RebelEM

JANUARY 18, 2024

It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Background: Sepsis remains one of the leading causes of morbidity and mortality. to 0.97; p = 0.02 Length of ICU Stay 906 patients Prehospital Abx: 300 pts No Prehospital Abx: 606 pts Pooled Mean Difference 0.11; 95% CI -1.85

Sepsis 121

Sepsis Hospitals Administration Outcomes 121

The Skeptics' Guide to EM

JULY 29, 2023

This has evolved due to recognition of some of the adverse effects of immobilization as well as limitations to its benefits. Some of this research has observed substantial under-treatment among patients who met criteria for precautions, as well as some patients with confirmed injuries who received no treatment from EMS [15-16].

Head Injuries 81

Head Injuries EMS Research Emergency Department 81

EMDocs

FEBRUARY 7, 2024

healthcare workers previously remained low and relatively stagnant between 2009 and 2021. Unionization of healthcare providers can create opportunities to improve staff’s financial and general well-being, but may also facilitate future strikes. Trends in labor unionization among US health care workers, 2009-2021.

Hospitals 76

Hospitals Research Wellness Patient Safety 76

The Skeptics' Guide to EM

JULY 8, 2023

She looks well enough to go home but asks if she should be prescribed oseltamivir (Tamiflu) because some of her friends have been given it recently by their doctors. Safety issues popped up soon after widespread use of the drug including neuropsychiatric effects as well as the more common adverse effects of nausea and vomiting.

CDC 95

CDC Hospitals EMS Emergency Department 95

ALiEM

JANUARY 22, 2024

The patient also complained of shortness of breath for one week associated with a dry cough, as well as an altered sensorium for one day. 2009 Jan;11(1):66-72. Fever was documented to be 102°F and was not associated with any chills or rigors. He was then extubated and discharged after 27 days. Infect Dis Clin North Am. 2007.08.002.

Documentation/Coding 64

Documentation/Coding Academics Emergency Department Hospitals 64

Cook County EM Blog

MAY 1, 2023

Findings suggestive of septic bursitis include complex fluid in the bursa with septations (as seen in this case), as well as hyperemia on color flow doppler or gas. 2009 Jun 25. 2009 Oct;37(3):269-272. Ultrasound is often a more useful imaging modality and is readily available at the bedside. emDocs.net. Skeletal Radiol.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Outcomes 52

EMDocs

SEPTEMBER 7, 2023

DGA concentrates in the kidney tissue and causes nephrotoxicity, as well as neurotoxicity. Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. Fatal Poisoning Among Young Children from Diethylene Glycol-Contaminated Acetaminophen — Nigeria, 2008—2009”.

Poisoning 65

Poisoning CDC Administration Emergency Department 65

Taming the SRU

APRIL 14, 2024

You may place cold packs or ice packs to the hernia site to help reduce inflammation and swelling, as well as to assist in local analgesia. Symptoms include persistent tenderness in the area, as well as symptoms of obstruction including nausea, vomiting, and pain, despite reduction. (2) 4, 1 July 2009, p. 6, June 2005, pp.

Ultrasounds 86

Ultrasounds Emergency Department Pediatrics Radiology 86

ALiEM

SEPTEMBER 29, 2023

Additional Images Physical Exam General : Well-appearing male in no distress Neck : Hemostatic wound to his left neck. 2009 Nov;67(5):1046-1050. He now presents requesting “Neosporin.” ” His tetanus status is out of date. No significant pain, no hematoma, no bruits. The Journal of Trauma. DOI: 10.1097/ta.0b013e3181b83b63.

Radiology 70

Radiology Radiology Academics Ultrasounds 70

PEMBlog

OCTOBER 18, 2023

The night prior to presentation, mom noticed he was not feeding as well and seemed fussy. Initially in the emergency department he was generally well-appearing with normal vital signs. Infants with NTED generally remain well-appearing and do not meet toxic shock syndrome (TSS) criteria. Overnight, she had to wake him to feed.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

EMDocs

JUNE 22, 2024

The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. Romero (2009). A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. She had a precipitous delivery while the ambulance was pulling in. Triage vital signs (VS) include BP 88/45, HR 121, T 97.1,

EMS 96

EMS Resuscitation Seizures Blood Transfusions 96

ALiEM

MAY 13, 2024

They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. Larger abscess with well-circumscribed borders D. Superficial abscess with well-circumscribed borders Table 1. Epub 2009 Aug 8. The rim may be echogenic or blend in with surrounding tissue.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

RebelEM

FEBRUARY 22, 2023

Giant Cell Arteritis (arteritic anterior ischemic neuropathy) ( Bagheri 2015 , Hayreh 2009 ) Pathophysiology Giant cell arteritis(GCA) affects that medium-sized and large arteries. T-cell-dependent disease. Predilection to involve the posterior ciliary artery.

Emergency Department 52

Emergency Department EMS Wellness 52

PulmCCM

JUNE 10, 2024

” Time-Limited Trials of Critical Care Time-limited trials of intensive care were suggested at least as far back as 2009 as a method of bridging the divide between clinicians and families' perspectives and expectations for ICU care. 2009 Nov;37(11):2888-94; quiz 2904. 2009 Fall;20(3):212-9. Crit Care Med. doi: 10.1097/CCM.0b013e3181ab86ed.

COPD 45

COPD Outcomes Hospitals EMS 45

Don't Forget the Bubbles

AUGUST 23, 2023

Definitive emotional support is critical to our emotional and psychological well-being. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. Psychological harm occurs. To limit the psychological harm, perhaps we should implement THE PAUSE.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

Pediatric EM Morsels

AUGUST 18, 2023

From 2001 to 2009, in a pediatric hospital gram negative culture showed a drop in sensitivity to ciprofloxacin from 96% to 93%. (Jackson 2016) It can also be used in UTIs , but is typically reserved for special cases where the infectious bacteria is found to be multidrug resistant or in complicated UTIs.

Pediatrics 130

Pediatrics Infectious Diseases Hospitals Seizures 130

SheMD

OCTOBER 22, 2023

I had to sign a contract at the start promising that I wouldn’t work during medical school so that I could focus on becoming a well-trained physician. I bought an inexpensive car my first year of medical school, paid it off, and refuse to buy a new vehicle until this little 2009 Nissan Versa dies on me.

Wellness 52

Wellness Academics 52

EMDocs

JULY 9, 2024

Addressing social determinants of health at well child care visits: a cluster RCT. 2009 Mar;123(3):858-64. JAMA Pediatr. 2016 Nov 7;170(11):e162521. doi: 10.1001/jamapediatrics.2016.2521. Epub 2016 Nov 7. PMID: 27599265. Garg A, Toy S, Tripodis Y, Silverstein M, Freeman E. Pediatrics. 2015 Feb;135(2):e296-304. doi: 10.1542/peds.2014-2888.

Pediatrics 71

Pediatrics Emergency Department Research Burns 71

Don't Forget the Bubbles

FEBRUARY 19, 2024

The Role of Gaming in Emotional Well-being Stress Relief: Gaming can be a form of relaxation and stress relief, providing an escape from the pressures of daily life. A study by Russoniello, O’Brien, and Parks (2009) demonstrated that playing casual video games effectively reduced stress and improved mood among participants.

Academics 59

Academics Leadership Research Teamwork 59

EMDocs

JUNE 25, 2024

Consider escharotomy if there is any issue with perfusion or neurologic deficit, as well as difficult ventilation in the intubated patient. National Burn Repository 2019 Update, Report of data from 2009–2018. Location: evaluate the neurovascular status in an extremity with circumferential or near circumferential burn injury.

Burns 73

Burns Fluid Resuscitation Resuscitation Poisoning 73

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. Int J Emerg Med 2009 PMID: 20157465 4. World J Emerg Surg 2023 PMID: 36918947 3.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

Dr. Smith's ECG Blog

SEPTEMBER 26, 2023

This retrospective observational cohort study considered consecutive STEMI patients from May 02, 2009 to December 31, 2018. But this is not what we see in the chest leads with BLUE arrows that instead suggest slight-but-real ST depression that may well indicate associated posterior OMI.

EKG/ECG 107

EKG/ECG Hospitals Outcomes Wellness 107

Critical Care Now

APRIL 21, 2022

Because HD, and subsequently CRRT, have been around for many years, dosing recommendations for medications are generally well established when using these modalities. Clin Infect Dis 2009; 49:433-7. However, there is another modality which is a hybrid of HD and CRRT – prolonged intermittent renal replacement therapy (PIRRT).

Burns 52

Burns Administration Outcomes Hospitals 52

EMDocs

FEBRUARY 7, 2024

Multiple well-designed, multicenter, multinational studies suggest GLP-1 agonists are associated with improved glucose control in diabetes type 2 and approximately a 15% reduction in weight over 1-2 years (around 2/3s of patients regain weight if treatment is stopped). 2009 Jun;160(6):909-17. Obesity affects over 40% of U.S.

Allergic Reactions 74

Allergic Reactions Anaphylaxis Dehydration Wellness 74

Greater Sydney Area HEMS

APRIL 26, 2023

Both the stuff of legend and go by multiple names including harness hang syndrome and orthostatic intolerance, as well as bigfoot and the abominable snowman, respectively. A literature search on ST as recently as 2009 yielded only 5 articles, as compared to thousands of non-medical commentaries. That’s it? I haven’t finished.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Shock Research Operations 52

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

ACEP Now

JANUARY 12, 2024

7 Postvoid residual urine volume and levels of prostate-specific antigen are useful for diagnostic purposes, as well as possible CT scan or ultrasound to evaluate for an enlarged and inflamed prostate. New York, NY: McGraw Medical; 2009:475-81. 6 Some studies estimate that E. Coyle EA, Prince RA. Pharmacotherapy in Primary Care.

Infectious Diseases 52

Infectious Diseases Ultrasounds Wellness Hospitals 52

Taming the SRU

NOVEMBER 14, 2023

A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6 B) on right: hand drawn images of layers of ear demonstrating auricular hematoma The epidemiology and incidence of ED presentation for auricular hematomas has not been well-studied because it is a relatively uncommon condition.

Emergency Department 86

Emergency Department Pediatrics Wellness Documentation/Coding 86

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

Dr. Smith's ECG Blog

JUNE 8, 2023

There were trends toward larger infarct size with delayed angiography, both by cMR and integral high-sensitivity troponin concentration, as well as toward higher rate of major adverse cardiovascular events (MACE) (8.5 Eur Heart J 2009 4 Lemkes et al. vs. 2.9%; P  = 0.28) in the delayed group. Int J Cardiol 2016 3. Busk et al.

EKG/ECG 61

EKG/ECG Documentation/Coding EMS Emergency Department 61

Dr. Smith's ECG Blog

NOVEMBER 19, 2022

1] If we look at the patient’s previous EKG on record, we’re able to see that this pattern is not new: Interestingly, the patient does appear to have PVCs in this ECG as well as WPW beats. Ultimately, our patient was determined to have a mild CHF exacerbation and diuresed well in response to IV furosemide. Epub 2009 Sep 29.

EKG/ECG 52

EKG/ECG Stroke Emergency Department Wellness 52

The Skeptics' Guide to EM

MAY 12, 2018

Bell distinguished these cases of extreme agitation from delirium tremens, diseases of the meninges and advanced typhoid based on a list of clinical criteria, as well as autopsy results from the brains and intestines of the patients.

Psychiatric 52

Psychiatric Emergency Department Hospitals Wellness 52

The Skeptics' Guide to EM

JUNE 4, 2017

Huber-Wagner et al ( Lancet 2009 ) showed a mortality reduction in a retrospective database study of patients who have had a pan scan. The NNT varied from 17 to 32 according to the injury severity.

Radiology 52

Radiology Radiology CPR Hospitals 52

The Skeptics' Guide to EM

OCTOBER 22, 2017

A systematic review by Wijesinge et al from 2009 found only two randomized control trials looking at supplemental oxygen. The Cochrane authors said that a well-designed RCT is needed due to the uncertainty of routinely using supplemental oxygen in patients with acute myocardial infarctions.

Hospitals 52

Hospitals EKG/ECG Wellness 52

Don't Forget the Bubbles

FEBRUARY 26, 2024

Increasing PEEP is thought to cause bronchodilation by providing direct mechanical stimulus as well as secondary stimulation through pulmonary stretch receptors coupled with activation of the non-cholinergic parasympathetic pathway. Changes in the use of invasive and noninvasive mechanical ventilation in pediatric asthma: 2009–2019.

Pediatrics 72

Pediatrics Research Documentation/Coding Outcomes 72

The Skeptics' Guide to EM

OCTOBER 7, 2017

Current evidence and clinical standards for acute management of simple sprains (Grade I and II) is limited and not well defined. BMJ 2009 * Janssen et al. Ankle sprains are one of the most common and burdensome injuries and are associated with a high rate of visits to an emergency department. Hupperets et al. Hupperets et al.

Urgent Care 40

Urgent Care Emergency Department Fractures Wellness 40

Pediatric Education

NOVEMBER 12, 2023

weeks was seen for well-care. 2009-0559 Davis NL. Patient Presentation A former 35 week, appropriate for gestational age male, now 37.5 He had regained his birth weight and was gaining weight appropriately while being fed 22 kcal/ounce premature infant formula, every 2-2.5 Pediatrics. 2009;123(5):1424-1429. doi:10.1542/peds.2009-0559

Pediatrics 40

Pediatrics Hospitals Poisoning Documentation/Coding 40