The Trauma Pro

OCTOBER 25, 2024

Authors from several well-known trauma centers collaborated to re-analyze data from the CLOTT study. Here are the factoids: The original data were derived from a 17-center study conducted from 2018-2020; this study only included 1,387 patients who had pelvic fractures (as well as other injuries).

Fractures 113

Fractures Head Injuries Operations Ultrasounds 113

The Skeptics' Guide to EM

FEBRUARY 15, 2020

Case: A 32-year-old woman with no previous medical history calls you while a passenger on a […] The post SGEM#284: Might as Well Jump, but We would Recommend a Parachute first appeared on The Skeptics Guide to Emergency Medicine. Secondary Outcomes: Health status and subgroup analysis based on type of aircraft or previous parachute use. .

Wellness 52

Wellness Outcomes Emergency Department Research 52

ACEP Now

MARCH 10, 2025

A sense of purpose is an integral part of well-being. The Experiment ; 2018. Ikigai and subsequent health and wellbeing among Japanese older adults: longitudinal outcome-wide analysis. 9 Furthermore, meaningful work is a cornerstone in the longevity of career academic physicians. Garca H, Miralles F. Lancet Reg Health West Pac.

Academics 52

Academics Wellness CPR Hospitals 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 Pediatrics Outcomes 145

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. to 53.54, p=0.053).

Stroke 95

Stroke Administration Documentation/Coding Outcomes 95

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 97

Sepsis Outcomes Administration EMS 97

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

RebelEM

JULY 27, 2023

In this group of patients, the use of alteplase poses a fine line of potential benefit (functional outcomes) vs potential harm (symptomatic intracranial hemorrhage). DAPT statistically noninferior to alteplase The finding was consistent in the per-protocol and as-treated groups as well Symptomatic ICH at 90d DAPT: 0.3% Alteplase: 91.4%

Stroke 98

Stroke Outcomes EMS Hospitals 98

Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Queen of hearts interpretations: Patient 1, ECG1: Patient 2, ECG1: Patient 1 Clinical Course and Outcome: The EM physician did not see that the S wave voltage has been truncated and squared off at 10 mm, thereby greatly limiting the assessment of proportionality. But he did well.

EKG/ECG 127

EKG/ECG EMS Outcomes Wellness 127

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

RebelEM

JANUARY 25, 2024

A 2018 systematic review and meta-analysis of 25 studies focusing on the accuracy of emergency lung ultrasound showed sensitivity of 85-95% and specificity of 75-90% for pneumonia, sensitivity of 78% and specificity of 94% for COPD/asthma, and sensitivity of 75-90% and specificity of 80-90% for acute heart failure [4].

Ultrasounds 125

Ultrasounds Outcomes COPD Hospitals 125

ACEP Now

JULY 7, 2023

1 Ventricular tachycardia (VT) and ventricular fibrillation (VF) represent the most common initial rhythms for patients presenting to the ED in out-of-hospital cardiac arrest, as well as for patients who develop cardiac arrest while in the ED. Heart disease and stroke statistics—2018 update: A report from the American Heart Association.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Sensible Medicine

NOVEMBER 14, 2023

Criticism of these programs is both well-deserved and unfair. Despite these well-deserved criticisms, I’ve found that residential treatment programs and therapeutic communities can be essential to my patients, and there’s evidence to support that. These higher quality studies usually achieved better outcomes.

Research 134

Research Psychiatric CDC Best Practices 134

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. Well more than a million views per month far exceeds are expectations.

Stroke 110

Stroke Academics Outcomes Shock 110

RebelEM

APRIL 17, 2023

However, It is unclear how well POCUS performs in ruling in or ruling out the diagnosis of PTA. Question: How well does the US perform in diagnosing PTA compared to CT, needle aspiration, or Incision and Drainage? Article: Kim DJ et al. Acad Emerg Med. 2023 Jan 10. Epub ahead of print. PMID: 36625850.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

RebelEM

AUGUST 22, 2024

hours of symptom onset appears to be the most promising approach for improving visual outcomes, supported by multiple studies and meta-analyses. 1,2 Intra-arterial (IA) tPA has also shown benefit but is less well studied. Patients whose last known well (LKW) time was within 24 hours of presentation. 1 week after treatment.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

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 Pediatrics 83

Dr. Smith's ECG Blog

SEPTEMBER 26, 2023

Groups were categorized based on moderate to severe chest pain (numerical rating scale pain ≥ 5/10) or less than moderate severity to compare procedural and clinical outcomes. And as we have shown before, morphine leads to slower times to treatment and worse outcomes. 414 patients were included in the analysis.

EKG/ECG 121

EKG/ECG Hospitals Outcomes Wellness 121

Sensible Medicine

AUGUST 7, 2024

There is evidence that, for children and adults, elevated cortisol levels and chronic stress can lead to behavioral, mental-health, and mood issues, as well as changes in inflammation and immunity. Research by Collett et al (2018) shows that, despite some improvement in PP by 18 months, the deformations persist beyond 36 months.

CDC 113

CDC Documentation/Coding Research Pediatrics 113

EMDocs

NOVEMBER 7, 2023

Antibiotics are recommended for those with complicated diverticulitis, as well as surgical specialist consult if necessary (e.g., No difference in their primary outcome of complications and need for emergency surgery (1.9% 2018 Jul;113(7):1045-1052. 2018 Jul;113(7):1045-1052. perforation). 623 patients included.

Sepsis 108

Sepsis Best Practices Hospitals Outcomes 108

Taming the SRU

MARCH 12, 2024

ED visits per 1000 adults with diabetes based on 2018 data resulting in over 500,000 annual hospital days. as well as patients less than 18 years old were excluded from analysis. The study’s primary outcomes were the operational impacts of the SQuID protocol on EDLOS and ICU admission rates.

Operations 97

Operations Hospitals Best Practices Wellness 97

Emergency Medicine Journal

SEPTEMBER 25, 2024

Being a trauma team leader, emergency physician in charge or clinical lead all look very different and require a range of skills, but are all certainly forms of leadership that have a significant impact on the running of an emergency department, patient outcomes and, as is increasingly being recognised, staff well-being.

Leadership 52

Leadership Emergency Department Outcomes Wellness 52

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 4, 8 Paper: Dahyot-Fizelier, C., Included traumatic and nontraumatic brain injuries.

CDC 111

CDC Radiology Radiology Head Injuries 111

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 Administration 52

Don't Forget the Bubbles

JUNE 17, 2024

High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. Loss of psychological safety and mental well-being persist long after the episode and can impact future episodes of care. John Wiley & Sons, 2018 Edward KL, Ousey K, Warelow P, Lui S. Australian Health Review.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Systolic function normal by visual assessment only, unable to visualize well for further characterization. The patient did well and was discharged. Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). RV: Cavity size normal. 1900: RBBB and LAFB are almost fully resolved. No cardiac MRI was done.

EKG/ECG 116

EKG/ECG Wellness Fractures Emergency Department 116

EMDocs

JANUARY 29, 2024

However, other sources suggest that the optimal blood pressure target is not well established and may vary depending on the individual patient’s characteristics and the type of hemorrhagic transformation [7]. Lowering the MAP may mitigate these risks and possibly improve outcomes.

Stroke 91

Stroke Outcomes EMS Seizures 91

The Skeptics' Guide to EM

JUNE 24, 2018

[display_podcast] Date: June 15th, 2018 Reference: Silva et al. 2018 Guest Skeptics: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. display_podcast] Date: June 15th, 2018 Reference: Silva et al. Ann Emerg Med. Ann Emerg Med. Reference: Silva et al.

Emergency Department 52

Emergency Department Administration Outcomes Research 52

Mount Sinai EM

OCTOBER 11, 2024

There was significant heterogeneity among studies and outcomes were not measured consistently. And well before the depth at which it would reach the carotid). A lot of times we consult ENT and they perform the aspiration, but it is well within our scope of practice to do it ourselves! in the medical cohort and 6.2%

Ultrasounds 100

Ultrasounds Wellness Outcomes Hospitals 100

The Skeptics' Guide to EM

FEBRUARY 2, 2019

The Lancet 2018. The Lancet 2018. This study expands upon that investigation to patients with other conditions as well. The Lancet 2018. Comparison: The lower oxygen target (conservative group) * Outcomes: The authors do not report any one outcome as a primary outcomes, but instead listed morbidity and mortality.

Poisoning 52

Poisoning Administration Hospitals Sepsis 52

The Skeptics' Guide to EM

OCTOBER 31, 2018

[display_podcast] Date: October 30th , 2018 Reference: Raskob GE et al. NEJM 2018 Guest Skeptic: Dr. Anand Swaminathan is an assistant professor of Emergency Medicine at the St. display_podcast] Date: October 30th , 2018 Reference: Raskob GE et al. Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism.

EMS 52

EMS Outcomes Wellness 52

ALiEM

DECEMBER 8, 2023

Major risk factors for their development include prior abdominal surgeries that weaken the musculature as well as cardiovascular co-morbidities. Incidence, etiology, management, and outcomes of flank hernia: review of published data. 2018 Apr;22(2):353-361. Epub 2018 Jan 27. PMID: 32310432. Zhou DJ, Carlson MA.

Academics 60

Academics Emergency Department Outcomes Wellness 60

Taming the SRU

JUNE 11, 2023

It’s reflection of underlying metabolism, circulation and ventilation may serve well to identify patients with early dysfunction of physiologic functions. Enrollment period was from February 2016 to August 2018. The primary outcome was in-hospital mortality. The secondary outcome focused on ICU admissions.

Hospitals 88

Hospitals Emergency Department EMS Outcomes 88

Don't Forget the Bubbles

JULY 26, 2023

A cardiac family history should of course be sought, but think a little outside the box as well. On arrival at hospital the child was well with normal observations. In some specific congenital heart diseases, the prevalence of arrhythmias is now being seen as a late surgical complication as children now survive into adulthood.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Taming the SRU

NOVEMBER 14, 2023

B) on right: hand drawn images of layers of ear demonstrating auricular hematoma The epidemiology and incidence of ED presentation for auricular hematomas has not been well-studied because it is a relatively uncommon condition. Elsevier; 2018. Updated 2018 Dec 16]. Courtesy of wiki commons under CC Attribution 3.0 Stat Pearls.

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Brief aside: "Early repolarization" is a frequently proclaimed and poorly understood electrocardiographic phenomenon which mostly serves to reassure clinicians that not all ST elevations are ischemic (something readers of this blog know well). linking the finding with long term risk of idiopathic ventricular fibrillation. Stuckey, T.,

EKG/ECG 132

EKG/ECG Documentation/Coding Wellness Emergency Department 132

The Skeptics' Guide to EM

JANUARY 20, 2018

[display_podcast] Date: January 15th, 2018 Reference: Sadeghirad B, et al. display_podcast] Date: January 15th, 2018 Reference: Sadeghirad B, et al. However, previous systematic review and meta-analyses have been confounded by co-administration of antibiotics and analgesics, as well as variability in measures of efficacy among studies.

Academics 52

Academics Emergency Department EMS Administration 52