RebelEM

JANUARY 24, 2024

Wallace 2011 ) If addressed early and appropriately, most patients have good self-reported long-term outcomes regardless of the treatment modality Links Orthobullets: Achilles Tendon Rupture Resources: Sheth U et al. J Bone Joint Surg Br 2011; 93(10):1362-6. PMID: 21969435 Erickson BJ. Orthop J Sports Med.

Operations 101

Operations Ultrasounds Fractures Outcomes 101

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St.

Stroke 99

Stroke Outcomes EMS Seizures 99

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below). to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 136

Stroke Outcomes Hospitals Administration 136

RebelEM

SEPTEMBER 23, 2024

However, it is well-established that even a single dose of etomidate can cause adrenal suppression ( Albert 2011 ). Proponents of its use often dismissed this effect of the drug as there had never been any evidence it impacted clinical outcomes. appeared first on REBEL EM - Emergency Medicine Blog. Intensive Care Med.

EMS 77

EMS Outcomes Resuscitation Wellness 77

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? first appeared on The Skeptics Guide to Emergency Medicine.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

EMDocs

JANUARY 3, 2024

10 Evidence For nearly a decade, the only randomized controlled trial with insight into the effectiveness of CardioMEMS TM was the 2011 CHAMPION trial. Remote Monitoring With Appropriate Reaction to Alerts Was Associated With Improved Outcomes in Chronic Heart Failure: Results From the OptiLink HF Study. 2011 Feb 19;377(9766):658-66.

Allergic Reactions 113

Allergic Reactions Hospitals EMS Emergency Department 113

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 4, 8 Paper: Dahyot-Fizelier, C.,

CDC 122

CDC Radiology Radiology Head Injuries 122

Taming the SRU

SEPTEMBER 25, 2023

This places a significant responsibility on the EM physician to diagnose and treat fractures. Specifically, EM physicians should be able to recognize fractures that will likely require operative management and facilitate close follow up, such as a Maisonneuve fracture. 2011 Jan-Feb;50(1):62-7. screws for medial malleolus.

Fractures 101

Fractures Operations Emergency Department EMS 101

PHEM Cast

APRIL 16, 2018

The outcomes from different resuscitative interventions in a haemorrhagic shock model in porcine model: From: Watts et al. Critical Care; 2011. Survival and neurological outcome after OOH TCA in pediatric & adult populations: a systematic review. Anneals of EM; 2015: 297-307. 2011; 82: 1138-43. Doi: 1098/rstb.2010.0232

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

ALiEM

OCTOBER 30, 2024

Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. Our experience: It was not long ago that we instructed our staff that: ‘COWS >8, give ’em 8 (mg of buprenorphine).’ 2011 Dec;6:1-4. They report insufflating ‘a bundle’ of tranq dope per day. 2023 Jan 1;53(1):140-2.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

RebelEM

MARCH 22, 2023

Amal Mattu’s ECG Blog has an excellent review of AVNRT vs. VT and REBEL EM reviews the sensitivity and specificity of various algorithms. Multiple studies comparing verapamil to adenosine demonstrate equal efficacy of either agent with verapamil causing more hypotension ( Delaney 2011 , Hood 1992 ) Dose: 0.07 2011; 18(3): 148-52.

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

RebelEM

FEBRUARY 12, 2024

2011; 18(7):699-707. CT in Detecting Urinary Tract Calculi: Influence on Patient Imaging and Clinical Outcomes Radiology. appeared first on REBEL EM - Emergency Medicine Blog. Radiological Imaging of Patients With Suspected Urinary Tract Stones: National Trends, Diagnoses, and Predictors. Gottlieb RH, La TC, Erturk EN, et al.

Radiology 77

Radiology Radiology Emergency Department Ultrasounds 77

PHEM Cast

DECEMBER 12, 2016

Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. Joint Position Statement of Nat Assoc EMS Physicians and ACS Committee on Trauma. Resuscitation; 2011: 1194-1197 Emergency thoracotomy in thoracic trauma: a review. Injury; 2006 (37): 1-19. Clay et al. Rhee et al.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

The Skeptics' Guide to EM

DECEMBER 7, 2018

You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). There was also no increase in survivors with good neurological outcomes with ACLS. published in Resuscitation 2011. Jenn Doyle is a paramedic educator at Middlesex-London Paramedic Service.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 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

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Case: You are the medical director of an EMS system in a large city deciding on whether to respond to all out of hospital cardiac arrests (OHCA) with ACLS capabilities, or if resources should be directed to those candidates for extracorporeal CPR. You need to recognize an arrest and activate your EMS system. vs. 5.1%, p=0.83).

CPR 52

CPR Academics Resuscitation Hospitals 52

SheMD

APRIL 30, 2023

Emergency Medicine (EM) physicians work a shift-work schedule, which may have implications for fertility. Additionally, infertility in female physicians is an issue for how we mentor women in their careers, for burnout and for recruiting more women into the field of EM. What were their outcomes: Impaired fecundity was found in 24.9%

CDC 52

CDC EMS Outcomes 52

EMDocs

AUGUST 22, 2024

Certified interpreter use can improve communication and patient outcomes. Conducting research regarding best practices for improving health outcomes for NELP patients. Pearls NELP patients have worse health outcomes despite widespread language-access policies. February 2011. Youdelman M. National Health Law Program.

Documentation/Coding 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

ACEP Now

AUGUST 1, 2023

Factoring such, an order to transfer the patient immediately by ground or air EMS is the only actual support per se these non-physicians receive. Quillen College of Medicine (2003) Response The workforce study shook the foundation of emergency medicine (EM). The workforce dilemma is a challenge we will face for years to come.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

RebelEM

JUNE 5, 2023

One study from a county in Massachusetts found that of all nonfatal opioid doses seen in the emergency department from 2011-2015, 1 in 20 patients subsequently died within one year of initial visit with 66% of these deaths being directly related to an opioid overdose (4). mg tablet) 1 Buprenorphine 0.5

Emergency Department 97

Emergency Department Hospitals Outcomes EMS 97

PHEM Cast

APRIL 21, 2021

The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. Difficult prehospital endotracheal intubation – predisposing factors in a physician based EMS. 2011 Dec;82(12):1519-24. Epub 2011 Jul 2. J Trauma 2003; 54:444-453 Mort TC. Resuscitation. 2011.06.028.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

EMDocs

JANUARY 4, 2024

Whole bowel irrigation: 3 Not routinely performed and limited evidence to support improved outcome in general. 2011; 109: 418-422. Clinical characteristics and outcomes associated with bupropion overdose: a Canadian perspective. Remember patients must be able to protect their airway/be intubated and have active bowel sounds.

Seizures 92

Seizures EKG/ECG Poisoning Shock 92

PHEM Cast

APRIL 10, 2016

And from our buddies at HEFT EM CAST: [link] A bit more detail covering some of the research in an easy to understand way. This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. 2011 Aug 30;18(9):934–40.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

RebelEM

SEPTEMBER 15, 2022

PMID: 23131078 For More Thoughts on This Topic Checkout: PulmCrit: PulmCrit Hot Take – Acetazolamide Plus Furosemide for Decongestion of Heart Failure (ADVOR Trial) Post Peer Reviewed By: Frank Lodeserto, MD The post The ADVOR Trial: Acetazolamide in Acute Decompensated Heart Failure appeared first on REBEL EM - Emergency Medicine Blog.

Hospitals 52

Hospitals Outcomes EMS 52

PulmCCM

JUNE 10, 2024

Background I’m not sure if you’ve noticed this, but patients and families frequently disagree with their physicians about the likely outcomes from critical illness. A suggested schema for time-limited trials was suggested by Quill and Holloway in 2011 in JAMA. Expectations and outcomes of prolonged mechanical ventilation.

COPD 45

COPD Outcomes Hospitals EMS 45

Taming the SRU

SEPTEMBER 8, 2023

NAC: Jiang SX, Hussaini T, Yoshida EM. Prognosis of acute severe autoimmune hepatitis (as-AIH): The role of corticosteroids in modifying outcome.” 16, 2011, p. “Acute Liver Failure: Evidence-Based Evaluation and Management.” emDOCs.Net - Emergency Medicine Education, 26 Nov. Saudi J Gastroenterol. 2022 Mar-Apr;28(2):85-91.

Radiology 59

Radiology Radiology Ultrasounds EMS 59

RebelEM

SEPTEMBER 11, 2023

Outcomes: Primary: Percent change in management decisions after introducing the Radiology Department RUQ US. 2011 Mar;18(3):227-35. appeared first on REBEL EM - Emergency Medicine Blog. References: Ross M, Brown M, McLaughlin K, Atkinson P, Thompson J, Powelson S, Clark S, Lang E. Acad Emerg Med. PMID: 21401784.

Ultrasounds 68

Ultrasounds Radiology Radiology Emergency Department 68

Dr. Smith's ECG Blog

AUGUST 23, 2017

Ventricular slowing l50 Joules, Ibutilide/Amiodarone lDiltiazem slows at AV node Procainamide before Diltiazem is dangerous it will slow the atrial rate and allow for 1:1 conduction results in a FASTER ventricular rate See this case: Wide complex tachycardia at a rate of 270 Relevant literature Emergency Department Management and 1-Year Outcomes of (..)

Stroke 52

Stroke Sepsis Emergency Department EMS 52

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. This is a critical error that leads to poorer outcomes for patients in need of critical care. 2011 Feb 15; Epub 2010 Aug 27. REFERENCES: Acute Respiratory Distress Syndrome Network et al.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

RebelEM

MARCH 23, 2023

The primary outcome, hospital length of stay, was significantly shorter both before and after propensity score adjustment for the phenobarbital group. A broad range of variables were included that potentially influences treatment decisions and/or outcomes. The protocols used in the study were using symptom-driven medications.

Emergency Department 52

Emergency Department Outcomes Burns Hospitals 52

ACEP Now

JUNE 7, 2023

Background DHH patients experience disparities in social outcomes as well as health inequities. However, little research has been done to compare ED-focused outcomes for these two groups of patients. 1 This is likely due to audism, which creates privilege for non-DHH people in our society. 1,6 Reference: James TG, et al.

Emergency Department 52

Emergency Department Outcomes Research Academics 52

RebelEM

NOVEMBER 3, 2022

Albert 2011, Jabre 2009) However, the existing literature comparing etomidate and ketamine is conflicting. Outcomes: Primary Outcome: Incidence of post-induction hypotension Secondary Outcome : First-pass success rate of endotracheal intubation Primary Results: 84 articles were identified for potential inclusion.

Outcomes 52

Outcomes Emergency Department Sepsis Operations 52

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

now an EM resident at Beth Israel. However, none of the formulas have proven to be definitively better than another and none are well correlated with outcomes or events! None is considered definitive due to the paucity of data (and conflicting data) relating QTc to outcomes. The article is written by Dr. Smith and Dr. Friedman.

EKG/ECG 52

EKG/ECG Outcomes Wellness Hospitals 52

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. From 2010 to 2011, the number of ED visits by children aged 12 to 17 years old due to synthetic cannabinoid use also has doubled.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

OCTOBER 5, 2024

We’ll keep it short, while you keep that EM brain sharp. 12 Complications Inadequate empiric therapy can lead to treatment delays and worse outcomes. Imipenem confers highest risk of seizures ESBL-E are often hospital acquired infections and can prolong hospital stay or lead to worse outcomes. Microb Drug Resist 2011; 17:267.

EMS 97

EMS Infectious Diseases Sepsis Hospitals 97

EMDocs

DECEMBER 16, 2023

We’ll keep it short, while you keep that EM brain sharp. A 34-year-old male is brought via EMS after collapsing during an outdoor adventure race. EMS reports the patient was conscious but altered, with slurred speech and confusion. The post EM@3AM: Hyperthermia appeared first on emDOCs.net - Emergency Medicine Education.

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Epub 2011 Dec 12. Open Access Emerg Med. 2020 Apr 15;12:87-92.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98