheral administration. 1 The initial vasopressor of choice for septic shock is norepinephrine, as early administration has been shown to increase survival in these patients. units/minute.

Sepsis 90

Sepsis Fluid Resuscitation Resuscitation Shock 90

Taming the SRU

MAY 5, 2023

Despite the complexity and heterogeneity of patients with sepsis, there have been few interventions which have been demonstrated to decrease mortality: early antimicrobial and fluid administration (Levy, Evans et al. 2018, Kuttab, Lykins et al. 2019, Evans, Rhodes et al. 2021, Im, Kang et al. vs 33.2%; OR, 0.42; 95% CI 0.32-0.55;

Sepsis 52

Sepsis Shock Administration Resuscitation 52

EMDocs

JANUARY 16, 2024

Be careful with excessive medication administration. For warmed IV fluids, the Belmont can be used but generally the fluid administration rates will be much lower than for sick trauma patients. Published 2009 Jun 10. This is because medications will accumulate and may only fully metabolize once the patient is normothermic.

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

Cook County EM Blog

MAY 29, 2023

From 2004 to 2009, prescriptions in the US increased by 50%. Analysis of benzonatate overdoses among adults and children from 1969-2010 by the United States Food and Drug Administration. Food and Drug Administration (FDA). The market share of benzonatate amount antitussives increased from 6.3% Pharmacotherapy. doi: 10.1002/phar.1153.

Seizures 52

Seizures Poisoning Resuscitation Administration 52

Pediatric Emergency Playbook

AUGUST 1, 2016

The subcutaneous tissues will swell to a point where you have a steady state fluid administration rate, and as soon as you stop the infusion, the remaining fluid will start to subside as it is absorbed. in 2007 compared subcutaneous administration of lactated ringer’s solution by gravity with and without hyalurondase. Kuensting et al.

Allergic Reactions 52

Allergic Reactions Dehydration Pediatrics Geriatric Emergencies 52

PulmCCM

OCTOBER 30, 2023

If you thought administrators had a bee in their bonnet for SEP-1 before, just wait. Then, in 2009, the condition disappeared completely. Hospital administrators put VAP on the kill list. The stakes are going up. That was the pregame. ICUs, and a popular research focus for academics, generating a steady stream of papers.

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

Don't Forget the Bubbles

JUNE 10, 2024

Use of Probiotics : The administration of probiotics to VLBW infants has shown promise in reducing the incidence of NEC, though the optimal strains and dosages remain under investigation. Careful Advancement of Enteral Feeding : Gradual introduction and advancement of enteral feeds can help minimise the risk of NEC. Fitzgibbons, S.C.,

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

PHEM Cast

APRIL 18, 2016

Following the lecture I found this on Minh’s PHARM website: a review of prehospital ketamine administrations. Blackham & Benger, 2009. Key is to consider environment, perhaps it is unsurprising that patient’s get agitated when the aircraft starts up! Muscle spasm is superior to any artificial method.

Fractures 40

Fractures Operations Administration Shock 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

Pediatric Emergency Playbook

JANUARY 1, 2017

Further, children participate in and absorb their family’s culture and specific personality from a very young age ( Finley 2009 ). Once the pain is controlled, less frequent administration of medications, with frequent reassessments, are indicated. Knowing the context of the episode may help.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

JUNE 3, 2023

Early administration of antibiotics may not be prioritized in the setting of hemodynamic instability but antibiotics are a critical portion of management if open fracture is suspected. Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality. J Clin Orthop Trauma.

Fractures 63

Fractures Resuscitation Operations EMS 63

Dr. Smith's ECG Blog

APRIL 8, 2015

in 2010 EM Clinics of North America (full text link) For an Exhaustive Review of Syncope and its full management outside the ED environment, go to the 2009 European Society of Cardiology Guidelines (full text pdf). Yield of Diagnostic Tests in Evaluating Syncopal Episodes in Older Patients Arch Intern Med 2009 Jul 27; 169:1299-1305.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

RebelEM

NOVEMBER 11, 2024

PMID: 38739397 Clinical Question: In adult patients with suspected sepsis treated empirically, does the administration of piperacillin-tazobactam compared to cefepime affect 90-day mortality? 2009 Dec;37(12):3114-9. 2009 Mar 26;360(13):1283-97. Mortality of Patients With Sepsis Administered Piperacillin-Tazobactam vs Cefepime.

Sepsis 108

Sepsis Outcomes Administration Shock 108

American Medical Compliance

MARCH 19, 2025

It may include all of the key administrative clinical data relevant to that persons care under a particular provider. These and other EHR capabilities are requirements of the meaningful use criteria set forth in the HITECH Act of 2009. A CDS system is one that assists the provider in making decisions with regard to patient care.

Documentation/Coding 52

Documentation/Coding Outcomes Radiology Radiology 52

EMDocs

NOVEMBER 13, 2023

Emerg Radiol 2009, 16 (3), 195-201. Frequency of acute kidney injury following intravenous contrast medium administration: a systematic review and meta-analysis. Acute kidney injury following contrast media administration in the septic patient: A retrospective propensity-matched analysis. ; Gonzalez, R. Schaefer, P. Duhaime, A.-C.;

Stroke 105

Stroke Radiology Radiology Emergency Department 105

EMDocs

JANUARY 22, 2025

What are the pharmacokinetics of naloxone and how do they vary by route of administration? Route of Administration and Pharmacokinetics 7,11-14 Route Dose Onset (minutes) Time to peak effect (minutes) t Duration IV 0.04-2mg* Prehosp Emerg Care , 2009, 13(4):512-5. When should a naloxone infusion be considered? 2mg* 2 5 0.5-1.5

Seizures 96

Seizures Administration Emergency Department Poisoning 96

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. Elsevier; 2009:274-278. 7 Approximately 14.6 million infected people suffer from skin disease and 1.15 2005;4(1):1.

Infectious Diseases 73

Infectious Diseases Emergency Department EMS Administration 73

Taming the SRU

NOVEMBER 13, 2024

opiates or anticholinergics): Use initial nomogram and treat if initial level is above the treatment line. haffner and wright The number of psychiatric emergencies across the U.S.,

Psychiatric 90

Psychiatric Seizures Emergency Department Pediatrics 90