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 Ultrasounds Shock CPR 52

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 91

Pediatrics Sepsis Urgent Care Emergency Department 91

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

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 72

Pediatrics Anaphylaxis Emergency Department Outcomes 72

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 65

EMS Outcomes Resuscitation Wellness 65

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

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 101

Fractures Operations Emergency Department EMS 101

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

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 91

Pediatrics Research Outcomes 91

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 65

Radiology Radiology Emergency Department Ultrasounds 65

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 95

Sepsis Fractures Documentation/Coding Administration 95

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

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

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

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 77

Radiology Radiology Stroke Hospitals 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

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 80

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 80

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

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 73

EMS Fluid Resuscitation Resuscitation Radiology 73

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 84

Emergency Department Hospitals Outcomes EMS 84

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

AUGUST 17, 2019

JAMA 2011). The “I” for intervention is replaced by “E” for exposure because this is a prospective observational study looking at the relationship between an exposure (opioid prescription) and an outcome not a trial of an intervention. ED physicians are among the most frequent prescribers of opioids. Volkow et al.

Emergency Department 52

Emergency Department Academics Fractures Outcomes 52

PHEM Cast

APRIL 21, 2021

The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. 2011 Dec;82(12):1519-24. Epub 2011 Jul 2. Click here to hear what our friends over at the Resus Room think about Airways 2 References (kindly shared by Rich) Davis DP et al. J Trauma 2003; 54:444-453 Mort TC. 2011.06.028.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

The Skeptics' Guide to EM

APRIL 28, 2018

This is an update from their previous review on the topic published in 2011. Outcome: * Primary Outcome: All-cause mortality at 30 days after randomization. If 30-day mortality not reported then the outcome closest to 30-days was used. Comparison: Placebo or no corticosteroids.

Hospitals 40

Hospitals Emergency Department Outcomes Shock 40

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 75

Poisoning Fluid Resuscitation Seizures Resuscitation 75

RebelEM

SEPTEMBER 15, 2022

What They Did: Acetazolamide in Decompensated Heart Failure with Volume Overload (ADVOR) trial Multicenter, parallel-group, double-blind, randomized, placebo-controlled trial Performed at 27 sites in Belgium Patients with acute decompensated heart failure, clinical signs of volume overload (i.e. Placebo: 30.5% RR 1.46; 95% CI 1.17 Placebo: 27.8%

Hospitals 52

Hospitals Outcomes EMS 52

Critical Care Now

APRIL 21, 2022

Outcomes of sustained low-efficiency dialysis versus continuous renal replacement therapy in critically ill adults with acute kidney injury: a cohort study. Crit Care Med 2011; 39:3 PEER Reviewed by Dr. Mike Tom PEER Reviewed by Dr. Lauren Igneri PEER Reviewed by Dr. Ruben Santiago BMC Nephrol 2015;16:127.

Burns 52

Burns Administration Outcomes Hospitals 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

Don't Forget the Bubbles

SEPTEMBER 5, 2024

In this study, the Broselow tape had the best overall accuracy, with 50.7% (vs 30.88% for APLS 2011) of estimates occurring within 10% of measured weight and 80.0% (vs 55% for APLS 2011) estimates within 20% of measured weight. Obesity is considered a contributing factor for some musculoskeletal outcomes. years (IQR 2.5–14.2

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52

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

SheMD

APRIL 30, 2023

How they measured things: They performed a cross-sectional survey of women in emergency medicine to determine the rate of impaired fecundity and compared it to the national 2011–2015 CDC National Survey of Family Growth database. What were their outcomes: Impaired fecundity was found in 24.9%

CDC 52

CDC EMS Outcomes 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