2015 - Emergency Care Today

Superior Mesenteric Artery Syndrome (SMA Syndrome) in Children

Pediatric EM Morsels

AUGUST 4, 2023

Record, 2015) Normal aortomesenteric angle ranges from 28 o to 65 o and the normal distance from 10 to 34 mm. Record, 2015) Nausea and pain are typically post-prandial. Record, 2015). Record, 2015) Secondary findings on imaging including gastric distension and distension of the proximal duodenum. The Oschner Journal.

Pediatrics

Pediatrics Burns Operations Ultrasounds

ECG Blog #434 — WHY Did this Patient Arrest?

Ken Grauer, MD

JUNE 14, 2024

The cause of the abnormal baseline deflections seen in Figure-2 is most likely muscle tremor artifact ( See Bouthillet T — ACLS Med Training, Dec, 2015 ). PEARL # 2: We can tell at a glance in Figure-1 — that the "culprit" causing the artifact in today's ECG is the RA ( R ight A rm ) extremity.

EKG/ECG

EKG/ECG Wellness Hospitals

Travel-Related Illnesses in Children

Pediatric EM Morsels

FEBRUARY 2, 2024

Hospitalization for travel-related illness are around 10% for both VFR and tourists (Leuthard 2015) Multiple studies have reported the most common travel infections in various countries. In the 1950’s travel accounted for 25 million international tourists. A study of swiss tourists found they compromised 53.4%

Infectious Diseases

Infectious Diseases Pediatrics Sepsis Documentation/Coding

Overdiagnosis: Would we better better off not looking?

First 10 EM

MARCH 25, 2024

Carpenter 2015) […] The post Overdiagnosis: Would we better better off not looking? Between 2001 and 2010 the use of CT in emergency departments increased 3-fold (and the use of MRI increased 9-fold, but for some reason it is still almost impossible for me to get one done.) appeared first on First10EM.

Emergency Department

Delayed sequence intubation: An RCT

First 10 EM

SEPTEMBER 25, 2023

Weingart 2011, Weingart 2015) It is a brilliant concept, makes a ton of sense on paper, and anecdotally has seemed to help a number of my patients. Introduced to the world by our friend Scott Weingart, delayed sequence intubation (DSI) is often summarized as procedural sedation for the procedure of preoxygenation.

EMS

Glasgow Coma Scale in Children

Pediatric EM Morsels

JULY 21, 2023

2015 Feb;100(2):207-8. Systematic review showed 85% of studies with substantial reliability with kappa statistic >0.6 Nayana Prabha PC, Nalini P, Tiroumourougane Serane V. Role of Glasgow Coma Scale in pediatric nontraumatic coma. Indian Pediatr. 2003 Jul;40(7):620-5. PMID: 12881617. Biradar, S. Pediatr Crit Care Med. doi: 10.1097/PCC.0000000000001957.

Head Injuries

Head Injuries Pediatrics Outcomes Shock

Congenital Pulmonary Airway Malformation (CPAM)

Pediatric EM Morsels

JUNE 30, 2023

Let’s take a moment to digest a morsel on this condition that may lead to recurrent pulmonary problems: Congenital Pulmonary Airway Malformation: Basics Developmental lesion of the lungs characterized by pseudocysts, lesions, and dilated airways (Dessole, 2019) Incidence is 1 in 11,000 to 1 in 35,000 (Dessole, 2019) Most often unilateral 85% (..)

Ultrasounds

Ultrasounds Pediatrics Operations EMS

The Broselow-Luten System

Pediatric EM Morsels

OCTOBER 27, 2023

Britnell 2015] Broselow tape performed better than APLS method in Chinese children. Khouli 2015] In South Sudan, the Broselow system overestimated weight by 26.6% [Gültekingil-Keser 2017] Broselow out-performed age-based formulas (Theron, APLS, and Shann) in New Zealand, estimating within 10% of actual weight 73% of the time.

Pediatrics

Pediatrics Resuscitation Documentation/Coding Wellness

ECG Blog #415 — The Cath showed NO Occlusion!

Ken Grauer, MD

FEBRUARY 3, 2024

Figure-3: Comparison between ST elevation in lead V3 due to a repolarization variant ( TOP — from 4/27/2019 ) — vs acute OMI ( BOTTOM — from 9/20/2015 ) , which manifests T-QRS-D ( See text ). What is M INOCA?

EKG/ECG

EKG/ECG Resuscitation Hospitals Wellness

Cardiac electrostimulation: the leadless pacemaker

Emergency Live

JUNE 16, 2023

As technology evolved, the leadless pacemaker was introduced in 2015; a real revolution in cardiac electrostimulation The post Cardiac electrostimulation: the leadless pacemaker appeared first on Emergency Live.

Ocular POCUS and ICP elevation

Mount Sinai EM

OCTOBER 10, 2024

2015) of 12 studies with 478 patients found a sensitivity of 96% and specificity of 92% for elevated ICP, as compared to CT. Image Credit: POCUS Toronto Contraindications to Evaluation : Globe rupture The Evidence: A meta-analysis (Ohle et al., A meta-analysis (Aletreby et al.,

Urgent Care

Urgent Care Ultrasounds

Fluoroquinolone Use In Children

Pediatric EM Morsels

AUGUST 18, 2023

Binz 2015) Remember, dogs grow 18 times as fast an infant in the first year of life. Binz 2015) More recent lamb studies have been performed, where the growth more closely approximates a human child. Binz 2015). Oral Fluoroquinolone Prescribing to Children in the United States From 2006 to 2015. This myth is: BUSTED-ish.

Pediatrics

Pediatrics Infectious Diseases Seizures Hospitals

The UK-REBOA trial

First 10 EM

JANUARY 29, 2024

Norii 2015, […] The post The UK-REBOA trial appeared first on First10EM. There have been some observational studies that suggested REBOA was associated with worse outcomes, but the outcomes were largely assumed to be the result of confounders.

Resuscitation

Resuscitation Outcomes EMS

Should I Apply Compression Devices To Patients With DVT?

The Trauma Pro

DECEMBER 26, 2023

A meta-analysis of 13 studies published in 2015 showed that early ambulation was not associated with a higher incidence of new PE. PLOS One , April 10, 2015, [link] Bed Rest or Ambulation in the Initial Treatment of Patients With Acute Deep Vein Thrombosis or Pulmonary Embolism: Findings From the RIETE Registry.

Documentation/Coding

Documentation/Coding Fractures Hospitals Research

REBEL Core Cast 107.0 – Vertebral Osteomyelitis

RebelEM

AUGUST 30, 2023

Most common organism is Staph Aureus (36-67% of cases) ( Boody 2015 ). Executive Summary: 2015 Infectious Disease Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clin Infect Dis 2015 Sept 15;61(6):859-63. Other pathogens include: E.

Infectious Diseases

Infectious Diseases Fractures Radiology Radiology

REBEL Core Cast 132.0 – Recent-Onset AFib

RebelEM

DECEMBER 4, 2024

Ann Emerg Med 2015; 65(5): 532-9. Ann Emerg Med 2015; 65(5): 532-9. J Emerg Med 2015. Cardioversion recommendations exclude patients with recent strokes or valvular heart disease. REBEL Core Cast 132.0 – Recent-Onset AFib Click here for Direct Download of the Podcast. Read More Atzema CL, Barrett TW. JACC 2003; 41: 255-62.

Emergency Department

Emergency Department Stroke EMS Shock

What is this ECG finding? Do you understand it before you hear the clinical context?

Dr. Smith's ECG Blog

FEBRUARY 2, 2024

Sci 5[4] 268-270, 2015 ) both highlight a likely association between acute development of ischemic J waves — and high risk of developing malignant ventricular arrhythmias ( My Comment in the September 23, 2020 post ). Rituparna et al — as well as Chauhan and Brahma ( Int. Smith’s ECG Blog ).

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia EKG/ECG Wellness

Preperitoneal Packing Vs Angioembolization: Part 1

The Trauma Pro

APRIL 26, 2024

A multi-center trial published in 2015 showed an astounding 32% mortality rate for patients with shock from pelvic fracture. Next, I’ll review an early paper that compared the snippets of information we had to angioembolization. As I continue to preach, going anywhere but the OR is dangerous for the patient.

Fractures

Fractures Head Injuries Radiology Radiology

Leukocytosis After Splenic Injury

The Trauma Pro

MAY 12, 2023

American College of Surgeons Scientific Forum Abstracts pg S164, 2015. Don’t believe it. Reference: Leukocytosis after Splenic Injury: A Comparison of Splenectomy, Embolization, and Observation.

Clinical Conundrum: Should We Always Treat Fever in Patients with Sepsis?

RebelEM

DECEMBER 17, 2024

One side argues that fever places additional physiological stress on patients, who are already ill ( Young 2015 ). On the other hand, fever may serve as a protective role by enhancing immune cell function and inhibiting pathogen growth and spread ( Young 2015 ). NEJM 2015; 373(23): 2215-24. PMID: 26436473 Schortgen F et al.

Sepsis

Sepsis Shock EMS Emergency Department

Closed Head Injury – PECARN for < 3 Months: Rebaked Morsel

Pediatric EM Morsels

MAY 12, 2023

2015 Nov;100(11):1032-7. Epub 2015 Aug 21. Burrows P, Trefan L, Houston R, Hughes J, Pearson G, Edwards RJ, Hyde P, Maconochie I, Parslow RC, Kemp AM. Head injury from falls in children younger than 6 years of age. Arch Dis Child. doi: 10.1136/archdischild-2014-307119. PMID: 26297697; PMCID: PMC4680174.

Head Injuries

Head Injuries Fractures Pediatrics EMS

Trauma Resuscitation Updates

RebelEM

MAY 25, 2023

JAMA 2015 [7] The PROPPR Trial 680 severely injured adult trauma patients Patients randomized to Plasma, Platelets, and PRBCs in a 1:1:1 ratio vs 1:1:2 ratio No difference in overall mortality at 24 hrs BUT 1:1:1 achieved hemostasis faster and fewer experienced death due to exsanguination at 24hrs Crombie N et al. Lancet 2019.

Resuscitation

Resuscitation Fluid Resuscitation Head Injuries Shock

Early Vs Delayed Thoracic Endovascular Repair

The Trauma Pro

OCTOBER 6, 2023

vs. 2.1%), but significantly shorter ICU stay (7 vs 10 days) When patients who died within the first 24 hours were excluded, the in-hospital mortality remained significantly higher, and the ICU and hospital lengths of stay were significantly shorter Bottom line: Some society guidelines began recommending delayed TEVAR in 2015.

Head Injuries

Head Injuries Research Hospitals Resuscitation

Outcomes of adult patients discharged at scene by emergency medical services

Emergency Medicine Journal

JULY 22, 2024

Methods This was a retrospective data linkage study on consecutive adult EMS patients discharged at scene by paramedics in Victoria, Australia, between 1 January 2015 and 30 June 2019. This study aims to describe the outcomes of adult patients discharged at scene by paramedics and identify factors associated with 72-hour outcomes.

Outcomes

Outcomes EMS Hospitals Research

The Ankle Radiograph

Mount Sinai EM

JANUARY 11, 2023

Saunders Ltd; 2015. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: [link] Raby Nigel, Berman L, Morley S, de Lacey G. Ankle & Hindfoot. Accident and Emergency Radiology: A Survival Guide,3e. Accessed January 04, 2023. Sports Medicine for the Emergency Physician A Practical Handbook, pp.

Radiology

Radiology Radiology Fractures Dislocations

Elbow Dislocations

RebelEM

NOVEMBER 6, 2024

2015 Jan;38(1):42-4. Anterior elbow dislocation with recurrent instability. Acta Orthop Belg. 2003 Apr;69(2):197-200. PMID: 12769023 Skelley NW, Chamberlain A. A novel reduction technique for elbow dislocations. Orthopedics. doi: 10.3928/01477447-20150105-05. PMID: 25611409 Stoneback JW, Owens BD, Sykes J, Athwal GS, Pointer L, Wolf JM.

Dislocations

Dislocations Fractures Soft Tissue Injuries Outcomes

SGEM#436: For the Longest Time – To Give TNK for an Acute Ischemic Stroke

The Skeptics' Guide to EM

APRIL 13, 2024

hours from onset of symptoms.

Stroke

Stroke Documentation/Coding Emergency Department EMS

A Prompt for a Reflection

Sensible Medicine

MAY 21, 2024

” My daughter answered: “In 2015, the city of Melbourne, Australia created a "tree-mail" service, in which all of the trees in the city received an email address so that residents could report any tree-related issues. 1 My son answered: “So where is Waldo, really?”

Cuffed Endotracheal Tubes for Children: ReBaked Morsel

Pediatric EM Morsels

NOVEMBER 17, 2023

Epub 2015 Aug 22. Shi F, Xiao Y, Xiong W, Zhou Q, Huang X. Cuffed versus uncuffed endotracheal tubes in children: a meta-analysis. 2016 Feb;30(1):3-11. doi: 10.1007/s00540-015-2062-4. PMID: 26296534. The post Cuffed Endotracheal Tubes for Children: ReBaked Morsel appeared first on Pediatric EM Morsels.

Pediatrics

Pediatrics Emergency Department Outcomes Sepsis

The Modified Valsalva Maneuver: Practical Treatment or Pointless Trick?

RebelEM

MAY 27, 2024

Background: The REVERT Randomized Controlled Trial demonstrated the superiority of the modified valsalva maneuver (MVM) over the standard valsalva maneuver (VM) in re-establishing normal sinus rhythm (NSR) in patients with PSVT (Appelboam 2015). Using MVM in parallel while establishing IV access or preparing medications is practical.

Outcomes

Outcomes Research Hospitals Operations

Sternal Osteomyelitis

Don't Forget the Bubbles

AUGUST 19, 2024

2015 Apr;34(4):e92-e101. 2015 Sep;35(6):634-9. [link] Schweitzer A, Della Beffa C, Akmatov MK, Narchi H, Abaev YK, Sherry DD, Pessler F. Primary osteomyelitis of the sternum in the pediatric age group: report of a new case and comprehensive analysis of seventy-four cases. Pediatr Infect Dis J. doi: 10.1097/INF.0000000000000597.

Infectious Diseases

Infectious Diseases Pediatrics Emergency Department Hospitals

The US FDA's cancer drug approval process is broken and needs audit

Sensible Medicine

APRIL 25, 2024

Thanks to JAMA IM editor Rita Redberg In 2015, Rita Redberg— then JAMA IM editor took 2 papers from our group. But in work that Chul Kim and I did in 2016 we found this was not the case. The FDA repeatedly violated their stated standards, and granted full approval for wobbly surrogates. One examined this question.

Poisoning

Poisoning Outcomes

The ‘Hidden C’

Don't Forget the Bubbles

JUNE 17, 2024

Riskin (2015) showed that rudeness accounted for a 12% reduction in diagnostic and procedural performance in a simulated resuscitation. 2015 May;30:656-74. 2015 Sep 1;136(3):487-95. Civility Saves Lives The impact of incivility in healthcare cannot be understated. British journal of nursing. 2014 Jun 26;23(12):653-9. Pediatrics.

Leadership

Leadership Resuscitation Teamwork Patient Safety

Probiotics don’t improve outcomes in children with acute gastroenteritis

PEMBlog

OCTOBER 31, 2024

N Engl J Med 2018; 379:2015-2026. N Engl J Med. 2018 Nov 22;379(21):2002-2014. doi: 10.1056/NEJMoa1802598. PMID: 30462938; PMCID: PMC6358014. Freedman et al. Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis. DOI: 10.1056/NEJMoa1802597. Parker et al. Pediatrics, 2013. Szajewska et al.

Outcomes

Outcomes Pediatrics Emergency Department Research

Diagnostics and Therapeutics: Pneumomediastinum

Taming the SRU

OCTOBER 28, 2024

2015 Feb;7(Suppl 1):S44-9. 2015 May;166(5):1317-1317.e1. 2015 Mar;16(2):321-4. 2015 Summer;19(3):e122-4. 2015 Aug;150(8):757-62. Pneumomediastinum. J Thorac Dis. PMC free article] [PubMed] 4. Pneumomediastinum after nose blowing. Reha J, Davis P. West J Emerg Med. PMC free article] [PubMed] 10. PubMed] 12.

COPD

COPD Pediatrics Emergency Department Ultrasounds

The EMERGE Trial: Emergency vs Delayed Catheterization in Survivors of Out-of-Hospital Cardiac Arrest

RebelEM

MARCH 30, 2023

Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable neurological outcomes. Empana, J.-P., P., & Cariou, A. PMID: 26453685 Vyas, A.,

Hospitals

Hospitals Outcomes EKG/ECG Resuscitation

Don’t Forget the Orbeez!

Don't Forget the Bubbles

JANUARY 17, 2024

2015 But we all know that what happens in the lab does not always mirror what happens in real life. The liquids were chosen to “approximate a pediatric digestive environment.” ” ( Ed. – Very few three-year-olds drink 210mls of vodka in one sitting ). After Darracq et al., A recent literature review by Caré et al.

Pediatrics

Pediatrics Poisoning Ultrasounds Dehydration

Diagnostics: Inflammatory Markers

Taming the SRU

AUGUST 30, 2023

A 2015 prospective, cross-sectional study of 78 Thai patients published in the International Journal of Rheumatic Disease demonstrated a sensitivity of 59% and specificity of 84% for PCT with a cut-off of 0.5 2015 Mar;18(3):352-9. They recommended synovial fluid analysis as essential to the diagnosis [30]. Int J Rheum Dis. 2018.09.070.

Infectious Diseases

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing

REBEL Core Cast 108.0 – Angioedema

RebelEM

SEPTEMBER 13, 2023

2015; 372(5):418-25. Read More EMCrit: Podcast 145 – Awake Intubation Lecture from SMACC ERCast: Angioedema References: Baş M et al. A randomized trial of icatibant in ACE-inhibitor-induced angioedema. N Engl J Med. PMID 25629740 Hassen GW et al. J Emerg Med 2013; 44 (4): 764-772.

Allergic Reactions

Allergic Reactions Airway Management Anaphylaxis Emergency Department

Clinical Conundrums: Should Ketamine be Preferred Over Etomidate in RSI?

RebelEM

SEPTEMBER 23, 2024

Opponents of ketamine often point to the risks of spiking intracranial pressure but this concern has been widely debunked ( Cohen 2015 ). Ann Emerg Med 2015; 65(1): 43-51. Unlike etomidate, ketamine offers the advantage of having no effect on the adrenal glands. Intensive Care Med. 2011;37(6):901-910. PMID: 21373823 Cohen L et al.

EMS

EMS Outcomes Resuscitation Wellness

SGEM#448: More than A Feeling – Gestalt vs CDT for Predicting Sepsis

The Skeptics' Guide to EM

JULY 27, 2024

Dave Schriger and colleagues reviewed publications in the Annals of Emergency Medicine from 1998 to 2015 and found that only 11% of the studies compared decision aids to clinical judgement [4]. A similar review by Sanders et al 2015 concludes that clinica.

Sepsis

Sepsis Outcomes Documentation/Coding Hospitals

Clinical Conundrums: Should You Give the First Dose of Antibiotics IV Before Discharging Home on Oral Antibiotics?

RebelEM

JANUARY 9, 2024

Additionally, multiple studies demonstrate increased harm with IV antibiotics such as increased rate of diarrhea ( Haran 2014 ), complications from IV placement ( Li 2015 ), and increased length of stay or cost ( Lorgelly 2010 ). 2015; 12(5):e1001825. The American journal of emergency medicine. 2014; 32(10):1195-9. PLoS medicine.

Infectious Diseases

Infectious Diseases Pediatrics EMS Administration

Don’t Forget About the IO in the Critically Ill Patient

RebelEM

APRIL 29, 2024

In these situations, the American Heart Association (AHA) and the European Resuscitation Council (ERC) of 2015 recommend the intraosseous (IO) route after the peripheral route and before the central venous route ( 1). 2015 PMID: 25768683 8 Leidel BA. This can often lead to significant delays in proper resuscitation. Trauma 1996.

Resuscitation

Resuscitation Administration Emergency Department Ultrasounds

Journal Feed Weekly Wrap-Up

EMDocs

JUNE 15, 2024

Source Shifts in Diagnostic Testing for Headache in the Emergency Department, 2015 to 2021. JAMA Netw Open. 2024 Apr 1;7(4):e247373. doi: 10.1001/jamanetworkopen.2024.7373. PMID: 38639937; PMCID: PMC11031686. The post Journal Feed Weekly Wrap-Up appeared first on emDOCs.net - Emergency Medicine Education.

Sepsis

Sepsis Emergency Department

Superior Mesenteric Artery Syndrome (SMA Syndrome) in Children

ECG Blog #434 — WHY Did this Patient Arrest?

Trending Sources

Travel-Related Illnesses in Children

Overdiagnosis: Would we better better off not looking?

Delayed sequence intubation: An RCT

Glasgow Coma Scale in Children

Congenital Pulmonary Airway Malformation (CPAM)

The Broselow-Luten System

ECG Blog #415 — The Cath showed NO Occlusion!

Cardiac electrostimulation: the leadless pacemaker

Ocular POCUS and ICP elevation

Fluoroquinolone Use In Children

The UK-REBOA trial

Should I Apply Compression Devices To Patients With DVT?

REBEL Core Cast 107.0 – Vertebral Osteomyelitis

REBEL Core Cast 132.0 – Recent-Onset AFib

What is this ECG finding? Do you understand it before you hear the clinical context?

Preperitoneal Packing Vs Angioembolization: Part 1

Leukocytosis After Splenic Injury

Clinical Conundrum: Should We Always Treat Fever in Patients with Sepsis?

Closed Head Injury – PECARN for < 3 Months: Rebaked Morsel

Trauma Resuscitation Updates

Early Vs Delayed Thoracic Endovascular Repair

Outcomes of adult patients discharged at scene by emergency medical services

The Ankle Radiograph

Elbow Dislocations

SGEM#436: For the Longest Time – To Give TNK for an Acute Ischemic Stroke

A Prompt for a Reflection

Cuffed Endotracheal Tubes for Children: ReBaked Morsel

The Modified Valsalva Maneuver: Practical Treatment or Pointless Trick?

Sternal Osteomyelitis

The US FDA's cancer drug approval process is broken and needs audit

The ‘Hidden C’

Probiotics don’t improve outcomes in children with acute gastroenteritis

Diagnostics and Therapeutics: Pneumomediastinum

The EMERGE Trial: Emergency vs Delayed Catheterization in Survivors of Out-of-Hospital Cardiac Arrest

Don’t Forget the Orbeez!

Diagnostics: Inflammatory Markers

REBEL Core Cast 108.0 – Angioedema

Clinical Conundrums: Should Ketamine be Preferred Over Etomidate in RSI?

SGEM#448: More than A Feeling – Gestalt vs CDT for Predicting Sepsis

Clinical Conundrums: Should You Give the First Dose of Antibiotics IV Before Discharging Home on Oral Antibiotics?

Don’t Forget About the IO in the Critically Ill Patient

Journal Feed Weekly Wrap-Up

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