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). Acad Emerg Med. 2016 Feb;30(1):3-11.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

The Skeptics' Guide to EM

OCTOBER 21, 2023

Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Population: Adults attending at continuously-staffed EDs in a health network covering 15 states, 2016-19.

Emergency Department 135

Emergency Department Radiology Radiology Hospitals 135

EMDocs

DECEMBER 6, 2024

7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. Tintinallis Emergency Medicine: A Comprehensive Study Guide, 8e. McGraw Hill; 2016. Pediatric Emergency Care, 27 (10), 978-985. Antiemetics as needed. 2 L/hr in adults.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

The Trauma Pro

OCTOBER 4, 2024

years from 2013 to 2016. Clinical outcomes assessed at 60 days included an unplanned return to the emergency department (ED), re-admission, complications, and development of new bleeding confirmed by surgery, ultrasound, or computed tomography (CT) at 60 days post-injury. J Ped Surg 54:335-339, 2019.

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Certified interpreter use can improve communication and patient outcomes. An implementation science approach improves language access in the emergency department. One cohort study in a public ED found that 84.5% 45:446-458. Taira B, et al.

Documentation/Coding 105

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 105

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

Emergency Medicine Journal

JANUARY 22, 2024

1–3 However, the literature is sparse surrounding the characteristics, treatment, outcomes, costs, disposition and resource utilisation of people who co-use compared with those who use opioids alone. Many overdose deaths are associated with patient co-use of opioids and other substances, such as benzodiazepines.

Outcomes 40

Outcomes Emergency Department Poisoning Documentation/Coding 40

Emergency Medicine Journal

OCTOBER 23, 2024

This study aimed to analyse the advice provided in NHS 111 calls, the duration between the call and ED attendance, and the outcomes of such attendances made by children and young people (C&YP). This linked-data study examined NHS 111 calls and ED outcomes. This linked-data study examined NHS 111 calls and ED outcomes.

Emergency Department 52

Emergency Department Outcomes 52

RebelEM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

EMDocs

JANUARY 25, 2025

A 45-year-old outdoor enthusiast presents to the emergency department with fever, headache, myalgias, and malaise. 0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. Geneva: World Health Organization; 2016. No rash is identified. Curr Opin Hematol.

EMS 96

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 96

RebelEM

JUNE 8, 2023

Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

EMDocs

DECEMBER 23, 2024

Gorgels et al (5) looked at procainamide vs lidocaine and again and primary outcome was VTach termination. Its narrow indication for stable VT means many emergency departments may not routinely stock the medication. Best Clinical Practice: Emergency Medicine Management of Stable Monomorphic Ventricular Tachycardia.

EKG/ECG 75

EKG/ECG Shock Wellness EMS 75

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

RebelEM

APRIL 29, 2024

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ). Crit Care Med. Resuscitation.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Emerg Med J. Paediatr Int Child Health. 2024 Jan 11:1-7.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. Poor blood pressure management can worsen the outcome of hemorrhagic stroke by increasing the risk of hematoma expansion, cerebral edema, and ischemia [8-14]. PMID: 11988609.

Stroke 101

Stroke Outcomes EMS Seizures 101

Don't Forget the Bubbles

OCTOBER 2, 2023

P aediatric R esearch A cross the M idlands ( PRAM ) is a trainee-led research collaborative across the West Midlands, networking since 2016. The reported prevalence of undiagnosed hypoglycaemia disorders among children seen in the emergency department (ED) for any reason ranges between 10% and 28%. Why does it matter?

Outcomes 138

Outcomes Research Wellness Emergency Department 138

Don't Forget the Bubbles

JULY 19, 2023

Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation. This data was collected over a five-year period (2016-2020) had true papilloedema. Outcome of pediatric patients referred for papilledema. Clin Ophthalmol.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98

Emergency Medicine Journal

MAY 23, 2023

Background Upper gastrointestinal bleeding (UGIB) is a medical emergency with an approximate mortality of 10%, which results in a high hospitalisation rate. The Glasgow-Blatchford score (GBS) is recommended to identify low-risk patients who can be discharged from the emergency department (ED).

Emergency Department 40

Emergency Department Blood Transfusions Hospitals Wellness 40

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. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this. c) Or, do both?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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. doi: 10.1136/neurintsurg-2016-012515. Epub 2016 Jul 15. Arch Neurol.

EMS 98

EMS Stroke Outcomes Hospitals 98

EMDocs

OCTOBER 30, 2023

Background and Context Contrast-enhanced computed tomography (CECT) is of paramount importance in the emergency department (ED) due to its indispensable role in facilitating precise diagnostic outcomes. Increased Computed Tomography Utilization in the Emergency Department and Its Association with Hospital Admission.

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). 2016, April 13). He was intubated for altered mental status. Ziaeian, B.,

EKG/ECG 115

EKG/ECG Wellness Fractures Emergency Department 115

Don't Forget the Bubbles

AUGUST 7, 2023

This prospective cohort study included patients between 0-16 years old, who presented to one of four NHS hospital sites in Greater Manchester (a large metropolitan area in the North of England), consisting of an Urgent Care Centre and three Emergency Departments. Yes Was the outcome accurately measured to minimize bias?

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

Taming the SRU

JUNE 11, 2023

End-tidal carbon dioxide measured at emergency department triage outperforms standard triage vital signs in predicting in-hospital mortality and intensive care unit admission. Acad Emerg Med 2023; 10.1111/acem.14703 Enrollment period was from February 2016 to August 2018. The primary outcome was in-hospital mortality.

Hospitals 88

Hospitals Emergency Department EMS Outcomes 88

Taming the SRU

JANUARY 10, 2024

89% agree that violence in the emergency department has harmed patient care. Phenobarbital has been proven to be equivalent to benzodiazepines with regard to clinical, pharmacologic and utilization outcomes. None of the physicians in the study believe that the rate of violence has decreased at all.

EKG/ECG 93

EKG/ECG Shock Fractures Dislocations 93

The Skeptics' Guide to EM

AUGUST 28, 2021

Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. Case: A forty-year-old woman presents to the emergency department […] The post SGEM#342: Should We Get Physical, Therapy for Minor Musculoskeletal Disorders in the ED?

Emergency Department 52

Emergency Department Research Outcomes 52

The Skeptics' Guide to EM

MAY 5, 2018

Child Development December 2016. He has particular interests in Emergency Care, Aboriginal Health, Paediatrics, Trauma and Women’s Anaesthesia. . […] The post SGEM#217: The Batman Effect on Improving Perseverance first appeared on The Skeptics Guide to Emergency Medicine. Child Development December 2016.

Emergency Department 52

Emergency Department Outcomes 52

EMDocs

AUGUST 8, 2023

Bimodal age of distribution: at birth and 12-18 years 14% of cases occur in adults; older patients have worse outcomes Bell clapper deformity – bilateral in 80% of patients Prior episode of torsion Family history Trauma (can be minor) Clinical Presentation: Sudden/severe testicular pain Often unilateral, may radiate.

Ultrasounds 95

Ultrasounds Documentation/Coding Outcomes Emergency Department 95

Pediatric Emergency Playbook

NOVEMBER 1, 2017

To scan or not to scan: pediatric minor head trauma in your office, clinic or emergency department. Acad Emerg Med. Children with Arachnoid Cysts who Sustain Blunt Head Trauma: Injury Mechanisms and Outcomes. Acad Emerg Med. 2016; 23:358-361. Headache in Traumatic Brain Injuries from Blunt Head Trauma.

Pediatrics 52

Pediatrics Emergency Department Outcomes 52

RebelEM

MARCH 23, 2023

The primary outcome, hospital length of stay, was significantly shorter both before and after propensity score adjustment for the phenobarbital group. The 30-day emergency department readmission rate and all-cause 30-day readmission were significantly lower only when adjusted for propensity scores.

Emergency Department 52

Emergency Department Burns Outcomes Hospitals 52

The Skeptics' Guide to EM

MAY 25, 2019

Clinical Question: What are the outcomes of trauma patients after REBOA placement? Population: All adult (over 18 years of age) patients in the ACS-TQIP database from 2015-2016. Reference: Joseph et al. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. JAMA Surgery March 2019.

Military 52

Military Resuscitation PPE Emergency Department 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). actors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department. Int J Emerg Med. J Emerg Med.

Emergency Department 93

Emergency Department Soft Tissue Injuries Airway Management Operations 93

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. While it was < 15% in 1990, by 2016 it reached 40%. Jeff: And we also have the AspireAssist siphon, which was approved in 2016.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Taming the SRU

JANUARY 29, 2024

She was concerned that this was not improving and decided to come to the emergency department (ED). Hospital Course The patient was initiated on a therapeutic heparin drip in the emergency department with vascular surgery consultation. 2016 Feb;50(2):98-101. Epub 2016 Feb 11. Vasc Endovascular Surg.

Emergency Department 94

Emergency Department Fractures Hospitals Operations 94

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. There have been reports of the Orbeez Challenge leading to serious outcomes. What are the risks of water beads? 2016;11:39-43.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

RebelEM

MARCH 8, 2023

Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. Emergency Department Management: Emergency ophthalmology consultation. Emergency surgical management indicated if concomitant retinal tear, vitreous hemorrhage, or retinal detachment. >10 floaters, (+) LR 8.1-36

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52