EMDocs

AUGUST 22, 2024

have limited English proficiency according to the 2015 U.S. 3,4 Notably, institutions receiving federal funding (such as hospitals receiving Medicare reimbursement) must abide by Title VI of the 1964 Civil Rights Act, which entitles persons with NELP to language assistance. Over 25 million individuals in the U.S. Lion KC, et al.

Documentation/Coding 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

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). The surgery is then performed. Circulation.

Outcomes 52

Outcomes Operations Research Hospitals 52

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). Many clinicians don’t consider IO placement while others consider it a last resort or only a pre-hospital procedure.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Don't Forget the Bubbles

JUNE 17, 2024

High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. Riskin (2015) showed that rudeness accounted for a 12% reduction in diagnostic and procedural performance in a simulated resuscitation. 2015 May;30:656-74. Conclusion Critical care resuscitation is stressful. Edmondson, Amy C.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

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. In hospital mortality estimated at 30-40%. hour IV thrombolytic window.

EMS 97

EMS Stroke Outcomes Hospitals 97

PulmCCM

JANUARY 22, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Mind The Bleep

OCTOBER 29, 2024

First aid done pre-hospital. Proper stabilization and detailed communication with the burns centre are essential for optimal patient outcomes. 2015 Jun;11(2):227-31. The AMPLE framework offers a structured approach [2]. Type of chemical and strength. Was the patient wearing any protective equipment? J Toxicol Clin Toxicol.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

RebelEM

APRIL 17, 2023

2015 May;204(5):1064-8. 33 studies selected for full review Of those 33 studies, 17 of those met criteria for inclusion Of the 18 studies, 1 was an RCT, 14 were prospective cohort studies, and 3 were retrospective cohort studies Total of 812 patients of whom 541 had PTA from 17 studies. Epub 2020 Jun 2. PMID: 32482146. AJR Am J Roentgenol.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

ALiEM

OCTOBER 30, 2024

Clinical impact: Rather than arguing with the patient about the likelihood of this phenomenon occurring and whether this is a true allergy, the patient is informed that they do not need to immediately start treatment to receive care in the hospital. 2015 Apr 28;313(16):1636-44. Journal of general internal medicine. 2017 Jun;32:660-6.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

PHEM Cast

APRIL 16, 2018

It might be better to consider traumatic cardiac arrest as a completely different disease eg LOST: Low Output State due to Trauma The 2015 European Resuscitation Council and UK Resuscitation Council Algorithms for Traumatic Cardiac Arrest: To read the whole ERC guideline on special circumstances cardiac arrest including trauma, click here.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

The Skeptics' Guide to EM

MAY 20, 2023

Guest Skeptic: Dr. Kat Priddis is a paediatric emergency medicine consultant and trauma director at Watford General Hospital. Guest Skeptic: Dr. Kat Priddis is a paediatric emergency medicine consultant and trauma director at Watford General Hospital. Which hospital should you transfer the patient to? NEJM Evidence.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

EMDocs

JULY 13, 2024

A) Administer ceftriaxone 500 mg IM and doxycycline 100 mg PO B) Consult OB/GYN for incision and drainage C) Establish IV access and administer clindamycin and gentamicin D) Prescribe doxycycline with metronidazole and ensure close OB/GYN follow-up Answer: C Most postpartum infections are identified after hospital discharge. Am J Clin Pathol.

OB/GYN 89

OB/GYN EMS Sepsis Fluid Resuscitation 89

Emergency Medicine Journal

DECEMBER 22, 2023

Using CPMs to identify patients, rather than prespecified criteria, accommodates for the dynamic hospital user population and for sufficient time to provide preventative support. Co-primary outcomes were emergency hospitalisation and ED attendances, which will be reported separately. Mortality at 24 months was a safety endpoint.

Emergency Department 52

Emergency Department Hospitals Outcomes 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 Pediatrics Outcomes Documentation/Coding 75

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Background: The liberal use of supplemental oxygen therapy in acutely ill adults has a long history in the hospital, but high-quality therapy supporting its practice is unclear. The patient has an oxygen saturation of 98% on room air and your nurses ask if you want the patient to receive supplemental oxygen. The Lancet 2018.

Poisoning 52

Poisoning Administration Hospitals Sepsis 52

Taming the SRU

AUGUST 30, 2023

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. . + Procalcitonin (PCT) Etiology: PCT was first discovered in 1984. However, it was not until a 1993 study that its significance was realized.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). Between 81-95% of life-threatening ventricular dysrhythmias and acute cardiac failure occur within 24-48 hours of hospitalization. 2015, March 1). RBBB in blunt chest trauma seems to be indicative of several RV injury. Cramer, M. 2003, May).

EKG/ECG 115

EKG/ECG Wellness Fractures Emergency Department 115

EMDocs

SEPTEMBER 27, 2023

This would be similar to how all other Medicare providers (long-term care facilities, hospital payments, etc.) 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. are already reimbursed (5). link] Bond, A.

Emergency Department 88

Emergency Department Research Outcomes Hospitals 88

Emergency Medicine Journal

DECEMBER 22, 2023

Background Long waiting times in the ED have been shown to cause negative outcomes for patients. Methods Discrete event simulation was used to model a large urban teaching hospital in the UK, as a case study, with a colocated GP service.

Emergency Department 52

Emergency Department Research Outcomes Hospitals 52

The Skeptics' Guide to EM

JUNE 5, 2021

He also works at an urgent care and a rural critical access hospital. He also works at an urgent care and a rural critical access hospital. Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis on Functional Outcome Among Patients With Acute Ischemic Stroke: The SKIP Randomized Clinical Trial.

Stroke 52

Stroke Urgent Care Critical Access Outcomes 52

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. The classic paper on ACLS drugs is called OPALS (Ontario Pre-hospital Advanced Life Support) study and was done by Dr. Ian Stiell and team.

CPR 52

CPR Academics Resuscitation Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 10, 2022

2022 Guest Skeptic: Dr. Harrison Hayward is a Pediatric Emergency Medicine fellow at Children’s National Hospital. He finished his General Pediatrics residency at Yale-New Haven Hospital. 2022 Guest Skeptic: Dr. Harrison Hayward is a Pediatric Emergency Medicine fellow at Children’s National Hospital. Pediatr Emerg Care.

Pediatrics 52

Pediatrics Emergency Department Urgent Care Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 16, 2017

Guest Skeptic: Dr. Anand Swaninathan is an Assistant Professor of Emergency Medicine at NYU/Bellevue Hospital in the Department of Emergency Medicine. Guest Skeptic: Dr. Anand Swaninathan is an Assistant Professor of Emergency Medicine at NYU/Bellevue Hospital in the Department of Emergency Medicine. J Allergy Clin Immunol Pract 2017.

Anaphylaxis 52

Anaphylaxis Administration EMS Emergency Department 52

RebelEM

MARCH 23, 2023

REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal Click here for Direct Download of the Podcast Clinical question : Is a phenobarbital-based or lorazepam-based alcohol detoxification protocol associated with a lower hospital length of stay compared to Ativan for alcohol withdrawal? Paper : Hawa F et al.

Emergency Department 52

Emergency Department Outcomes Burns Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation. Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation. Background: The American Heart Association estimates there are approximately 350,000 EMS-assessed out-of-hospital cardiac arrests (OHCAs) in the United States per year.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

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. Severe Sepsis in Pre-Hospital Emergency Care. 2015 Aug 26;:1–31. 2015 Oct 17;:1–16. 2015 Apr 24;:1–10. 2009;13(5):R167. ACCEPTED MANUSCRIPT.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

PulmCCM

JANUARY 24, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

The Skeptics' Guide to EM

NOVEMBER 28, 2020

Date: November 25th, 2020 Guest Skeptic: Dr. Joe Vipond has worked as an emergency physician for twenty years, currently at the Rockyview General Hospital. Date: November 25th, 2020 Guest Skeptic: Dr. Joe Vipond has worked as an emergency physician for twenty years, currently at the Rockyview General Hospital.

Infectious Diseases 52

Infectious Diseases Operations Outcomes Wellness 52

Sensible Medicine

AUGUST 7, 2024

A 2015 Nature (Pediatric Research) paper by Nils J. This is an astounding difference in the quality of sleep, and to this day, premature infants in the hospital are slept on their stomachs. To receive new posts and support our work, consider becoming a free or paid subscriber. This may not be true for infants.

CDC 113

CDC Documentation/Coding Research Pediatrics 113

Don't Forget the Bubbles

NOVEMBER 15, 2023

One-liner… Understanding how to manage maintenance fluids in critically unwell children best is a basic but important way to improve outcomes. The REVERSE-AKI feasibility trial suggests that fluid restriction can improve outcomes without significant renal consequences. A fluid shift, if you will. Ann Intensive Care.

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

The Skeptics' Guide to EM

NOVEMBER 20, 2021

AEM November 2021 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). Background: We looked at geriatric falls on an SGEM Xtra in 2015. Date: November 16th, 2021 Reference: Hammouda et al.

Geriatric Emergencies 52

Geriatric Emergencies Elder Abuse Research Academics 52

PHEM Cast

APRIL 21, 2021

The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. 2015 Oct 23;10(10):e0141034. Scand J Trauma Resusc Emerg Med 23, 57 (2015). The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

Pediatric Emergency Playbook

OCTOBER 1, 2017

2015; 4, Art. Outcomes of Children Bridged to Heart Transplantation With Ventricular Assist Devices: A Multi-Institutional Study. Predictors of In-Hospital Mortality in Children After Long-Term Ventricular Assist Device Insertion. Neuroscience and Biobehavioral Reviews. 2005; 29: 493–500. Cochrane Database of Systematic Reviews.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

The Skeptics' Guide to EM

JULY 2, 2017

Impact of Thrombolytic Therapy
 on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism. JACC March 2017 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals Trust (North West England). [display_podcast] Date: June 21st, 2017 Reference: Konstantinides et al.

Fractures 40

Fractures Emergency Department Ultrasounds Outcomes 40

ACEP Now

OCTOBER 15, 2023

Regardless, the reason this study became widely discussed is because the primary outcome of the trial was negative, concluding there was “no evidence that opioids should be prescribed for people with acute non-specific low back or neck pain.” The primary outcome was a more relevant seven-day outcome, rather than six-week follow-up.

Emergency Department 52

Emergency Department Outcomes CDC Research 52

Taming the SRU

OCTOBER 23, 2023

After a short period of recovery in the hospital, she is discharged home in stable condition with follow-up with OBGYN. Discrimination between an IUP and an interstitial pregnancy is critical as interstitial pregnancies can have devastating outcomes. 2015 Jun;33(6):743-8. Epub 2015 Feb 21. Am J Emerg Med. 2015.02.023.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

ACEP Now

APRIL 3, 2024

1,2 However, the European TTM1 trial in 2013 showed similar outcomes for those cooled to 33 degrees Celsius compared to 36 degrees Celsius, leading to a 2015 AHA class I recommendation of “cooling between 32 degrees Celsius-36 degrees Celsius.” 5,6 In 2021, the TTM2 trial was published. degrees Celsius for 72 hours.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40