Emergency Medicine Journal

JUNE 22, 2023

Methods This is a retrospective review of medical records of the ED of three public hospitals in Sydney, New South Wales, Australia from January 2016 to October 2021. The main outcome measures were ambulance transport, lumbar imaging, opioid administration and hospital admission.

Emergency Department 40

Emergency Department Administration Hospitals Outcomes 40

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. IOs can be used both for resuscitation, medication administration, and for laboratory testing, but there are a few important considerations. 2016 Dec 14;20(1):102. Li Y, editor.

Emergency Department 93

Emergency Department Ultrasounds Administration Burns 93

RebelEM

APRIL 29, 2024

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Intravenous vs intraosseous adrenaline administration in cardiac arrest: A protocol for systematic review and meta-analysis. 2016 PMID:27075364 13 Astasio-Picado Á et al. Resuscitation. 2012 PMID: 21893125. 9 Zhang W et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The patient’s symptoms begin to improve after initial intravenous (IV) fluid administration of one litre of 0.9% However, over the past 20 years, there is burgeoning evidence that fast-acting subcutaneous insulin analogs could be a potential treatment option for mild to moderate severity DKA including a 2016 Cochrane SRMA [4].

Diabetic Emergencies 110

Diabetic Emergencies Operations Hospitals Research 110

RebelEM

NOVEMBER 6, 2023

ug/kg/min of norepinephrine equivalent at time of hydroxocobalamin or methylene blue administration Exclusion Criteria: Administration of hydroxocobalamin or methylene blue for non-VS indications Hydroxocobalamin or methylene blue given > 48 hours after CPB Pre-intervention cardiac index < 2.0 J Cardiothorac Vasc Anesth.

Shock 71

Shock Administration Academics Hospitals 71

PEMBlog

JUNE 14, 2023

Marianne Gausche-Hill New England EMSC: New England Regional Behavioral Health Toolkit Disclaimer The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. Children’s Mental Health Emergency Department Visits: 2007-2016.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

EMDocs

AUGUST 3, 2023

IV is usually recommended due to faster onset, ease of administration, and shorter protocol duration. 2016 Jul;54(6):519-22. Epub 2016 Apr 27. PMID: 25133498 Ghannoum M, Kazim S, Grunbaum AM, Villeneuve E, Gosselin S. Massive acetaminophen overdose: effect of hemodialysis on acetaminophen and acetylcysteine kinetics.

Poisoning 98

Poisoning Seizures Administration Pediatrics 98

Dr. Smith's ECG Blog

OCTOBER 12, 2024

The providers documented concern for ST elevation in the precordial and lateral leads as well as a concern for hyperkalemic T waves in the setting of succinylcholine administration. 2016 Nov;34(11):2182-2185. Epub 2016 Aug 27. Potassium resulted as 4.9, initial troponin I 0.05 What do you think? Lee DH, Walsh B, Smith SW.

EKG/ECG 114

EKG/ECG Documentation/Coding Emergency Department COPD 114

Taming the SRU

FEBRUARY 12, 2024

Given her intracranial hemorrhages, significant attempts were made to improve coagulation including administration of IV vitamin K, 3 units of fresh frozen plasma, and administration of four-factor prothrombin complex concentrate (PCC, Kcentra). However, crucially, this assay must be calibrated to the agent of interest. [8] Nov 26; 10.

Administration 81

Administration Fractures Anaphylaxis Head Injuries 81

PulmCCM

JANUARY 23, 2025

Of course, they also have limitations you won’t likely learn from the marketers and hospital administrators eager to implement the latest advancements. These technologies seem to offer the potential to revolutionize standard care for sepsis by making faster, more accurate diagnoses. About one hour, according to the manufacturer.

Sepsis 45

Sepsis Wellness Emergency Department Research 45

ALiEM

FEBRUARY 20, 2024

Here is the patient’s EKG after administration of a 300 mEq sodium bicarbonate showing significant improvement of the cardiac sodium channel blockade as evidenced by a narrower QRS complex. 2016 Mar;12(1):121-9. What are other agents that block cardiac socium channels? Acute Card Care. 2013 Dec;15(4):90-2. Epub 2013 Nov 7.

Shock 73

Shock EKG/ECG Poisoning Burns 73

RebelEM

MAY 11, 2023

3, 4 Much of the appeal of phenobarbital lies in its ability to stave off severe alcohol withdrawal symptoms days after administration, without the necessity of daily redosing. What They Did: Retrospective cohort study at a single academic medical center between July 1, 2016 to June 30, 2019. 5 Paper: Lebin J et al.

Emergency Department 95

Emergency Department Administration Hospitals Academics 95

EMDocs

OCTOBER 21, 2023

15 Treatment: Several treatment modalities have been described for BAO, including intravenous thrombolysis (IVT) which involves systemic administration of agents such as TNK or tPA, intra-arterial thrombolysis (IAT) via microcatheter at thrombus site, or mechanical endovascular thrombectomy (EVT). doi: 10.1136/neurintsurg-2016-012515.

EMS 97

EMS Stroke Outcomes Hospitals 97

The Skeptics' Guide to EM

FEBRUARY 23, 2019

The Surviving Sepsis Campaign makes a number of recommendations in their 2016 guideline. One recommendation that they make is the rapid administration of 30ml/kg of crystalloid for hypotension. This is a strong recommendation from SSC based on low quality evidence. For more information see PulmCrit recent post. Reference: Lane et al.

Sepsis 52

Sepsis Administration Documentation/Coding Hospitals 52

Emergency Medicine Journal

NOVEMBER 28, 2023

The non-COVID-19 cohort included patients with lower respiratory tract bacterial infections admitted between January 2016 and April 2018. Conclusion The RR/SpO 2 relationship before oxygen administration does not differ between patients with COVID-19 and those without COVID-19, except in elderly patients.

Administration 52

Administration 52

ACEP Now

OCTOBER 26, 2023

However, to the extent these practices derive from departmental or institutional policies, emergency physicians need to work with ED nursing and clerical staff and hospital administration to revise overly conservative approaches to PHI transmittal of relevant clinical information. Published January 2016. HHS website.

Infectious Diseases 52

Infectious Diseases Documentation/Coding Hospitals Emergency Department 52

EMDocs

JANUARY 29, 2024

hypertensive emergency, need for thrombolytic administration) [1]. 2016 Sep 15;375(11):1033-43. Epub 2016 Jun 8. Current guidelines do not recommend acute treatment of hypertension in these patients unless extreme (SBP > 220 mmHg or DBP > 120 mmHg), or another indication is present (e.g. N Engl J Med.

Stroke 98

Stroke Outcomes EMS Seizures 98

RebelEM

NOVEMBER 2, 2022

Journal of Gastroenterology and Hepatology 2016. Pneumoniae, Enterococci 3rd Generation Cephalosporin covers vast majority of cases Ceftriaxone 25 mg/kg up to 1 gm daily Cefotaxime 25 mg/kg up to 1 gm Q8 Alternate antibiotic choices Ciprofloxacin 400mg IV BID Levofloxacin 750mg IV daily Piperacillin/Tazobactam 4.5g grams/kg within 6 hours 1.0

EMS 52

EMS Administration Hospitals 52

RebelEM

FEBRUARY 2, 2023

Unfortunately, the exact dose and time of administration of first line medications was not reported before a second line medication was given. Clinical Bottom Line: Numerically, amiodarone may be a better medication for rate and rhythm control. Therefore, no definitive conclusions can be made about this trial. References Mason JM, et al.

Emergency Department 52

Emergency Department Administration Dehydration EMS 52

Don't Forget the Bubbles

MAY 29, 2023

OJIN: The Online Journal of Issues in Nursing [Internet] 2016 :21:3. JONA: The Journal of Nursing Administration. Berry P, Gillespie G, Fisher B, Gormley D., Psychological Distress and Workplace Bullying Among Registered Nurses. DOI: 10.1097/ACM.0000000000005003 0000000000005003 Bureau JS, Gagné M, Morin AJS, Mageau GA.

Leadership 98

Leadership Patient Safety Academics Research 98

PHEM Cast

APRIL 10, 2016

March 2016. The control group received many similar treatments as the ‘intervention’ group (just not full protocolised EGDT) highlighting that with good sepsis care (fluid resuscitation, close monitoring, early appropriate antibiotic administration), mortality can be reduced. 2016 [cite Date Accessed]. Resuscitation.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

RebelEM

MARCH 23, 2023

and IM, and the physician was able to choose the method of administration. This study differed in that the phenobarbital administration was administered in a symptom-triggered protocol as opposed to a bolus. 2016 Apr;32:101-7. The protocols in the hospitals in the study included phenobarbital and lorazepam IV, p.o., J Crit Care.

Emergency Department 52

Emergency Department Burns Outcomes Hospitals 52

Northwestern EM Blog

MARCH 28, 2022

Fomepizole is now the preferred treatment because the administration of ethanol is more difficult, ethanol causes sedation, and titration of the therapy is challenging in co-ingestions [6]. Br J Clin Pharmacol, 2016. Ethanol was used historically before the effects of fomepizole were studied. Acad Emerg Med, 2002. McMartin, K.,

Poisoning 52

Poisoning Seizures Administration Pediatrics 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2016; 13:590-600. Eur J Pediatr Surg 2016; 26:192. 2016; 5(1):5-12. Plasma levels of lidocaine following nebulized aerosol administration. Necrotizing Enterocolitis. N Eng J Med. 2011; 364(3):255-264. Niño DF et al. Necrotizing enterocolitis: new insights into pathogenesis and mechanisms. Walsh MC et al. Pediatr Rev.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

RebelEM

JANUARY 23, 2023

Benadryl (diphenhydramine hydrochloride injection,USP) [package insert] New Brunswick , NJ: Johnson & Johnson; 2016. The effectiveness of IV cetirizine was determined to be statistically non-inferior. Allergy Asthma Proc. 2007 Jul-Aug;28(4):418-26. PMID: 17883909. Bernstein J, Leslie T. Antihistamines. Patterson’s allergic diseases.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Downeast Emergency Medicine

JULY 17, 2021

A convenience sample of 150 adults aged 18-64 presenting between November 2016 and October 2018 with pain between the costal margin and groin suspected by the EM physician of being caused by renal colic were enrolled. Treatment was either lidocaine 1.5 mg/kg, lidocaine 1.5 mg/kg and 30 mg ketorolac, or 30 mg of ketorolac alone.

Emergency Department 52

Emergency Department Wellness Administration EMS 52

Don't Forget the Bubbles

JANUARY 31, 2024

This retrospective cohort study was conducted in Boston Children’s Hospital and affiliated paediatric outpatient clinics between 2016 and 2019. Academic Pediatrics 2024 24 1 51-58 What’s it about? It recruited 784 children between the ages of 5 and 17 diagnosed with a concussion either in the ED or in primary care.

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

PulmCCM

NOVEMBER 11, 2021

Accordingly, the baseline PPV was 20%, suggesting greater preload dependency prior to phenylephrine administration. Goertz AW, Schmidt M, Seefelder C, Lindner KH, Georgieff M: The effect of phenylephrine bolus administration on left ventricular function during isoflurane-induced hypotension. Anesthesiology 1993, 78(5):834-841.

Stroke 40

Stroke Sepsis Administration Wellness 40

EMDocs

OCTOBER 30, 2023

Published online 2016. Contrast Media, Iodinated, Dose, and Administration. Journal of Medical Imaging and Radiation Oncology. doi:10.1111/1754-9485.13559 Millet I, Sebbane M, Molinari N, et al. doi:10.1007/s00330-016-4425-0 Agarwal MD, Levenson RB, Siewert B, Camacho MA, Raptopoulos V. J Am Coll Radiol. doi:10.1016/j.jacr.2023.06.032

Radiology 99

Radiology Radiology Emergency Department Hospitals 99

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

This appears to be immediately beneath the sternal fracture. But because of the much greater electrical mass of the LV — electrical activity ( and therefore ECG abnormalities ) from the much smaller and thinner RV are more difficult to detect.

EKG/ECG 52

EKG/ECG Fractures Hyperthermia / Hypothermia Wellness 52

Pediatric EM Morsels

NOVEMBER 3, 2023

2016 Apr; 32(4): 227–231. Food and Drug Administration Approval of Artesunate for Severe Malaria: Enough to Achieve Best Practice? Worldwide, children <5 years old account for 76% of deaths related to malaria, but these are predominantly in Sub-Saharan Africa (WHO 2022) P. vivax , P. malariae , and the less common P. vivax and P.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

RebelEM

NOVEMBER 30, 2023

For those with sepsis, the administration of intravenous fluids (IVF) at the volumes recommended in the Surviving Sepsis Campaign (SSC) requires careful consideration of an individual’s chronic medical conditions and subsequent sensitivity to IVF. Studies without a clear timeframe for fluid administration. 2.89, p = 0.01.

Sepsis 121

Sepsis Fluid Resuscitation Resuscitation Administration 121

EMDocs

NOVEMBER 16, 2024

In stable patients, fluid/tissue cultures should be obtained prior to administration of antibiotics. 2016 Mar 21;8(1):6253. 2016 Jan;30(1):10-6. Periprosthetic Joint Infection : Diagnosis requires joint fluid sampling, which is typically obtained in consultation with Interventional Radiology and Orthopedic Surgery.

EMS 97

EMS Dislocations Fractures Operations 97

ACEP Now

APRIL 9, 2025

CDPH still insists that following the Food and Drug Administrations (FDA) package insert is the gold standard when it comes to medical practice. It did so with varenicline on December 16, 2016 15 and canagliflozin on August 26, 2020. Food and Drug Administration. Food and Drug Administration. Food and Drug Administration.

Emergency Department 52

Emergency Department Administration EKG/ECG Resuscitation 52

Don't Forget the Bubbles

APRIL 7, 2025

A stimulating substance is administered to provoke hormone secretion, with levels measured before, during, and after administration at regular intervals. Steroid Administration The emergency care plan of children with a known diagnosis should guide the administration of steroids. Pediatr Rev March 2015; 36 (3): 92103.

Dehydration 72

Dehydration Pediatrics Administration Seizures 72

EMDocs

DECEMBER 6, 2024

In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. McGraw Hill; 2016. In the late 1990s, iron was the leading cause of poisoning deaths reported to poison control centers for children less than 6 years of age. & Rangan, C.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

RebelEM

MAY 15, 2024

Early administration of antibiotics is the only factor known to reduce this mortality. Early administration of antibiotics is the only factor known to reduce this mortality. Epub 2016 Dec 29. Cohort Study of the Impact of Time to Antibiotic Administration on Mortality in Patients with Febrile Neutropenia. Ann Emerg Med.

Infectious Diseases 98

Infectious Diseases Administration Sepsis Anaphylaxis 98