Taming the SRU

FEBRUARY 12, 2024

Given her intracranial hemorrhages, significant attempts were made to improve coagulation including administration of IV vitamin K, 3 units of fresh frozen plasma, and administration of four-factor prothrombin complex concentrate (PCC, Kcentra). However, crucially, this assay must be calibrated to the agent of interest. [8]

Administration 80

Administration Fractures Anaphylaxis Head Injuries 80

EMDocs

AUGUST 3, 2023

IV is usually recommended due to faster onset, ease of administration, and shorter protocol duration. 2010 Aug;48(7):770]. A multicenter comparison of the safety of oral versus intravenous acetylcysteine for treatment of acetaminophen overdose [published correction appears in Clin Toxicol (Phila). Clin Toxicol (Phila).

Poisoning 98

Poisoning Seizures Administration Pediatrics 98

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate administration will increase the pH. * Sodium bicarbonate has historically been used during CPR with the goal of alkalizing blood pH and treating metabolic acidosis. There are a few key assumptions about the use of sodium bicarbonate. * Low pH decreases cardiac function and responsiveness to catecholamines.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

RebelEM

JANUARY 23, 2023

Despite being highly effective in treating acute allergic reactions, first-generation H1 antihistamines cross the blood-brain barrier and bind to H1 receptors, which can lead to undesirable side effects, including drowsiness, sedation, fatigue, and decreased cognition (Church MK 2010). 2010 Apr;65(4):459-66. Epub 2010 Feb 8.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 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. 2010 Apr;38(4):1045–53. 2010 Apr;14(2):145–52. Crit Care Med.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Broome Docs

APRIL 6, 2023

Renal outcomes following intravenous contrast administration in patients with acute kidney injury: a multi-site retrospective propensity-adjusted analysis. 2010 Oct 5;182(14):1527-32. Epub 2010 Aug 23. Am J Emerg Med. 2023 Feb;64:206.e1-206.e3. doi: 10.1016/j.ajem.2022.11.027. 2022.11.027. Epub 2022 Nov 21. Intensive Care Med.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2010; 26:769-781. 2010; 149(3):386-391. 2010; 45:1182-1186. 2010; 28(11):544-548. Plasma levels of lidocaine following nebulized aerosol administration. 2010 Oct;40(4):613-20. . J Emerg Med. 2012; 43(1):49-51. Martin V, Shaw-Smith C. Review of genetic factors in intestinal malrotation. Pediatr Surg Int.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Don't Forget the Bubbles

MAY 29, 2023

Psychological Bulletin [Internet] 2010: 136 :5:894–914. JONA: The Journal of Nursing Administration. Available at: [link] Fehr R, Gelfand MJ, Nag M. The road to forgiveness: A meta-analytic synthesis of its situational and dispositional correlates. Fnais N, Soobiah C, Chen MH, et al. Acad Med [Internet] 2014; 89:5:817-827.

Leadership 98

Leadership Patient Safety Academics Research 98

RebelEM

JANUARY 25, 2023

2010, (Ch) 92: p 1216-1227. Am Surg 2010; 76:687-691. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 Louis, Mosby, Inc., References Taylor MR, Lalani N. Adult small bowel obstruction.

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

ACEP Now

JUNE 14, 2024

Transfers have always been an area of concern to hospital administrators and emergency physicians. percent of patients—twice the rate in 2010 (Table 1). Patients who need inpatient services do not match the index hospitals’ capabilities, or the patient requests such a transfer, or the hospital has no available inpatient space.

Emergency Department 52

Emergency Department Operations Hospitals Leadership 52

The Skeptics' Guide to EM

MARCH 9, 2019

This gap is seen across numerous professions, including law, marketing, administration and medicine. According to one 2010 analysis, the disparity in medicine is one of the highest for any professional industry, trailing only dentistry (5).

Sexual Assault 40

Sexual Assault Academics Research Emergency Department 40

The Skeptics' Guide to EM

JUNE 22, 2019

That episode reviewed a 2010 cohort study done by the Legend of Emergency Medicine, Dr. Ian Stiell. In the United States especially, these patients are often admitted to the hospital with rate control and cardiology decides on cardioversion. In Canada, these patients are often cardioverted and discharged home.

Academics 40

Academics Emergency Department Hospitals EKG/ECG 40

RebelEM

NOVEMBER 2, 2022

2010, (Ch) 90: p 1186-1205. Pneumoniae, Enterococci 3rd Generation Cephalosporin covers vast majority of cases Ceftriaxone 25 mg/kg up to 1 gm daily Cefotaxime 25 mg/kg up to 1 gm Q8 Alternate antibiotic choices Ciprofloxacin 400mg IV BID Levofloxacin 750mg IV daily Piperacillin/Tazobactam 4.5g grams/kg within 6 hours 1.0 Louis, Mosby, Inc.,

EMS 52

EMS Administration Hospitals 52

Dr. Smith's ECG Blog

FEBRUARY 8, 2015

This is a letter to the Editor I wrote in 2010 that was not accepted for publication: It Is Not Surprising that Beta Blockade is not Dangerous in the Setting of Cocaine. University of Pittsburgh, Veterans Administration Medical Center, Pennsylvania 15240. The data in the paper by Rangel et al. is intuitive, and not surprising.

Seizures 52

Seizures Administration Outcomes Hospitals 52

RebelEM

MARCH 22, 2023

An alternate administration approach can be found on ALiEM. 2010, (Ch) 79: p 1034-63. Verapamil (Non-dihydropyridine Calcium Channel Blocker) Class IV antidysrhythmic agent that slow Ca 2+ channels and thus, slow conduction at the AV node and suppresses the SA node. Louis, Mosby, Inc.,

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

RebelEM

MARCH 23, 2023

and IM, and the physician was able to choose the method of administration. This study differed in that the phenobarbital administration was administered in a symptom-triggered protocol as opposed to a bolus. Epub 2010 Mar 25. The protocols in the hospitals in the study included phenobarbital and lorazepam IV, p.o., 2009.10.010.

Emergency Department 52

Emergency Department Outcomes Burns Hospitals 52

EB Medicine

AUGUST 6, 2019

Nachi: However, in 2010, the FDA approved the first DOAC, a real game-changer. Make sure to get the name, dose, and time of last administration of any DOAC. High dose infusions for those on rivaroxaban doses of >10 mg or apixaban doses >5 mg within the last 8 hours and for unknown doses and unknown time of administration.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

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. Take Home Points: There are many causes of neutropenia, chemotherapy being by far the most dangerous. Febrile neutropenia is a condition conveying high mortality.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

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! 2010 Dec;1(2):103-20. Low morbidity and mortality in children with diabetic ketoacidosis treated with isotonic fluids. PMID: 23499379.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

EMDocs

JUNE 8, 2023

and 9 hours after onset of symptoms, with non-infarcted brain tissue, does the administration of alteplase improve functional outcome at 90 days? My take: More date are needed prior to the routine administration of thrombolytic agents in patients presenting between 4.5 Intervention: Alteplase 0.9 in alteplase group versus 0.9%

Stroke 98

Stroke Administration Documentation/Coding Outcomes 98

RebelEM

MAY 22, 2023

In 2010, the United States Food and Drug Administration (FDA) granted approval for intravenous (IV) acetaminophen as a pain management option. Undoubtedly, some patients cannot tolerate oral medications and may benefit from parenteral administration.

Emergency Department 94

Emergency Department Administration Dislocations Hospitals 94

RebelEM

MAY 25, 2023

Lancet 2010 [10] >20,000 adult trauma patients with SBP <90mmHg Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs Placebo given within 8hrs of injury In-hospital mortality by 28d reduced (14.5% 2010; 376(9734):23-32. Intensive Care Med 2020. [13] Lancet (London, England). Intensive Care Med 2020.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

RebelEM

JUNE 26, 2024

CMAJ 2010; 182(15): 1631-5. Definition: A serum potassium level > 5.5 patients can jump from peaked T waves to sine wave) Management Basics: ABCs, IV, O 2 , Cardiac Monitor and, 12-lead EKG Identify + treat underlying cause of hyperkalemia (i.e. rhabdomyolysis -> hydration) Remove inciting factors (i.e. PMID: 20855477 Wrenn K et al.

EKG/ECG 58

EKG/ECG Administration Burns EMS 58

RebelEM

JUNE 19, 2023

PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy? Lancet 2010; 376(9734): 23-32. Article: PATCH-Trauma Investigators and ANZICS Clinical Trial Group.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

RebelEM

JANUARY 29, 2024

PMID: 37188358 Clinical Question: What is the efficacy and safety of low-dose (25mg) prolonged administration (over 6hrs) of alteplase in patients with massive PE? CHEST 2010. Reduced-Dose Systemic Fibrinolysis in Massive Pulmonary Embolism: A Pilot Study. Clin Exp Emerg Med 2023. PMID: 19741062 Kucher N et al. Circ 2014.

Stroke 136

Stroke Outcomes Hospitals Administration 136

EMDocs

JANUARY 17, 2024

The US Food and Drug Administration (FDA) approved benzonatate in 1958 for cough relief in patients ≥ 10 years. 3, 7) The accumulating post marketing adverse event reports led to the FDA release of a Drug Safety Communication (DSC) in 2010, over 50 years after initial approval. (9) McLawhorn MW, Goulding MR, Gill RK, Michele TM.

Poisoning 89

Poisoning Seizures Pediatrics EMS 89

EMDocs

SEPTEMBER 7, 2023

2 Administration of an alcohol dehydrogenase (ADH) inhibitor, such as fomepizole, is recommended in suspected or known DEG poisoning. 1, 2010, pp. In-Vivo Evidence of Nephrotoxicity and Altered Hepatic Function in Rats Following Administration of Diglycolic Acid, a Metabolite of Diethylene Glycol.” Accessed August 2022.

Poisoning 91

Poisoning CDC Administration Emergency Department 91

Cook County EM Blog

MAY 29, 2023

This subsequently led the FDA to issue a Black Box Warning in 2010 which warned that the capsules resemble candy and may be visually appealing to young children. Analysis of benzonatate overdoses among adults and children from 1969-2010 by the United States Food and Drug Administration. Food and Drug Administration (FDA).

Seizures 52

Seizures Administration Resuscitation Poisoning 52

ACEP Now

AUGUST 28, 2024

TeamHealth, which is a physician staffing and contract management company owned since 2010 by the private equity firm Blackstone, has managed the emergency department at Ascension St. His article in MedPage Today last year cites support for unionization from an unlikely source, a frustrated hospital administrator.

Emergency Department 98

Emergency Department Hospitals Patient Safety Leadership 98

ACEP Now

SEPTEMBER 3, 2024

Private equity investment in health care has increased more than 20-fold since 2000, with 70 percent of this activity since 2010. The AMA found that administrative burden of reimbursement and low rates were the most frequent factors in physicians’ decisions to sell their practices.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

Advanced Emergency Nursing from AENJ

APRIL 29, 2015

In 2010, the AHA recommendation for pediatrics was : ”Hyperoxia can be toxic, particularly to the preterm infant. It may be reasonable, when the appropriate equipment is available, to titrate oxygen administration to maintain the arterial oxyhemoglobin saturation ≥94%. Has oxygen administration delayed appropriate respiratory care?

Resuscitation 40

Resuscitation Pediatrics Administration Emergency Nursing 40

The Skeptics' Guide to EM

OCTOBER 17, 2020

Background: The CRASH-2 trial, published in 2010, showed a 1.5% Clinical Question: Does pre-hospital administration of TXA to patients with moderate or severe traumatic brain injury improve neurologic outcomes at 6 months? Other injuries appear minimal with some abrasions from the fall. Reference: Rowell et al.

EMS 52

EMS Head Injuries Outcomes Hospitals 52

Northwestern EM Blog

JANUARY 24, 2022

At those levels, bicarbonate administration has not been shown to improve cardiac output, MAP or pressor response. For example, a patient in cardiogenic shock will likely worsen with the administration of fluids and the wrong vasopressors. 2010; 36: 2019-2029. Alternate Shock Not all shock is declared equal. 2007; 25: 309-331.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

The Skeptics' Guide to EM

JANUARY 19, 2019

Wave 2: Rapid increase in overdose deaths involving heroin starting in 2010. However, we were conservative in our bottom line recognizing there are patients that can be safely discharged home after an opioid overdose and administration of naloxone. Opioids depress the heart rate and breathing, and overdoses can result in death.

EMS 52

EMS CDC Emergency Department Hospitals 52

Downeast Emergency Medicine

APRIL 26, 2021

2][3] If earlier treatment with TXA is better, would there be benefit in its administration in the prehospital setting? Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. If so, could this be done safely? These questions are asked in the first paper that we reviewed.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

EMDocs

APRIL 22, 2024

The Accu-Chek was 214, and there was no response to empiric Narcan administration. 2010 Apr;38(4 Suppl):S495-501. Advanced cardiac life support (ACLS) had been initiated and on arrival at the ED, the patient was found to have Pulseless Electrical Activity (PEA). link] Beckman MG, Hooper WC, Critchley SE, Ortel TL. Am J Prev Med.

Ultrasounds 98

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

Mind The Bleep

MAY 12, 2023

Administration of human albumin solution (HAS) in SBP reduces the incidence of renal failure by 72% and mortality by 47%. In those who are grossly obese, it may be better to employ a more cautious approach with regard to albumin administration. 2010 Feb;12(1):1-6. Lancet Gastroenterol Hepatol. 2020 Mar;5(3):245-66. 1964;1:1-85.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52