EMDocs

JUNE 12, 2024

HypoCa is common in trauma patients and is associated with poor outcomes. Calcium and resuscitation Severely injured trauma patients are commonly hypocalcemic. Giancarelli et al found that 97% of patients who underwent massive transfusion protocols during trauma resuscitation were hypocalcemic (iCa < 1.1 Am J Emerg Med.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 105

Don't Forget the Bubbles

JUNE 30, 2023

Elsa was found face down in the family pool 20 minutes after last visual contact and was picked up without resuscitation. She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. Emergency Medical Services found her apneic and pulseless. C and remained pulseless.

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. They looked at 119 adult patients from an (unspecified) number of trauma centres. to −0.5%]; P  = 0.03.).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Mind The Bleep

OCTOBER 29, 2024

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications. Proper stabilization and detailed communication with the burns centre are essential for optimal patient outcomes. 2015 Jun;11(2):227-31.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

RebelEM

SEPTEMBER 23, 2024

You decide to intubate the patient after resuscitation. 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 ).

EMS 77

EMS Resuscitation Outcomes Wellness 77

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

PHEM Cast

DECEMBER 12, 2016

pdf Equipment required for resuscitative thoracotomy: Surface anatomy: Appearance of pericardial clot A foley catheter being used to fill a cardiac wound – note how easily this could be pulled out. An open chest with aortic compression Simulation of resuscitative thoracotomy by London HEMS team. Resuscitation; 2011: 1194-1197

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

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 66

Hospitals Outcomes EKG/ECG Resuscitation 66

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. Resuscitation. 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 96

PPE Ultrasounds Resuscitation Emergency Department 96

The Skeptics' Guide to EM

MAY 25, 2019

Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. Clinical Question: What are the outcomes of trauma patients after REBOA placement? Date: May 23rd, 2019 Reference: Joseph et al.

Military 52

Military Resuscitation PPE Emergency Department 52

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

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. In a PICU setting, sodium can come from various sources (resuscitation fluids, IV drugs and infusions, enteral feed), not just the maintenance fluids we prescribe. sodium chloride.

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

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

PHEM Cast

JULY 27, 2021

2015 Marik PE, Cavallazzi R. Kenji Inaba. Does central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense.

Ultrasounds 52

Ultrasounds Fractures Resuscitation EMS 52

PHEM Cast

APRIL 10, 2016

It is worth noting, that with “Sepsis 3” many of these terms will become out-of-date – but validation work is required… The Rivers’ paper can be accessed here: [link] It was a single centre study which compared standard care with protocolised resuscitation packaged together as early goal-directed therapy (EGDT).

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

ACEP Now

APRIL 3, 2024

Targeted temperature management (TTM) for patients following cardiac arrest resuscitation has gone through several dosing iterations in the past two decades. Finally, the guidelines support active temperature management’s (though not necessarily hypothermia) role in improving post-arrest outcomes. degrees Celsius for 72 hours.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

EMDocs

JULY 13, 2024

Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis. Incidence, treatment and outcome of peripartum sepsis. 2015 Feb 2;2015(2):CD001067. Am J Clin Pathol. 1999 Aug;112(2):211-5. doi: 10.1093/ajcp/112.2.211.

OB/GYN 89

OB/GYN EMS Sepsis Fluid Resuscitation 89

The Skeptics' Guide to EM

MAY 20, 2023

They started cardiopulmonary resuscitation (CPR) until EMS arrived. 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. He had been having some upper respiratory symptoms in the previous days.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

This basically means rapid access to ACLS type resuscitation skills (intubation and intravenous drug therapy). It also did not show an increase in good neurologic outcome in the survivors (78.3% Resuscitation 2011 * Hagihara et al. You need to recognize an arrest and activate your EMS system. vs. 5.1%, p=0.83).

CPR 52

CPR Academics Resuscitation Hospitals 52

The Skeptics' Guide to EM

FEBRUARY 2, 2019

In the 2015 AVOID study there was some suggestion of increased MI size in the group of STEMI patients that received oxygen at 8 L/min compared to a room air control group. This study expands upon that investigation to patients with other conditions as well.

Poisoning 52

Poisoning Administration Hospitals Sepsis 52

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

Advanced Emergency Nursing from AENJ

APRIL 29, 2015

Every five years, a conference determines the current state of the art for resuscitation recommendations. For babies born at term, it is best to begin resuscitation with room air rather than 100% oxygen. The association between hyperoxia and patient outcomes after cardiac arrest: analysis of a high-resolution database.

Resuscitation 40

Resuscitation Pediatrics Administration Emergency Nursing 40

Advanced Emergency Nursing from AENJ

NOVEMBER 27, 2017

AHA gives focused recommendations ​. ​ ​​ The International Liaison Committee on Resuscitation (ILCOR) has for some years been meeting and agreeing upon resuscitation practices every five years; in addition to which there is the necessary slack time before and after each meeting to produce and disseminate the newly appropriate course materials.

CPR 40

CPR Basic Life Support Resuscitation Pediatrics 40

Northwestern EM Blog

FEBRUARY 14, 2022

Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation. The primary outcome of the study was the response in MAP three hours after the start of angiotensin II infusion.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

PHEM Cast

APRIL 21, 2021

The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. Resuscitation. 2015 Oct 23;10(10):e0141034. Scand J Trauma Resusc Emerg Med 23, 57 (2015). Resuscitation. J Trauma 2003; 54:444-453 Mort TC. 2011 Dec;82(12):1519-24. doi: 10.1016/j.resuscitation.2011.06.028.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

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

Pediatric Emergency Playbook

AUGUST 1, 2017

Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease? Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. 2015; 18 Gilmore AW et al. Hirschsprung disease, associated syndromes and genetics: a review. J Med Genet 2008; 45:1. 2007; 16:27-33.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Northwestern EM Blog

JANUARY 24, 2022

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. There is a subset of patients who, despite aggressive conventional resuscitation, have an inadequate hemodynamic response and develop refractory shock. California Medicine.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Don't Forget the Bubbles

JULY 3, 2023

This retrospective cohort study compared pre- and post-guideline outcomes. Recalling and identifying anatomical landmarks for safe sites for thoracic decompression can be challenging in the pressurised, time-critical trauma resuscitation environment. Four hundred data sets were included, 54% belonging to female patients.

Emergency Department 105

Emergency Department Hospitals Domestic Violence Pediatrics 105

Don't Forget the Bubbles

MARCH 18, 2024

She receives fluid resuscitation, and you organise some tests to find out why she is so tired. Early Volume Expansion and Outcomes of Hemolytic Uremic Syndrome. 2015 Nov;46(5):586–9. 2015 Jul 4;30(12):2115–9. Treatment and outcome of Shiga-toxin-associated hemolytic uremic syndrome (HUS). 2015 [cited 2024 Jan 19].

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

The Injectable Orange

JUNE 20, 2017

The world is a strange place when we can’t do something so simple when it’s critical, but we do it so well when the outcomes are meaningless. Mental practice: a simple tool to enhance team-based trauma resuscitation. Epub 2015 Apr 10. Cheng (2015). This demands more research.” I’d better come back tomorrow.”

Head Injuries 52

Head Injuries Documentation/Coding Wellness Resuscitation 52

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). Resuscitation 2013; 84(11): 1500 – 4. WJEM 2015; 16(7): 1109 – 17. 2015 Dec;30(8):499-504. References: Heffner AC et al. PMID: 23911630 Kim WY et al. Am J Emerg Med.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

PHEM Cast

SEPTEMBER 6, 2017

Qvigstad et al showed in again in Resuscitation in 2013, confirming inter-individual variation in effectiveness of CPR using ETCO2 as a surrogate for CO Trauma Deakin et al. (J. trauma 2004) showed that end-tidal CO2 may be of value in predicting outcome from major trauma (19). O Capnogram showing rebreathing during inspiration.

CPR 52

CPR Resuscitation Operations Shock 52

Taming the SRU

FEBRUARY 19, 2024

This has been the central question of many research projects with variable outcomes. One such study of 263 patients without hypertensive emergencies treated in a resuscitation unit found that 40% of patients had a MAP difference ≥ 10 mmHg between IABP and NIBP measurements. Critical care and resuscitation, 11(1). Gelmann, D.,

Shock 59

Shock Resuscitation Ultrasounds Research 59

Taming the SRU

FEBRUARY 22, 2023

doing the little things right, with the understanding that small gains are additive, and that details can be the difference between a good outcome and a poor one. Lesson 10 Details matter and marginal gains accumulate. Lesson 11 Find what you love to do and surround yourself with people who make you better at doing it.

Hospice 40

Hospice EKG/ECG Resuscitation Seizures 40

EB Medicine

AUGUST 6, 2019

In the end, they reported similar rates of recurrence and bleeding outcomes for acute treatment. Jeff: Edoxaban is up next, approved by the FDA in 2015 for similar indications as the other Factor Xa inhibitors. This strategy reduces hospital days and costs with otherwise similar outcomes - total win all around.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

EB Medicine

SEPTEMBER 1, 2018

As some background, from 2006-2015 there were almost 66,000 reported snake exposures and 31 deaths from snake envenomation in the US. Nachi: Not only are they out, they actually worsen outcomes, so definitely don’t pursue any of them. Jeff: What a team! But, let’s get back to the snakes. It’s an easy number to remember.

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Emergency Department Poisoning Anaphylaxis Allergic Reactions 40