RebelEM

JANUARY 18, 2024

It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Three outcomes were evaluated, with none being deemed the primary outcome. Background: Sepsis remains one of the leading causes of morbidity and mortality. to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

Sepsis 131

Sepsis Hospitals Administration Outcomes 131

Pediatric EM Morsels

SEPTEMBER 22, 2023

2018 Oct;14(2):47-54. Epub 2018 Oct 31. Orenstein JB, Klein BL, Gotschall CS, Ochsenschlager DW, Klatzko MD, Eichelberger MR. Age and outcome in pediatric cervical spine injury: 11-year experience. Korean J Neurotrauma. doi: 10.13004/kjnt.2018.14.2.47. 2018.14.2.47. PMID: 30402418; PMCID: PMC6218357. J Pediatr Surg.

Shock 300

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 300

Pediatric EM Morsels

JUNE 9, 2023

Carneiro de Moura, 2018 ] Seen in 57% of cohort. Banc-Husu, 2023 ; Luoto, 2020; Carneiro de Moura, 2018 ] Basics are best (always)! Banc-Husu, 2023 ; Luoto, 2020; Carneiro de Moura, 2018 ] Basics are best (always)! Long-term Outcomes and Health Perceptions in Pediatric-onset Portal Hypertension Complicated by Varices.

Pediatrics 152

Pediatrics Head Injuries Airway Management Administration 152

Emergency Medicine Journal

FEBRUARY 20, 2024

Background Andexanet alfa was approved in 2018 for reversal of direct oral anticoagulants but due to issues of cost and access, four-factor prothrombin complex concentrate (4F-PCC) continues to be used for this indication. Primary outcome includes rate of mortality/hospice at hospital discharge.

Hospice 74

Hospice Outcomes Hospitals 74

Taming the SRU

JUNE 28, 2024

In 2018, Cheskes et al in Canada decided to examine these therapies and compare their outcomes. They utilized paramedic services to compare outcomes of dual sequence vs vector change defibrillation in regards to survival to hospital discharge as well as termination of v fib, rates of ROSC, and neurologic outcome at discharge.

Shock 74

Shock Hospitals Outcomes CPR 74

Don't Forget the Bubbles

DECEMBER 25, 2023

Interpreting Research Outcomes with a Little Bathroom Humour You have learned a method for how to read a research paper , and now you are faced with a bunch of outcomes. There are primary, secondary, composite , and safety outcomes. What are these outcomes? We know there is a bias towards reporting positive outcomes.

Research 83

Research Outcomes Fractures Hospitals 83

The Skeptics' Guide to EM

OCTOBER 20, 2018

[display_podcast] Date: October 17th , 2018 Reference #1: Aycock, Westafer et al. Ann Emerg Med 2018 (CRD42017056195) Reference #2: Weisbord SD, Gallagher M, Jneid H, et al; PRESERVE Trial Group. Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine. NEJM 2018 (ClinicalTrials.gov NCT01467466.)

Outcomes 69

Outcomes Emergency Department Pediatrics 69

Emergency Medicine Journal

OCTOBER 26, 2023

Background Blood transfusion for bleeding trauma patients is a promising pre-hospital intervention with potential to improve outcomes. Methods Pre-hospital physicians, from two air ambulance sites in the south of England, were interviewed between December 2018 and January 2019.

Blood Transfusions 52

Blood Transfusions Hospitals Outcomes 52

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome was 28-day mortality – TXA improved survival with no increased risk of cerebral clots. Survival was better, both at 24 hours and six months, in the TXA group, although the primary outcome, a quality of life score at six months, called the Glasgow Outcome Scale Extended (GOS-E), was the same in both groups ( 53.7%

Head Injuries 145

Head Injuries Seizures Outcomes Pediatrics 145

Pediatric EM Morsels

AUGUST 9, 2024

Foles, 2024 ] In the US, from 2013-2018, cases increased from 362 to 1,306. If not treated early, then increased risk of poor outcomes and death. Worldwide, congenital syphilis complicates about 1 million pregnancies / year. Hussain, 2023 ] Leads to >300,000 perinatal deaths / year globally.

Hyperthermia / Hypothermia 152

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 152

EMDocs

JULY 20, 2023

A second primary outcome was added at the 30-month time frame by request of the FDA, the trial was still blinded at that time. A second primary outcome was added at the 30-month time frame by request of the FDA, the trial was still blinded at that time. POWER: 86% to detect a 1-point difference in the group’s first primary outcome.

Stroke 73

Stroke Outcomes Head Injuries Psychiatric 73

Sensible Medicine

SEPTEMBER 23, 2024

They also found that the largest difference between truncated and nontruncated trials occurred when the truncated trials had fewer than 500 outcome events. In 2018, three modern trials comparing asa vs placebo for primary prevention were published. This difference easily met statistical significance. All were nonsignificant.

Stroke 88

Stroke Outcomes Academics Shock 88

The Skeptics' Guide to EM

JULY 30, 2022

CT is generally the first choice of imaging, the “abdominal series” of plain X-rays have been demonstrated to have poor predictive value, but a 2018 meta-analysis found 92.4% AEM July 2022 * Population: Patients with ICD-10 coding “intestinal obstruction” from 2018 National Hospital Ambulatory Medical Care Survey. sensitivity and 96.6%

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

Sensible Medicine

SEPTEMBER 18, 2023

The title gives away the results: Here is what they did: They took 159 patients who had severe TR and were operated on from 2004-2018. They then looked at a primary outcome of death. Earlier surgery may improve outcomes in these high-risk patients. These were operations solely for the tricuspid valve. vs 18.2% ; P =.036).

Operations 120

Operations Academics Shock Outcomes 120

EMDocs

SEPTEMBER 26, 2024

This story, while unlikely to reflect the standards of most readers, has a somewhat surprising outcome. J Am Coll Rad 15:4;639-647, April 1, 2018. What role do discharge instructions play? Do they establish a standard of care? EKG, labs, and a CXR are interpreted by the EP as normal. Baccei SJ et al. Tyler W et al.

Radiology 75

Radiology Radiology EKG/ECG Documentation/Coding 75

Emergency Medicine Journal

NOVEMBER 28, 2023

Methods This multicentre randomised controlled trial was undertaken between December 2018 and July 2020 in the ED of four hospitals in the Netherlands. The primary outcome was the proportion of patients requiring more than one reduction attempt.

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40

ALiEM

DECEMBER 8, 2023

Incidence, etiology, management, and outcomes of flank hernia: review of published data. 2018 Apr;22(2):353-361. Epub 2018 Jan 27. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32310432. Zhou DJ, Carlson MA. doi: 10.1007/s10029-018-1740-1. PMID: 29380158.

Academics 60

Academics Emergency Department Outcomes Wellness 60

EB Medicine

JUNE 20, 2022

Association of High-Sensitivity Cardiac Troponin I Concentration With Cardiac Outcomes in Patients With Suspected Acute Coronary Syndrome. 2018 Mar 20;319(11):1168. 2018 Feb 26;11:23-32. Association of High-Sensitivity Cardiac Troponin I Concentration With Cardiac Outcomes in Patients With Suspected Acute Coronary Syndrome.

Outcomes 52

Outcomes 52

The Skeptics' Guide to EM

MARCH 2, 2019

Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Clinical Question #1: Are superglottic airway devices non-inferior to endotracheal intubation in OHCA with regards to neurologic outcome?

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

The Skeptics' Guide to EM

MARCH 11, 2023

This was discussed with paramedic and physician assistant (PA), Missy Carter when critically appraising the AIRWAYS-2 trial regarding the use of the iGel in OHCA on SGEM #247 Clinical Question: Which supraglottic airway is associated with better patient outcomes, the iGel or the King-LT in patients with an out-of-hospital cardiac arrest.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

EMDocs

JUNE 8, 2023

and 9 hours after onset of symptoms, with non-infarcted brain tissue, does the administration of alteplase improve functional outcome at 90 days? and 9 hours of symptom onset; stroke symptoms that started during sleep were assumed to have started halfway between the actual last known well and the time of wake-up. Intervention: Alteplase 0.9

Stroke 78

Stroke Administration Outcomes Documentation/Coding 78

PulmCCM

JUNE 26, 2023

After the 2018 MIND-USA trial found neither haloperidol nor ziprasidone reduced delirium in the ICU, critical care guidelines advised against their wide use. No outcomes regarding the delirium itself were reported (i.e., Read in NYT Deadly fungal infections are on the rise, and are often diagnosed late, leading to worse outcomes.

Outcomes 98

Outcomes Ultrasounds Hospitals Wellness 98

SheMD

MAY 18, 2023

What were their outcomes: 8.6 2018 Dec 11;320(22):2372-2374. 2018 Jul 1;153(7):644-652. Article Summary What they looked at: -12 top United States medical schools were reviewed for institutional policies on childbearing leave between September 2016 and August 2017. weeks was the mean amount of total family leave (range 2-52).

Academics 52

Academics Pediatrics Outcomes Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

[display_podcast] Date: September 21st, 2018 Reference: Kawano et al. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. display_podcast] Date: September 21st, 2018 Reference: Kawano et al.

Basic Life Support 52

Basic Life Support Airway Management CPR Resuscitation 52

Taming the SRU

MAY 5, 2023

2018, Kuttab, Lykins et al. The CLASSIC trial is a randomized controlled trial conducted in the ICU setting which compared restrictive versus standard fluid strategies with a primary outcome of death by 90 days in patients with septic shock. Sixty centers participated during the years 2018-2022. 2019, Evans, Rhodes et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Emergency Medicine Journal

FEBRUARY 20, 2024

Unfortunately, there are no accurate estimates of the miss rate for AAS, risk factors for missed diagnosis or its effect on outcomes. Incident cases of AAS were identified between 2003 and 2018 using a validated algorithm based on ICD codes and death.

Documentation/Coding 40

Documentation/Coding Hospitals Outcomes 40

EMDocs

NOVEMBER 7, 2023

No difference in their primary outcome of complications and need for emergency surgery (1.9% 2018 Jul;113(7):1045-1052. Outcome measures were complicated diverticulitis, recurrent diverticulitis and sigmoid resection at 24 months’ follow up. Included 480 patients, with primary outcome return visit with hospital admission.

Sepsis 88

Sepsis Best Practices Hospitals Outcomes 88

RebelEM

DECEMBER 1, 2022

Additionally, small-bore catheter placement is performed via the Seldinger technique;’ a skill possessed by all Emergency Physicians (Bauman 2018). 153,5 (2018): 1201-1212. Heterogeneity was 0% for the primary outcome, and overall heterogeneity was low for secondary outcomes, which increases external validity.

Outcomes 52

Outcomes Hospitals Research Critical Access 52

The Skeptics' Guide to EM

FEBRUARY 15, 2020

Intervention: Jumping from aircraft with parachute * Comparison: Jumping from aircraft with backpack * Outcome: * Primary Outcome: Composite of death and major traumatic injury (ISS>15) within five minutes of impact or at 30 days. Date: February 11th, 2020 Reference: Yeh et al. Guest Skeptic: Marcus Prescott is a nurse in Norway.

Wellness 52

Wellness Outcomes Emergency Department Research 52

The Skeptics' Guide to EM

JULY 17, 2018

[display_podcast] Date: July 16th, 2018 Reference: Gupta M et al. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. display_podcast] Date: July 16th, 2018 Reference: Gupta M et al. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Pediatrics 52

Pediatrics Head Injuries Academics Emergency Department 52

The Skeptics' Guide to EM

DECEMBER 7, 2018

Date: December 6th , 2018 Reference: Perkins et al. Date: December 6th , 2018 Reference: Perkins et al. There was also no increase in survivors with good neurological outcomes with ACLS. Clinical Question: Does the use of epinephrine in cardiac arrest improve survival rates with a favourable neurological outcome?

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

Mount Sinai EM

OCTOBER 10, 2024

2021 looked at smartphone addiction and associated health outcomes in adults. 2018 showed less loneliness, depressive symptoms, and FOMO when social media in the experimental group was limited to 10 mins per day (via monitoring app – Screen Time) vs their normal social media use in the control group.

Wellness 100

Wellness Research Outcomes 100

PulmCCM

JUNE 10, 2024

Background I’m not sure if you’ve noticed this, but patients and families frequently disagree with their physicians about the likely outcomes from critical illness. Time-limited trials were reviewed in 2018 in Intensive Care Medicine by Vink et al , and in 2024 in Chest by Kruser et al. 2018 Sep;44(9):1369-1377.

COPD 45

COPD Outcomes Hospitals EMS 45

The Trauma Pro

MAY 10, 2024

And its correlation with outcomes varies. 2018 May;84(5):718-726. The most important one is that it relies only on the Injury Severity Score (ISS) to judge whether some type of mistriage occurred. The ISS is usually calculated after discharge, so it can only be applied after the fact. What is NFTI, Exactly? J Trauma Acute Care Surg.

Blood Transfusions 147

Blood Transfusions Documentation/Coding Radiology Radiology 147

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 73

Stroke Outcomes EMS Seizures 73

The Skeptics' Guide to EM

DECEMBER 15, 2018

Date: December 13th , 2018 Reference: Murata et al. 2018 Guest Skeptic: Dr. Damian Roland is a Consultant at the University of Leicester NHS Trust and Honorary Associate Professor for the University of Leicester’s SAPPHIRE group. Date: December 13th , 2018 Reference: Murata et al. Pediatrics. Pediatrics.

Seizures 52

Seizures Pediatrics Emergency Department Outcomes 52

RebelEM

MARCH 8, 2023

Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. Philadelphia: Elsevier, 2018 (Ch) 61: p. Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. Take Home Points: Assess patients with floaters or flashers for retinal or vitreous detachment.

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52