RebelEM

NOVEMBER 30, 2023

Studies without IRB approval Studies older than 2016 Intervention: Administration of <30 mL/kg IV crystalloid fluids within three hours of sepsis identification. Outcomes: Primary Outcome: In-hospital mortality. Secondary Outcomes: Delayed hypotension, increased ICU stay, and other relevant outcomes.

Sepsis 121

Sepsis Fluid Resuscitation Resuscitation Administration 121

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 136

Stroke Outcomes Hospitals Administration 136

PulmCCM

OCTOBER 7, 2024

What’s the evidence for this practice, in terms of efficacy, outcomes, and safety? Observational Trials of Midodrine in the ICU At least six observational studies on midodrine in the ICU were published between 2016 and 2021. All but one were retrospective.

Shock 98

Shock Outcomes 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

Don't Forget the Bubbles

JULY 22, 2024

Randomised controlled trials addressing the benefit of steroids in preschool wheeze have compared different cohorts, used different trial designs and measured different outcomes. This is a way to overcome different trial outcomes. This paper’s primary outcome was a change in wheeze severity score (WSS). What does this mean?

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

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

EB Medicine

FEBRUARY 13, 2017

For the first episode, we are going to focus on one of the most popular articles from last year, the October 2016 issue, entitled “Optimizing Survival Outcomes For Adult Patients With Nontraumatic Cardiac Arrest.” Welcome to the inaugural episode of EMplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice journal.

Outcomes 40

Outcomes Resuscitation Shock 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

Sensible Medicine

APRIL 25, 2024

But in work that Chul Kim and I did in 2016 we found this was not the case. COVID19 vaccines have never shown benefit with respect to clinical outcomes among people who already had COVID. Regular approval means that there are no post marketing efficacy commitments, and the surrogate has to have a strong correlation with survival.

Poisoning 129

Poisoning Outcomes 129

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

MARCH 30, 2023

Diastolic shock index and clinical outcomes in patients with septic shock. the diastolic shock index) could provide providers a tool to quickly identify patients that are at risk for unfavorable outcomes. Diastolic Shock Index: A clinically relevant predictor of poor outcome in septic shock? Ann Intensive Care 2020;10(1):41.

Shock 52

Shock Outcomes Sepsis Resuscitation 52

Emergency Medicine Journal

OCTOBER 26, 2023

Methods All cases of OHCA between 1 January 2016 and 31 December 2021 in the Helsinki University Hospital catchment area in which the ECPR protocol was activated were included in the study. Cases of hypothermic cardiac arrest were excluded. Results The prehospital ECPR protocol was activated in 73 cases of normothermic OHCA.

Hospitals 75

Hospitals CPR Resuscitation Outcomes 75

EMDocs

SEPTEMBER 8, 2024

Delaying treatment of elevated BP in patients may lead to worse outcomes, and an optimal IV antihypertensive medication will reach the BP goal rapidly while avoiding hypotension and causing end organ injury. Authors extracted proportions dichotomous outcomes (in-hospital mortality) and calculated risk ratios. clevidipine).

Stroke 81

Stroke Outcomes Hospitals 81

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!). AEM October 2023.

Emergency Department 104

Emergency Department Radiology Radiology Hospitals 104

Advanced Emergency Nursing from AENJ

OCTOBER 30, 2016

" This puts into play the powerful forces of expectation of a positive outcome. The key is to be warm, engaging, cognizant of present difficulties yet optimistic and good-natured as to outcome and how to get there. ." "How soon, I wonder, do you think you'll be able to feel that way?" You, too, should definitely do so.

Outcomes 40

Outcomes Emergency Nursing Pediatrics Wellness 40

Sensible Medicine

MARCH 28, 2024

In 2016, Jonathan Reiner said this about Carrie Fisher’s mother, who died very shortly after her daughter. There has never been any credible data that disease awareness improves outcomes for people — and more to the point — that gossiping about a celebrities condition causes such disease awareness.

Hospitals 89

Hospitals Outcomes Wellness 89

RebelEM

AUGUST 14, 2023

days 2 most common sites of infection were lung (44.8%) and inta-abdominal (32.1%) Majority of infections were community-acquired (≈84%) Over half the patients were on mechanical ventilation (≈53%) Primary Outcome Results: 28-day mortality rate: Placebo 26.1% (230/882) vs. XBJ 18.8% (165/878); P<0.001 The risk difference was 7.3% (95% CI, 3.4-11.2)

Sepsis 98

Sepsis Outcomes Administration EMS 98

RebelEM

DECEMBER 23, 2024

There has been ongoing study about the clinical significance of these effects, as well as whether and for whom LR might provide meaningfully better clinical outcomes ( Myburgh 2013 , Self 2018 , Semler 2018 , Self 2020 ). The enrollment was multicenter, large, and adequately powered for clinically meaningful changes in outcome.

Fluid Resuscitation 82

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 82

EMDocs

DECEMBER 18, 2024

2016; 83(1): 67-79. Alcohol withdrawal syndrome: improving outcomes through early identification and aggressive treatment strategies. fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold Management of drug and alcohol withdrawal. N Engl JMed. 2003; 348:1786-1795. Br J Addict.

Seizures 80

Seizures Hyperthermia / Hypothermia Emergency Department EMS 80

Sensible Medicine

NOVEMBER 28, 2023

One of these was an article that Vinay Prasad and I wrote back in 2016: Wearables, Smartphones and Novel Anticoagulants: We Will Treat More Atrial Fibrillation, but Will Patients Be Better Off? The primary outcome was stroke or systemic embolism and the primary safety outcome was major bleeding.

Stroke 71

Stroke Academics Outcomes Administration 71

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). 2016, April 13). RBBB in blunt chest trauma seems to be indicative of several RV injury. In patient's at risk, physical activity should be limited for several months after the injury. References Alborzi, Z., Zangouri, V., Ghahramani, Z., Ziaeian, B.,

EKG/ECG 107

EKG/ECG Wellness Fractures Hospitals 107

EMDocs

JANUARY 29, 2024

Finally, anticipating and addressing known complications such as seizures, increased intracranial pressure, or cerebral edema with appropriate measures, including antiepileptic drugs or osmotic agents, is essential for improving patient outcomes. Lowering the MAP may mitigate these risks and possibly improve outcomes. doi: 10.1161/01.str.0000014509.11540.66.

Stroke 74

Stroke Outcomes EMS Seizures 74

Dr. Smith's ECG Blog

DECEMBER 11, 2023

We have shown that morphine is associated with worse outcomes (see learning points below) and have published many blog posts about it , such as this one: Another myocardial wall is sacrificed at the altar of the STEMI/NonSTEMI mass delusion (and Opiate pain relief). link] Opiates are associated with worse outcomes in Myocardial Infarction.

EKG/ECG 123

EKG/ECG Outcomes Documentation/Coding Academics 123

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

The Skeptics' Guide to EM

JUNE 4, 2017

Lancet August 2016. Lancet August 2016. A systematic review by the authors of the present study confirmed a possible benefit of the pan scan, but it showed a need for a well-designed, large, prospective randomized clinical trial with patient oriented outcomes ( Sierink et al 2012 ). Lancet August 2016.

Radiology 52

Radiology Radiology CPR Hospitals 52

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

Taming the SRU

FEBRUARY 24, 2024

ENRICH Trial - the leadership journey - EMS grand rounds - r4 capstone - r1 clinical knowledge - pediatric lecture ENRICH Trial WITH visiting professor Dr. david wright ICH makes up only 10-15% of all strokes yet has a higher mortality than ischemic strokes and SAH Current 2022 AHA/ASA guidelines for spontaneous ICH (prior to ENRICH Trial) minimally-invasive (..)

Leadership 92

Leadership EMS Pediatrics Stroke 92

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.

EMS 75

EMS Stroke Outcomes Hospitals 75

Sensible Medicine

JUNE 21, 2024

Governor Pete Shumlin of Vermont, speaking in 2016 , captured the zeitgeist: “We didn’t have a heroin crisis in America before OxyContin was approved and started being handed out like candy. From these reductions, whether they proceeded quickly or slowly, I saw terrible outcomes. Later papers substantiated these warnings.

Academics 69

Academics Research Burns Outcomes 69

Emergency Medicine Education

MAY 9, 2023

NEJM study in 2016 showed no survival benefits or favorable neurological outcome regarding use of Amiodarone vs Lidocaine vs placebo in OHCA. NEJM study in 2016 Acad Emerg Med

Outcomes 40

Outcomes 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. Injury 2016; 47: 797– 804. Blood product ratios made no difference to complications such as ARDS and AKI.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

RebelEM

NOVEMBER 6, 2023

to 1mg/kg/hr) Information regarding the vasopressors used in the study is as follows: Norepinephrine equivalents = norepinephrine mcg/kg/min + (phenylephrine mcg/kg/min/10) + epinephrine mcg/kg/min + (vasopressin units/min x2.5)

Shock 71

Shock Administration Academics Hospitals 71

Don't Forget the Bubbles

JULY 17, 2023

Clinical Outcomes of COVID-19 in Newborns and Infants: A Multicenter Experience of 576 Cases. 2023 Jun Oral food challenge outcomes in children and adolescents in a tertiary centre: A 5-year experience. Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review. 2023 Jun 9.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

EMDocs

DECEMBER 1, 2024

The disease is generally mild, but in untreated cases, it can lead to more severe outcomes, especially in patients with underlying conditions such as glucose-6-phosphate dehydrogenase deficiency. Even though the disease often resolves spontaneously, prompt antibiotic therapy is essential for optimal outcomes. 2016 Oct;29(5):433-9.

EMS 83

EMS Infectious Diseases Shock Airway Management 83

Don't Forget the Bubbles

JANUARY 17, 2024

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. Children will swallow almost anything. Why should Orbeez be an exception? Al-Saied G, Al-Malki T, Ayoub M, et al.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

The Skeptics' Guide to EM

JUNE 11, 2017

Lancet 2016. Lancet 2016. It stated that “none of these studies showed a mortality benefit or improved functional outcome with platelet transfusion in patients with spontaneous or traumatic intracerebral hemorrhage who were receiving antiplatelet medications.” Lancet 2016.

Stroke 52

Stroke EMS Outcomes 52

The Injectable Orange

JUNE 20, 2017

References: Brazil, Spurr, Petrosoniak, Simulcast Episode 5, November 2016 – Put the Rubber to the Road [link] Life in the Fast Lane, Critical Care Compendium – In Situ Simulation, revised November 2016. 2016 Mar;18(2):136-42. Debrief2Learn Sept 2016. Eppich (2016). link] Petrosoniak, A., Auerbach, A.

Head Injuries 52

Head Injuries Documentation/Coding Wellness Resuscitation 52