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

OCTOBER 16, 2024

This is a remarkable example of the differences between societies, which might influence the processes of clinical trials and their outcomes. RIPC has not been shown to improve cardiovascular outcomes more generally after cardiac surgery. Circulation. 2024 Sep 25. doi: 10.1161/CIRCULATIONAHA.124.071408. 124.071408. Epub ahead of print.

Outcomes 52

Outcomes Operations Research Hospitals 52

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 126

Ultrasounds Outcomes COPD Hospitals 126

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 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 134

Stroke Outcomes Hospitals Administration 134

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 72

Sepsis Shock EMS Emergency Department 72

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

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

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 105

Leadership Resuscitation Teamwork Patient Safety 105

The Skeptics' Guide to EM

JULY 27, 2024

It is a medical emergency that requires prompt recognition and treatment to improve patient outcomes. The primary outcome reported was no statistical difference in mortality at 28 days (8% in both groups) despite giving antibiotics 96 minutes earlier [2]. A similar review by Sanders et al 2015 concludes that clinica.

Sepsis 74

Sepsis Outcomes Documentation/Coding Hospitals 74

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 109

Dislocations Fractures Soft Tissue Injuries Outcomes 109

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 100

Outcomes Hospitals Research Emergency Department 100

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 126

Poisoning Outcomes 126

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 114

CDC Radiology Radiology Outcomes 114

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 70

EMS Outcomes Resuscitation Wellness 70

RebelEM

DECEMBER 4, 2024

Ann Emerg Med 2015; 65(5): 532-9. Ann Emerg Med 2015; 65(5): 532-9. Thirty-day Outcomes of Emergency Department Patients Undergoing Electrical Cardioversion for Atrial Fibrillation or Flutter. J Emerg Med 2015. Cardioversion recommendations exclude patients with recent strokes or valvular heart disease.

Emergency Department 86

Emergency Department Stroke EMS Shock 86

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 104

Emergency Department Radiology Radiology Hospitals 104

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

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

Emergency Medicine Journal

MAY 23, 2023

We validated the score in a large patient data set and constructed a model that allows early prediction of the probability of clinical outcomes based on the individual’s NEWS+L Score. The outcomes were hospital death or a composite of hospital death and intensive care unit admission at 24 hours, 48 hours and 72 hours.

Outcomes 40

Outcomes Emergency Department Academics Operations 40

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 60

Hospitals Outcomes EKG/ECG Resuscitation 60

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 Ultrasounds 105

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 96

Stroke Fractures Outcomes Operations 96

Broome Docs

MARCH 28, 2024

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! Emerg Med J. 2024 Jan 22;41(2):96-102. doi: 10.1136/emermed-2023-213285.

PPE 107

PPE Ultrasounds Resuscitation Administration 107

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

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

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

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

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 Ultrasounds Shock CPR 52

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 Federal Emergency Management Agency Best Practices 82

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

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. There have been reports of the Orbeez Challenge leading to serious outcomes. The liquids were chosen to “approximate a pediatric digestive environment.” ” ( Ed. After Darracq et al., Darracq, M.A., Rentmeester, L.,

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

Don't Forget the Bubbles

JANUARY 8, 2024

This led to her death at 19, an outcome ruled as homicide at inquest, indicating others’ contribution to her demise. Verbal de-escalation not only helps in avoiding the need for physical intervention but also fosters a therapeutic relationship, crucial for successful treatment outcomes in these sensitive situations. Mulraney, M.,

Research 105

Research Emergency Department Psychiatric Outcomes 105

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 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

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 Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. Highly recommended. 108(1): 11-16.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 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 Outcomes Pediatrics Documentation/Coding 75

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 102

EMS CPR EKG/ECG Wellness 102