RebelEM

SEPTEMBER 23, 2024

Proponents of its use often dismissed this effect of the drug as there had never been any evidence it impacted clinical outcomes. 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. Intensive Care Med.

EMS 75

EMS Outcomes Resuscitation Wellness 75

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). The unblinded nature of the study could influence outcomes due to observer bias.

Outcomes 137

Outcomes Research Hospitals Operations 137

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. Article: How-Berlemont C, Lamhaut L, Diehl J, et al.

Hospitals 83

Hospitals Outcomes EKG/ECG Resuscitation 83

RebelEM

MAY 25, 2023

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Epub 2015 Aug 22. That sounds reasonable, so what has changed?

Pediatrics 183

Pediatrics Emergency Department Outcomes Sepsis 183

Pediatric EM Morsels

NOVEMBER 15, 2024

2015) Childhood epilepsy centrotemporal spikes (benign Rolandic Epilepsy) , Epilepsy Foundation. Care and three-year outcomes of children with Benign Epilepsy with Centro-Temporal Spikes in England. References : Hernandez, A., Holmes, G.L. and Fisher, R. Edited by E. Available at: [link] (Accessed: 14 November 2024). Pediatr Neurol.

Seizures 152

Seizures Stroke Pediatrics Wellness 152

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. 2015 Sep 1;136(3):487-95. British journal of nursing. Pediatrics.

Leadership 104

Leadership Resuscitation Teamwork Patient Safety 104

ETM Course

JUNE 11, 2015

If you’re interested in trauma systems and their effect on patient outcomes, this is a great presentation by Russell Gruen at the recent TAC – MUARC Symposium.

Outcomes 52

Outcomes 52

PulmCCM

SEPTEMBER 21, 2023

A 2015 meta-analysis of 13 randomized trials enrolling >12,000 patients suggested that active blood pressure management after ischemic strokes had little effect on eventual outcomes, and that delaying blood pressure control for three days did not lead to worse outcomes (death or disability).

Stroke 105

Stroke Outcomes 105

The Trauma Pro

OCTOBER 6, 2023

Although many of these injuries were managed within hours, a growing number were delayed by a few days to improve outcomes. We learned that temporizing with strict blood pressure control worked wonders at protecting the patient. Nowadays, thoracic endovascular aortic repair (TEVAR) is routine and much less morbid than the open procedure.

Head Injuries 147

Head Injuries Research Hospitals Resuscitation 147

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 130

Ultrasounds Outcomes COPD Hospitals 130

Sensible Medicine

OCTOBER 21, 2024

One of those rules was (and remains) that if differences are observed in outcomes that were not pre-specified these should be regarded merely as generating hypotheses for testing in further studies But then something happened. They did not expect this 9-fold higher death rate. They tried to publish their study.

Evidence-Based Practice 108

Evidence-Based Practice Shock Fractures Outcomes 108

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. 2015 Dec;21(6):1244-6. Epub 2015 Dec 29. Epub 2021 Apr 29.

Emergency Department 52

Emergency Department Outcomes Ultrasounds Pediatrics 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

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

ALiEM

NOVEMBER 1, 2024

2015 Apr;20(2):131-8. Pulmonary embolism with clot in transit: An analysis of risk factors and outcomes. References Athappan G, Sengodan P, Chacko P, Gandhi S. Comparative efficacy of different modalities for treatment of right heart thrombi in transit: a pooled analysis. doi: 10.1177/1358863X15569009. PMID: 25832601. 2021.07.1932.

Ultrasounds 64

Ultrasounds Academics Research Outcomes 64

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 137

Stroke Outcomes Hospitals Administration 137

EMDocs

AUGUST 22, 2024

have limited English proficiency according to the 2015 U.S. 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.

Documentation/Coding 82

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 82

Emergency Medicine Journal

DECEMBER 22, 2023

Background Long waiting times in the ED have been shown to cause negative outcomes for patients. The Centre for Urgent and Emergency Care research database patient-level database (May 2015–April 2016), secondary literature and expert elicitation were used to inform the model.

Emergency Department 52

Emergency Department Research Outcomes Hospitals 52

Taming the SRU

JULY 25, 2024

More efficacious than parenteral opioids alone Safer than opioids Decreased delirium Patients have been shown to have improved functional outcomes at 30 days Early pain control matters! Currently EVT for large core is being looked at and so far the outcomes seem to be favorable

Stroke 97

Stroke Fractures Outcomes Operations 97

The Skeptics' Guide to EM

OCTOBER 21, 2023

SGEM#366 concluded that we could not recommend the routine use of skeletal muscle relaxants, SGEM#304 agreed that adding acetaminophen to ibuprofen did not improve one-week outcomes, while SGEM#173 concluded the same about diazepam (there’s a theme here!).

Emergency Department 103

Emergency Department Radiology Radiology Hospitals 103

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. Co-primary outcomes were emergency hospitalisation and ED attendances, which will be reported separately.

Emergency Department 52

Emergency Department Hospitals Outcomes 52

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. COVID19 vaccines have never shown benefit with respect to clinical outcomes among people who already had COVID. But in work that Chul Kim and I did in 2016 we found this was not the case. One examined this question.

Poisoning 131

Poisoning Outcomes 131

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 126

CDC Radiology Radiology Outcomes 126

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

Don't Forget the Bubbles

JUNE 30, 2023

Extracorporeal life support rewarming rate is associated with survival with good neurological outcome in accidental hypothermia. The THAPCA-OH trial found that hypothermia did not result in a statistically significant benefit for survival with good functional outcomes at one year compared to normothermia. Saczkowski, R., Meert et al.

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

The Skeptics' Guide to EM

MAY 20, 2023

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. Clinical Question: Does therapeutic hypothermia provide any benefit in neurobehavioral outcomes and survival in out-of-hospital pediatric cardiac arrest?

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

EMDocs

MAY 11, 2024

2015 Sep;66(3):322-333.e31. Endovascular and Clinical Outcomes of Vertebrobasilar Intracranial Atherosclerosis-Related Large Vessel Occlusion. Nov 10 th , 2015. Clinical Policy: Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department. Ann Emerg Med. 2015.06.031.

Stroke 89

Stroke EMS EKG/ECG Radiology 89

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 59

Dislocations Fractures Soft Tissue Injuries Outcomes 59

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 105

Resuscitation Administration Emergency Department Hospitals 105

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 73

Sepsis Outcomes Pediatrics Documentation/Coding 73

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

JULY 19, 2023

2015 ) found an incidence of true papilloedema of 25% and 6%, respectively, in children referred to tertiary ophthalmology departments with suspected optic disc swelling. Outcome of pediatric patients referred for papilledema. 2015 Aug 1;19(4):344–8. Interestingly, the child’s gender made a difference. 2023 and Kovarik et al.,

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98

SheMD

DECEMBER 17, 2023

What were their outcomes: 33.2% Gender Distribution of First and Senior Authorship Across Most Cited Studies Within the Top Ten Surgical Journals From 2015-2020: Cementing Women Academic Surgery Representation. Gender categorization was done utilizing faculty profiles and gender pronouns. of authors were female, while 62.9%

Academics 52

Academics Leadership Research Outcomes 52

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 They recommended synovial fluid analysis as essential to the diagnosis [30].

Infectious Diseases 88

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

Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

The American Journal of Emergency Medicine 2015; 33(6):786-790. Smith : "What was the outcome?" Electrocardiographic Criteria to Differentiate Acute Anterior ST Elevation Myocardial Infarction from Left Ventricular Aneurysm. link] So I responded with these words: Smith : "There are QS waves, which suggest old MI.

EMS 108

EMS CPR EKG/ECG Wellness 108

PHARM

JUNE 6, 2023

Consecutive sampling of trauma patients who underwent PHEA using a fentanyl, ketamine, rocuronium drug regime were included, 2015–2020. The variables significantly associated with PIH only account for a small proportion of the observed outcome. Read on sjtrem.biomedcentral.com/articles/10.1186/s13049-023-01091-z

Resuscitation 40

Resuscitation Administration Outcomes 40