The Skeptics' Guide to EM

OCTOBER 21, 2023

Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Date: October 20, 2023 Reference: Cai et al.

Emergency Department 105

Emergency Department Radiology Radiology Hospitals 105

Broome Docs

JANUARY 30, 2023

Association of Chest Pain Protocol-Discordant Discharge With Outcomes Among Emergency Department Patients With Modest Elevations of High-Sensitivity Troponin. Does wound eversion improve cosmetic outcome?: 2015 Apr;72(4):668-73. Epub 2015 Jan 23. Am J Emerg Med. 2015 Dec;21(6):1244-6.

Emergency Department 52

Emergency Department Outcomes Ultrasounds Pediatrics 52

RebelEM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

Ultrasounds 130

Ultrasounds Outcomes COPD Hospitals 130

ACEP Now

OCTOBER 15, 2023

1 The emergency department remains an important frontier for work in judicious prescribing, but opiate analgesia remains a valuable tool for the initial treatment of a variety of presentations. The treatment response for any six-week program is of limited relevance to the acute treatment provided in the emergency department.

Emergency Department 52

Emergency Department Outcomes CDC Research 52

RebelEM

FEBRUARY 5, 2024

Sites: Investigators recruited patients at 31 French emergency departments at university and nonuniversity hospitals Duration : June 1, 2009 to March 31, 2015. Outcomes: Primary Outcome: Pulmonary expansion 24 hours after the procedure. Secondary Outcomes: Pulmonary expansion 7 days after the procedure.

Outcomes 105

Outcomes Hospitals Research Emergency Department 105

Emergency Medicine Journal

DECEMBER 22, 2023

Methods Emergency Department (ED) attenders and hospital inpatients between 2015 and 2019 were automatically screened for their risk of hospitalisation within 6 months of discharge using a locally trained CPM on routine data. However, it is unclear how this care model would negatively impact survival.

Emergency Department 52

Emergency Department Hospitals Outcomes 52

Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. 2015 May;30:656-74.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

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). World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4. Ong MEH, Chan YH, Oh JJ, et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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. The 30-day emergency department readmission rate and all-cause 30-day readmission were significantly lower only when adjusted for propensity scores.

Emergency Department 52

Emergency Department Outcomes Burns Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 10, 2022

Single-dose dexamethasone is not inferior to 2 doses in mild to moderate pediatric asthma exacerbations in the emergency department. Pediatr Emerg Care. 2022 Guest Skeptic: Dr. Harrison Hayward is a Pediatric Emergency Medicine fellow at Children’s National Hospital. Pediatr Emerg Care. Pediatr Emerg Care.

Pediatrics 52

Pediatrics Emergency Department Urgent Care Hospitals 52

Don't Forget the Bubbles

JULY 19, 2023

Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation. 2015 ) found an incidence of true papilloedema of 25% and 6%, respectively, in children referred to tertiary ophthalmology departments with suspected optic disc swelling.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98

EMDocs

MAY 25, 2023

Outcome: No statistically significant difference in primary outcome, which was absence of clinically apparent seizures without the need for additional anti-convulsant medications AND improving responsiveness at 60 minutes after the start of trial-drug infusion, as determined by the treating physician.

Seizures 64

Seizures Administration Anaphylaxis Outcomes 64

Don't Forget the Bubbles

JANUARY 8, 2024

Dr Bourke’s work is not only about deepening academic understanding but also about forging practical approaches to help healthcare professionals navigate the nuanced and often uncertain waters of adolescent care in emergency settings. Recent studies have indicated a significant rise in mental health disorders among young people.

Research 105

Research Emergency Department Psychiatric Academics 105

The Skeptics' Guide to EM

MAY 20, 2023

She is part of the Don’t Forget the Bubbles team and faculty at Queen Mary University in London where she teaches part of the Paediatric Emergency Medicine MSc. However, we have not covered the Therapeutic Hypothermia after Out-of-Hospital Cardiac Arrest (OHCA) in Children or THAPCA-OH published in the New England Journal of Medicine in 2015.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 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). PMID 33392580. mg tablet) 1 Buprenorphine 0.5

Emergency Department 98

Emergency Department Hospitals Outcomes EMS 98

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 8, 2023

Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. Bagheri 2015 ). Emergency Department Management: Emergency ophthalmology consultation. Emergency surgical management indicated if concomitant retinal tear, vitreous hemorrhage, or retinal detachment.

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

Broome Docs

MARCH 28, 2024

Emerg Med J. PMID: 38050078 Bottom line: High dose nitroglycerin seems to result in better outcomes in SCAPE, at least according to this small, single center, unblinded trial. Casey wrote a protocol for peripheral noradrenaline 9 years ago… in 2015! 2024 Jan 22;41(2):96-102. doi: 10.1136/emermed-2023-213285. Age Ageing.

PPE 107

PPE Ultrasounds Resuscitation Administration 107

RebelEM

NOVEMBER 6, 2024

Elbow Dislocations in the Emergency Department: A Review of Reduction Techniques. J Emerg Med. 2015 Jan;38(1):42-4. Anatomy, Shoulder and Upper Limb, Radial Nerve. 2023 Nov 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30521261 Gottlieb M, Schiebout J. 2018 Jun;54(6):849-854.

Dislocations 59

Dislocations Fractures Soft Tissue Injuries Outcomes 59

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. They recommended synovial fluid analysis as essential to the diagnosis [30].

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

EB Medicine

SEPTEMBER 1, 2018

Jeff: Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the September 2018 issue of Emergency Medicine Practice - Emergency Department Management of North American Snake envenomations.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

EMDocs

MAY 11, 2024

Available from: [link] American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Use of Intravenous tPA for Ischemic Stroke:; Brown MD, Burton JH, Nazarian DJ, Promes SB. Ann Emerg Med. 2015 Sep;66(3):322-333.e31. Erratum in: Ann Emerg Med. Nov 10 th , 2015. 2015.06.031.

Stroke 89

Stroke EMS EKG/ECG Radiology 89

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. Nachi: The 2015 EAST guidelines conditionally recommend ED thoracotomy for moribund patients with signs of life. Early defibrillation is linked to better outcomes.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EMDocs

SEPTEMBER 27, 2023

The MIPS system was established in 2015 as part of an effort to combat the perverse incentive to provide more care in a traditional fee-for-service model. This contributes not only to increases in our patients’ morbidity and mortality, but also to emergency department over-crowding and boarding placing strain our system across the country.

Emergency Department 63

Emergency Department Research Outcomes Hospitals 63

EMDocs

JUNE 12, 2024

HypoCa is common in trauma patients and is associated with poor outcomes. We need RCTs to determine if Ca administration in trauma impacts mortality and other patient-centered outcomes. Ionised calcium levels in major trauma patients who received blood in the Emergency Department. Emerg Med J. 2011;39(1):46-54.

Hyperthermia / Hypothermia 89

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 89

The Skeptics' Guide to EM

DECEMBER 17, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 71-year-old man is brought to your emergency department (ED) by emergency medical serviced (EMS) having fallen two steps at home.

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

PHEM Cast

DECEMBER 12, 2016

For an entertaining and insightful discussion about the impact of undertaking thoracotomy, listen to Dr John Hinds talk from SMACC 2015. Journal of the Royal Society of Medicine 2015. Emergency thoracotomy: “how to do it”. Emergency thoracotomy in thoracic trauma: a review. World Journal of Emergency Surgery; 2006: 1:4.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge. Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. Date: September 20th, 2021 Reference: Litell et al.

Sepsis 40

Sepsis Emergency Department COPD Hospitals 40

The Skeptics' Guide to EM

JUNE 5, 2021

Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis on Functional Outcome Among Patients With Acute Ischemic Stroke: The SKIP Randomized Clinical Trial. JAMA 2021 Case: A 74-year-old woman presents to your emergency department with 1.5 The tipping point came with the publication of MR. CLEAN in 2015.

Stroke 52

Stroke Urgent Care Critical Access Outcomes 52

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. 2015 But we all know that what happens in the lab does not always mirror what happens in real life. There have been reports of the Orbeez Challenge leading to serious outcomes. Pediatric Emergency Care , 31 (6), pp.416-418. Pediatric Emergency Care, 31 (8), pp.605-607.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

The Skeptics' Guide to EM

MAY 25, 2019

Clinical Question: What are the outcomes of trauma patients after REBOA placement? Population: All adult (over 18 years of age) patients in the ACS-TQIP database from 2015-2016. Reference: Joseph et al. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. JAMA Surgery March 2019.

Military 52

Military Resuscitation PPE Emergency Department 52

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Nachi: Recent estimates from 2015-2016 put the prevalence of obesity of those 2 years old to 19 years old at about 19%. First up, the kids.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EMDocs

SEPTEMBER 25, 2023

Still, there are those that believe that FPS is more of a physician-centered endpoint that does not fully reflect important patient-centric outcomes (16). actors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department. WJEM 2015; 16(7): 1109 – 17.

Emergency Department 65

Emergency Department Soft Tissue Injuries Operations Airway Management 65

Pediatric Emergency Playbook

NOVEMBER 1, 2017

Ann Emerg Med. 2015; 135(3):504-512. To scan or not to scan: pediatric minor head trauma in your office, clinic or emergency department. Acad Emerg Med. Children with Arachnoid Cysts who Sustain Blunt Head Trauma: Injury Mechanisms and Outcomes. Acad Emerg Med. 2014; 63(6):657-665. Dayan PS et al.

Pediatrics 52

Pediatrics Emergency Department Outcomes 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. 2015 Jul;5(3):142-50. hour IV thrombolytic window. hour IV thrombolytic window.

EMS 74

EMS Stroke Outcomes Hospitals 74

The Skeptics' Guide to EM

NOVEMBER 20, 2021

You wonder if any emergency department (ED)-based interventions would help her and people like her be safe. Background: We looked at geriatric falls on an SGEM Xtra in 2015. Moving the Needle on Fall Prevention: A Geriatric Emergency Care Applied Research (GEAR) Network Scoping Review and Consensus Statement.

Geriatric Emergencies 52

Geriatric Emergencies Elder Abuse Research Academics 52

EMDocs

JUNE 27, 2024

2015 May;169(4):492-505. Epub 2015 Mar 30. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. PMID: 38594419 The post emDOCs Revamp – Acute Chest Syndrome appeared first on emDOCs.net - Emergency Medicine Education.

Pediatrics 75

Pediatrics Dehydration EMS Hospitals 75