ACEP Now

MARCH 11, 2025

1 Further, a Cochrane review found that LMWH is associated with improved outcomes compared with UFH including reduced incidence of major hemorrhage (odds ratio [OR]=0.69; 95 percent CI, 0.50-0.95) 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Konstantinides SV, Meyer G, Becattini C, et al.

Hospitals 52

Hospitals Administration Outcomes Stroke 52

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

PulmCCM

OCTOBER 16, 2024

RenalRIPC Trial In the RenalRIPC trial, investigators at four hospitals in Germany randomized 240 patients planned for cardiac surgery who were at high risk for acute kidney injury in 2013 and 2014 to receive remote ischemic preconditioning or sham remote ischemic preconditioning (control).

Outcomes 52

Outcomes Operations Research Hospitals 52

ACEP Now

AUGUST 25, 2023

The National Heart, Lung, and Blood Institute released an expert panel report in 2014 with evidence-based guidelines for management of SCD recommending timely administration of parenteral opioids for VOE.2 Primary Outcome: Discharged home from the ED Secondary Outcomes: There were several secondary outcomes. Am J Hematol.

Administration 97

Administration Pediatrics Emergency Department Outcomes 97

ACEP Now

OCTOBER 10, 2023

Both INTERACT-2 and ATACH-2 showed no statistical difference in their primary outcome between intensively lowering the BP and a less-intensive strategy. Background There have been a couple of large and influential trials published on BP management after an intracranial hemorrhage (ICH). Reference Ma LM, Hu X, Song L, et.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

The Skeptics' Guide to EM

JULY 8, 2023

In 2009, the Cochrane group questioned Roche about the completeness of the data and after four years of requests, finally got access to all the data in 2013 and updated their review in 2014. We covered this SRMA on SGEM#98. There was a large unblinded RCT of over 3,000 patients published in the Lancet in 2020.

CDC 108

CDC Hospitals EMS Emergency Department 108

RebelEM

JANUARY 25, 2024

What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021. Outcomes: Primary Outcome: Reduction of dyspnea measured on a verbal dyspnea scale (VDS) from 0 to 10 recorded at enrollment, then at 2, 4, and 5 hours after arrival.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

The Trauma Pro

MAY 9, 2023

The Pennsylvania Trauma Outcomes Study database contains a huge amount of data. Reference: Defining the optimal time to the operating room may salvage early trauma deaths, J Trauma 76(5):1251-1258, 2014. They created two variables to more objectively compare times, the TD5 and the TD50.

Head Injuries 130

Head Injuries Operations Documentation/Coding Outcomes 130

The Skeptics' Guide to EM

NOVEMBER 11, 2023

One of the best systematic reviews and meta-analyses on the topic discussing the diagnostic accuracy of the history, physical examination and imaging is by Carpenter et al from AEM 2014 [1]. We went into some detail on SGEM#385. Initial Xray’s pick up only about 17% of fractures [2].

Fractures 131

Fractures Military Radiology Radiology 131

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

Sensible Medicine

APRIL 14, 2024

For instance, CAR-T was given to myeloma patients in 2014, but we only learned it can cause Parkinsonism in 2021. Medicine has become a financial commodity with the rare adverse event of better health outcomes. My biggest concern with the change wasn’t the cost however, but the safety risk. The current system is broken.

Patient Safety 145

Patient Safety Academics Outcomes Wellness 145

ACEP Now

AUGUST 14, 2024

This recommendation is a departure from the 2014 guideline iteration that only recommended against CCBs in patients with decompensated heart failure. Second, the outcomes definitions rate and rhythm control at four and 24 hours are far beyond times relevant in emergency medicine in the U.S. J Emerg Med. 2015;49(2):175-182. Circulation.

Emergency Department 105

Emergency Department Outcomes Research Wellness 105

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

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome was 28-day mortality – TXA improved survival with no increased risk of cerebral clots. Survival was better, both at 24 hours and six months, in the TXA group, although the primary outcome, a quality of life score at six months, called the Glasgow Outcome Scale Extended (GOS-E), was the same in both groups ( 53.7%

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

Emergency Medicine Journal

FEBRUARY 20, 2024

The objective of this study is to evaluate outcomes of reversal with these agents in patients with isolated traumatic brain injuries (TBI). Methods This is a retrospective review of 35 trauma centres from 2014 to 2021. Primary outcome includes rate of mortality/hospice at hospital discharge.

Hospice 74

Hospice Outcomes Hospitals 74

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 101

Stroke Outcomes EMS Seizures 101

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Both the outdated 2014 AHA/ACC guidelines and the updated 2023 ESC guidelines recommend immediate invasive management of patients with uncontrolled chest pain. 2014 AHA/ACC guideline for the management of patients with non–ST-elevation acute coronary syndromes. link] Opiates are associated with worse outcomes in Myocardial Infarction.

EKG/ECG 123

EKG/ECG Outcomes Academics Documentation/Coding 123

The Skeptics' Guide to EM

OCTOBER 14, 2023

Background: We have looked at pediatric vital signs on the SGEM back in 2014 with PedEM superhero Dr. Anthony Crocco ( SGEM#98 ). It seems awfully high. We have been reading online about something called sepsis that can be deadly. Does he have sepsis?”

Pediatrics 105

Pediatrics Sepsis Urgent Care Emergency Department 105

RebelEM

FEBRUARY 5, 2024

Outcomes: Primary Outcome: Pulmonary expansion 24 hours after the procedure. Secondary Outcomes: Pulmonary expansion 7 days after the procedure. Blinding the outcome assessors to the initial assessment reduces the risk of measurement bias, enhancing the objectivity of the results.

Outcomes 104

Outcomes Hospitals Research Emergency Department 104

The Skeptics' Guide to EM

JUNE 17, 2023

The National Heart, Lung, and Blood Institute (NHLBI) released an expert panel report in 2014 with evidence-based guidelines for management of sickle cell disease recommending timely administration of parenteral opioids for VOE. [7] 1-6] Children with SCD presenting to the ED with VOE require timely and effective pain control.

Emergency Department 74

Emergency Department Pediatrics Head Injuries Administration 74

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. link] Published January 2014. Epub 2014 Dec 4. 2012;43(6):1484-1489.

EMS 98

EMS Stroke Outcomes Hospitals 98

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. 2014 Jun 26;23(12):653-9. Civility Saves Lives The impact of incivility in healthcare cannot be understated.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Pediatric Emergency Playbook

NOVEMBER 1, 2017

2014; 63(6):657-665. 2014; 168(9):837-843. Children with Arachnoid Cysts who Sustain Blunt Head Trauma: Injury Mechanisms and Outcomes. Association of Traumatic Brain Injuries with Vomiting in Children with Blunt Head Trauma. Ann Emerg Med. Dayan PS et al. Headache in Traumatic Brain Injuries from Blunt Head Trauma. Pediatrics.

Pediatrics 52

Pediatrics Emergency Department Outcomes 52

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016. 2014 Sep;45(9):1287-95. They looked at 119 adult patients from an (unspecified) number of trauma centres.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

EMDocs

SEPTEMBER 27, 2023

Additionally, a 2022 study in JAMA found no association between MIPS measures and any meaningful clinical outcomes and moreover physicians who cared for the most medically and socially vulnerable were more likely to receive worse scores (8). Burleson (2014). References American Medical Association. ” from [link] Seidenwurm, D.

Emergency Department 90

Emergency Department Research Outcomes Hospitals 90

Northwestern EM Blog

APRIL 15, 2024

“Tracheostomy: Epidemiology, Indications, Timing, Technique, and Outcomes.” Respiratory Care 59 (2014): 895 - 919. Tracheotomy outcomes and complications: a national perspective. Rajendram, R., Repositioning a displaced tracheostomy tube with an Aintree intubation catheter mounted on a fibre-optic bronchoscope."

Emergency Department 98

Emergency Department Resuscitation Pediatrics Outcomes 98

RebelEM

MARCH 2, 2023

Essentially there was no difference, meaning we wouldn’t expect to find a difference in outcomes Although not patient oriented, why is there no breakdown of how many patients had cardiogenic shock, congestive heart failure, echocardiographic findings, or even troponin levels. Circulation 2014. Low O2 protocol: 3.1%

Outcomes 52

Outcomes EMS EKG/ECG Hospitals 52

ACEP Now

JULY 7, 2023

Prior to medical school, she received her MBA in Healthcare Management and currently works on health policy and outcomes-based research. Isha Joshi (@ISHAJOSHIII) is a third-year medical student at Penn State College of Medicine in Hershey, Pa. Dr. Marco is professor of emergency medicine at Penn State Health Milton S. Reyes JC, et al.

Forensics 98

Forensics Airway Management Emergency Department Administration 98

The Skeptics' Guide to EM

AUGUST 5, 2023

Annals of Emergency Medicine 2014. Annals of Emergency Medicine 2014. Annals of Emergency Medicine 2014. Reference: Easter JS et al. Comparison of PECARN, CATCH, and CHALICE rules for children with minor head injury: a prospective cohort study. Reference: Easter JS et al. Reference: Easter JS et al.

Head Injuries 40

Head Injuries Pediatrics Fractures Outcomes 40

The Skeptics' Guide to EM

MAY 1, 2021

Their efficacy endpoint was good functional outcome, defined as a modified Rankin Score (mRS) of 3 or less. improvement in good neurologic outcome, a 5.4% Emberson and colleagues reported only on alteplase (a problem we will discuss further) and found a 5% improvement in neurologic outcomes, a 5.5% increase in mortality.

Stroke 52

Stroke Outcomes Wellness 52

RebelEM

SEPTEMBER 22, 2022

This could lead to delays in antibiotics and medical care all of which could be associated with worsened patient outcomes Race is a social construct and patients self-identified to race (which is appropriate). to 0.05C; p = 0.18 Prevalence of fever in Black was 10.1% with a temporal thermometer and 13.2% with a temporal thermometer and 10.2%

EMS 52

EMS Hospitals Outcomes Wellness 52

Sensible Medicine

AUGUST 7, 2024

Moreover, a 2014 Brazilian study shows that prone-sleeping premature babies have lower salivary cortisol concentration, a better Brazelton sleep score, and a lower respiratory rate, indicating deeper sleep. This is an astounding difference in the quality of sleep, and to this day, premature infants in the hospital are slept on their stomachs.

CDC 113

CDC Documentation/Coding Research Pediatrics 113

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, Golden & Hervey, 1981 Oakley & Pethybridge, 1997 Tipton 2016 Bierens 2014.

Resuscitation 52

Resuscitation Hospitals Outcomes Wellness 52

Don't Forget the Bubbles

JANUARY 10, 2024

Some wonder if giving blood to children with a haemoglobin <6g/dl will improve outcomes. 3,950 children were recruited between September 2014 to May 2017. Outcomes Primary outcome Mortality at 28 days after randomisation. The authors chose a patient-centred, primary outcome in keeping with their pragmatic design.

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

PHEM Cast

APRIL 10, 2016

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. 2014 Oct 28;:1–9. UK Sepsis Trust; 2014 Nov pp. EMS Patients and Walk-In Patients Presenting With Severe Sepsis: Differences in Management and Outcome.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

ACEP Now

MAY 10, 2024

Primary Outcome: Diagnostic accuracy of identifying Stanford type A and Stanford type B AoDs Secondary Outcomes: Test characteristics of each of the three individual sonographic findings for diagnosing Stanford type A and Stanford type B AoDs. References Rotella JA, Yeoh M. Emerg Med Australas. 2018;30:119–21. Eur Heart J.

Ultrasounds 52

Ultrasounds Outcomes Academics Documentation/Coding 52

Taming the SRU

SEPTEMBER 8, 2023

Prognosis of acute severe autoimmune hepatitis (as-AIH): The role of corticosteroids in modifying outcome.” 4, 2014, pp. 8, 2014, pp. Hepatology, vol. 2, 2013, pp. 612–621, [link] Yeoman, Andrew D., Journal of Hepatology, vol. 876–882, [link] Potts, Jonathan R. World Journal of Gastroenterology, vol. 16, 2011, p. 2, 2000, pp.

Radiology 59

Radiology Radiology Ultrasounds EMS 59