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 125

CDC Radiology Radiology Outcomes 125

Don't Forget the Bubbles

JANUARY 24, 2024

Mortality is high, between 16-43.5% , and neurological outcomes are generally poor amongst survivors. These poor outcomes are related to both the SRSE itself and as a result of the prolonged PICU stay. One study suggests remission in 6 out of 7 patients where it was used, but long-term clinical outcomes remained poor.

Seizures 111

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 111

PulmCCM

JUNE 12, 2023

TTM2 found no improvement in survival or neurologic outcome among patients randomized to cooling to a target of 33 °C, as compared to controls receiving fever prevention (e.g. with acetaminophen) until temperatures reached 37.8 °C who then received external cooling to maintain a target temperature of 37.5 °C.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

Sensible Medicine

AUGUST 19, 2024

NEJM published STITCH in 2011. One of the core ideas in cardiology is that improving blood flow to a heart with severe reduction of flow due to coronary stenoses will improve outcomes. Over 5 years of follow-up, the authors reported no significant difference in the primary outcome of all-cause death. The median EF was 28%.

Outcomes 95

Outcomes Ultrasounds Wellness 95

Emergency Medicine Journal

JANUARY 22, 2024

We assessed safety and efficacy data from 10 years (2011–2021) of our N 2 O PPS programme. Contributing factors for these outcomes were assessed via regression analysis and compared between different N 2 O concentrations, N 2 O in combination with INF, and for physician versus nurse administered sedation.

Emergency Department 40

Emergency Department Outcomes 40

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. The effect of etomidate on adrenal function in critical illness: a systematic review.

EMS 79

EMS Outcomes Resuscitation Wellness 79

The Skeptics' Guide to EM

JANUARY 20, 2024

The American Academy of Pediatrics ( AAP ) released guidelines for the management of febrile infants and children 2 to 24 months back in 2011 [2]. UTIs are one of the most common bacterial infections in childhood that we see in the emergency department [1].

Pediatrics 71

Pediatrics Anaphylaxis Emergency Department Outcomes 71

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. 2011; 82: 1138-43. Ultrasound during TCA: Cureton et al. Doi: 1098/rstb.2010.0232

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

EMDocs

JANUARY 29, 2024

Finally, anticipating and addressing known complications such as seizures, increased intracranial pressure, or cerebral edema with appropriate measures, including antiepileptic drugs or osmotic agents, is essential for improving patient outcomes. Lowering the MAP may mitigate these risks and possibly improve outcomes. doi: 10.1161/01.str.0000014509.11540.66.

Stroke 74

Stroke Outcomes EMS Seizures 74

Don't Forget the Bubbles

JUNE 17, 2024

High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. At its heart lies an unpleasant reality- a critically unwell child with an anxious carer hoping for a positive outcome. 2011 Apr 1;78(2):202-9. Civility Saves Lives The impact of incivility in healthcare cannot be understated.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

The Skeptics' Guide to EM

OCTOBER 14, 2023

That episode reviewed the 2011 Fleming et al systematic review for the normal ranges of HR and RR in children from birth to 18 years of age. Does he have sepsis?” Background: We have looked at pediatric vital signs on the SGEM back in 2014 with PedEM superhero Dr. Anthony Crocco ( SGEM#98 ).

Pediatrics 86

Pediatrics Sepsis Urgent Care Emergency Department 86

RebelEM

FEBRUARY 12, 2024

2011; 18(7):699-707. CT in Detecting Urinary Tract Calculi: Influence on Patient Imaging and Clinical Outcomes Radiology. Radiological Imaging of Patients With Suspected Urinary Tract Stones: National Trends, Diagnoses, and Predictors. Gottlieb RH, La TC, Erturk EN, et al. 2002; 225(2):441-449.

Radiology 82

Radiology Radiology Emergency Department Ultrasounds 82

Pediatric Emergency Playbook

OCTOBER 1, 2017

2011; 7:491-500. Journal of Chemical Neuroanatomy; 2011; 42: 288–296. Outcomes of Children Bridged to Heart Transplantation With Ventricular Assist Devices: A Multi-Institutional Study. 2011; 58(11):1183–90 Fraser CD, Jaquiss RDB, Rosenthal DN et al. J Neurosurg Pediatrics. Groves DA, Brown VJ. 2005; 29: 493–500.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

Don't Forget the Bubbles

MAY 6, 2024

Outcomes included clinical status when urine culture was available, subsequent antibiotic treatment within seven days and subsequent UTI within 30 days. The primary outcome was the successful intubation on the second attempt. Secondary outcomes included tracheal intubation adverse events (TIAEs) or severe desaturation.

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

Taming the SRU

SEPTEMBER 25, 2023

Functional outcome of bimalleolar ankle fractures treated with fibular plate for lateral malleolus and C.C. Functional outcome of bimalleolar ankle fractures treated with fibular plate for lateral malleolus and C.C. 2011 Jan-Feb;50(1):62-7. Figure 1 highlights the mechanism of injury and range of severity. Abhiraj Patel.

Fractures 100

Fractures Emergency Department Operations EMS 100

RebelEM

MARCH 22, 2023

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. Can J Cardiol 2011; 27(1): 105-9. Can J Cardiol 2011; 27(1): 105-9. Am J Emerg Med 2011; 29(5): 545-8. Eur J Emerg Med.

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

Don't Forget the Bubbles

AUGUST 7, 2023

The controversy around what is ‘normal’ in infants’ and children’s vitals was demonstrated in a 2011 systematic review by Fleming et al. The study also did not assess outcomes for each patient, and as such, the impact on deviation from the normal range was not explored. Yes Was the outcome accurately measured to minimize bias?

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

PHEM Cast

DECEMBER 12, 2016

Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. Resuscitation; 2011: 1194-1197 Emergency thoracotomy in thoracic trauma: a review. Injury; 2006 (37): 1-19. Clay et al. World Journal of Emergency Surgery; 2006: 1:4. Rhee et al. J Am Coll Surg; 2000.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

Taming the SRU

JULY 3, 2023

Population 7180 noncritical febrile infants ≤60 days old presenting to a PECARN ED (list of centers: [link] ) between March 2011 and April 2019. Their last outcome was determining the prevalence of IBI in febrile infants with a positive UA who were deemed low risk by the PECARN febrile infant rule.

Pediatrics 90

Pediatrics Research Outcomes 90

Resus Review

OCTOBER 9, 2015

Long-term clinical outcomes after unprotected left main trunk percutaneous revascularization in 279 patients. Acute and late outcomes of unprotected left main stenting in comparison with surgical revascularization. (Le Lancet 1994;344:563–70. Tan WA, Tamai H, Park SJ, et al. ULTIMA) Circulation 2001;104:1609–14.

Stroke 52

Stroke Ultrasounds Outcomes 52

PHEM Cast

FEBRUARY 25, 2021

Prognostication Better outcomes: Rescued and BLS commenced < 5-10 min Children Those who have not aspirated Water temperature < 10 o C, core body temperature 33-35 o C Neurologically intact on arrival at hospital Minimum blood pH > 7.1, Tipton & Golden (2011). New Engl J Med. 366: 2102–10. Resuscitation. 82: 819-824.

Resuscitation 52

Resuscitation Hospitals Outcomes Wellness 52

Sensible Medicine

APRIL 16, 2024

The tool developed on the PLCO participants was used to analyze the CXRs of outpatients taken in 2010 or 2011 at 1 of 2 hospitals ( The General or The Brigham ). The primary outcome was incident MACE within 10 years of the CXR in populations who either did or did not have data from which ASCVD could be calculated.

Radiology 80

Radiology Radiology Stroke Hospitals 80

Taming the SRU

SEPTEMBER 1, 2023

for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 94

Sepsis Documentation/Coding Fractures Administration 94

The Skeptics' Guide to EM

DECEMBER 7, 2018

There was also no increase in survivors with good neurological outcomes with ACLS. published in Resuscitation 2011. Clinical Question: Does the use of epinephrine in cardiac arrest improve survival rates with a favourable neurological outcome? JAMA 2009, Hagihara et al. Reference: Perkins et al.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

ACEP Now

OCTOBER 9, 2024

In the emergency department (ED), physicians face the challenge of making rapid decisions that can significantly impact patient outcomes. This mindset shift is crucial for improving outcomes and fostering a more inclusive and equitable health care system. Dr. Harrell is a PGY-1 emergency physician at Houston Health. 2003;22(3):465-466.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Ultrasounds Outcomes 52

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 98

Emergency Department Hospitals Outcomes EMS 98

Pediatric Emergency Playbook

AUGUST 1, 2017

2011; 364(3):255-264. Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease? Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. 2011; 29:1136-1140.:205-211. 2011; 523-527. 2011; 24: 552-561. 2011; 146(6):660-665.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 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 82

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 82

EMDocs

DECEMBER 6, 2024

7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. If large number of tablets are visualized on abdominal x-ray, it can help guide GI decontamination decisions. 6 Absence of visualized tablets on x-ray does not exclude iron ingestion.

Poisoning 77

Poisoning Fluid Resuscitation Seizures Resuscitation 77

Don't Forget the Bubbles

FEBRUARY 26, 2024

2011 Oct;46(10):949-55. Outcomes of paediatric critical care asthma patients. 2011 Aug;37:1338-43. Non‐invasive ventilation in pediatric status asthmaticus: a prospective observational study. Pediatric pulmonology. Non-invasive ventilation in paediatric critical care. Paediatric respiratory reviews. 2016 Sep 1;20:24-31.

Pediatrics 72

Pediatrics Research Documentation/Coding Outcomes 72

Dr. Smith's ECG Blog

JULY 14, 2023

Two recent interventions have proven in randomized trials to improve neurologic survival in cardiac arrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation. Finally, head-up CPR (which was not used here), makes for better resuscitation.

Resuscitation 90

Resuscitation EKG/ECG CPR Outcomes 90

EMDocs

SEPTEMBER 7, 2024

Spontaneous retroperitoneal hematoma: etiology, characteristics, management, and outcome. Epub 2011 Sep 10. Clinical spectrum, risk factors, management and outcome of patients with retroperitoneal hematoma: a retrospective analysis of 3-year experience. J Emerg Med. 2012 Aug;43(2):e157-61. doi: 10.1016/j.jemermed.2011.06.006.

EMS 75

EMS Fluid Resuscitation Resuscitation Radiology 75

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

It also did not show an increase in good neurologic outcome in the survivors (78.3% Resuscitation 2011 * Hagihara et al. However, adding ACLS to the pre-hospital system did not demonstrate an improvement in survival to hospital discharge (5.0% vs. 5.1%, p=0.83). vs. 66.8%, p=0.73). JAMA 2009 * Jacobs et al.

CPR 52

CPR Academics Resuscitation Hospitals 52

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 * Population: Adults 18 years and older with non-traumatic OHCA between 2011 and 2015treated by 192 EMS agencies in the USA. Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

EMDocs

OCTOBER 21, 2023

The NIHSS cutoff that predicts outcomes is 4 points higher in AC compared with PC infarctions. Basilar artery occlusion remains a challenging diagnosis to make, and the delays in reaching the diagnosis can have considerable impact on health outcomes. 2011, 10:1002-1014. hour IV thrombolytic window. hour IV thrombolytic window.

EMS 75

EMS Stroke Outcomes Hospitals 75

Don't Forget the Bubbles

JANUARY 17, 2024

Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. There have been reports of the Orbeez Challenge leading to serious outcomes. Children will swallow almost anything. Why should Orbeez be an exception?

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

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