RebelEM

OCTOBER 2, 2023

The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics.

Operations 104

Operations Academics Fluid Resuscitation Outcomes 104

The Trauma Pro

OCTOBER 4, 2024

J Ped Surg 54:335-339, 2019. Unfortunately, the authors did not include an analysis of the “I don’t know if I complied” group, which would have been interesting. Be sure to follow with your performance improvement program to make sure that they actually do work as well as you think!

Pediatrics 113

Pediatrics Operations Emergency Department Outcomes 113

ACEP Now

JUNE 21, 2023

Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. Association of American Medical Colleges; 2019:1-12. The 2019 model of the clinical practice of emergency medicine. 15 Some of these training opportunities previously considered unique (i.e., J Emerg Med.

EMS 114

EMS Academics Telemedicine Operations 114

Taming the SRU

OCTOBER 23, 2023

At this point, the patient is taken to the operating room for a diagnostic laparoscopy. She was taken to the operating room and found to have a right tubal ectopic pregnancy with a pseudogestational sac. 2007), Free Fluid in Morison's Pouch on Bedside Ultrasound Predicts Need for Operative Intervention in Suspected Ectopic Pregnancy.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

Sensible Medicine

DECEMBER 11, 2023

Standard meaning the operators spent time checking to make sure the vein was isolated. The Struggle to Publish The authors presented this data at the European Heart Rhythm Association meeting in 2019. The team from Imperial College London randomized about 300 patients with paroxysmal AF to one of three arms. One arm got AF drugs.

Operations 116

Operations Hospitals 116

Ken Grauer, MD

FEBRUARY 9, 2024

Awareness of this common association made me instantly suspect that some type of Wenckebach conduction is probably operative in today's rhythm — even though I admittedly do not see any pattern of consistent group beating, or any repetitive PR intervals that typically clue me in to Mobitz I conduction defects.

EKG/ECG 266

EKG/ECG Operations Wellness 266

PulmCCM

APRIL 18, 2024

The real world success rates by operators experienced with intubation remained unknown. In the relatively few studies comparing video to direct laryngoscopy, intubations were usually performed by inexperienced trainees, and sample sizes were small. The results seem to hold for both major video laryngoscopes (GlideScope and McGrath).

Airway Management 98

Airway Management Operations EMS Research 98

Don't Forget the Bubbles

JUNE 17, 2024

Exposure to incivility hinders clinical performance in a simulated operative crisis. 2019 May 31:bmjqs-2019. 2019 May;27(4):758-64. BMJ Quality & Safety. Keller R, Allie T, Levine R. An evaluation of the “BE NICE Champion” programme: A bullying intervention programme for registered nurses.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Dr. Smith's ECG Blog

DECEMBER 19, 2023

Unfortunately, we do not have those images for review, but the operators described a ruptured LAD plaque and they stented this area, which ensures the stability of the plaque. From My Comment in the November 14, 2019 post in Dr. Smith's ECG Blog: A subject well worth periodic review — is the concept of Terminal QRS Distortion ( T-QRS-D ).

EKG/ECG 127

EKG/ECG EMS Wellness Operations 127

RebelEM

NOVEMBER 20, 2023

Comparator: The control group received standard care provided at a major trauma center, including intubation, blood product transfusion, interventions like tourniquet application, and early operative or endovascular hemorrhage control. J Spec Oper Med. Published 2019 Sep 20. 97% of patients sustained blunt trauma.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

Don't Forget the Bubbles

JUNE 30, 2023

These procedures require an experienced operator. A joint statement released by the American College of Surgeons/American College of Emergency Physicians recommends that zone 1 REBOA should only be performed if the anticipated time to start the operation is less than 15 minutes. These procedures require an experienced operator.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

NIOSH Science Blog

MAY 14, 2020

This year has seen nurses all over the world step up and battle coronavirus disease 2019 (COVID-19) fearlessly, often while navigating evolving guidance and operating under difficult conditions with strained resources. None of us could have anticipated how prescient that would be.

Wellness 52

Wellness Operations 52

ACEP Now

JUNE 7, 2023

Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. After drops of about 14 percent in overall ED volumes in 2020 compared to 2019, many EDs are managing patients at volumes near those of 2019 again. percent in 2019. percent in 2022, compared to 2.7

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

RebelEM

JANUARY 25, 2024

What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021. Point-of-care ultrasound (PoCUS) is inherently operator-dependent, which may have led to inconsistencies in the quality and findings of the ultrasound exams across different operators.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

Emergency Medicine Journal

JULY 22, 2024

Methods Adult patients transported to a single ED by ambulances and subsequently admitted to the hospital between 1 January 2019 and 18 April 2019 were eligible for inclusion. The discriminative ability of the EWS scores was assessed using the area under the receiver operating characteristic curve (AUROC). male, mean age 68.7±17.5

Ambulance Services 52

Ambulance Services Hospitals Operations Emergency Department 52

RebelEM

FEBRUARY 1, 2024

What they Did : Investigator-initiated, Multicenter, Parallel-ground, Open-label, Registry-linked, Randomized, Controlled, Non-Inferiority trial 22 Canadian Primary and Comprehensive Stroke Centers from December 2019 to January 2022 Eligible ischemic stroke patients randomized 1:1 to receive intravenous tenecteplase (0.25 vs Alteplase 34.8%

Stroke 135

Stroke Blood Transfusions Outcomes EMS 135

Dr. Smith's ECG Blog

AUGUST 4, 2024

An additional criterion that has sometimes been cited as helpful for making the diagnosis of acute Pericarditis — is the ST/T Wave Ratio in Lead V6 ( Please see My Comment at the BOTTOM of the page in the December 13, 2019 post of Dr. Smith's ECG Blog ).

EKG/ECG 117

EKG/ECG Wellness Operations Emergency Department 117

RebelEM

NOVEMBER 6, 2023

Methylene Blue for Vasoplegic Syndrome After Cardiac Operation: Early Administration Improves Survival. 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

Taming the SRU

MAY 13, 2024

Acute stump appendicitis without evidence of perforation or abscess (Figure 1) HOSPITAL Course Acute Care Surgery was consulted from the ED and recommended admission for operative resection of a 3 cm remnant of the appendix. No free intraperitoneal air. Stump appendicitis, a rare but serious complication of appendectomy: A case report.

Ultrasounds 98

Ultrasounds Emergency Department Wellness Operations 98

SheMD

MAY 4, 2023

Women were more likely to be first appointed to educational rather than operational roles (52.6% The most common pathway to a departmental chair role was through an operations track, and male physicians were more likely to have an initial role in operations, while females were more likely to have an initial role in education.

Leadership 52

Leadership Academics Operations Emergency Department 52

The Skeptics' Guide to EM

FEBRUARY 16, 2019

Date: February 15th, 2019 Reference: Gottileb, Holladay and Peksa. AEM January 2019. Date: February 15th, 2019 Reference: Gottileb, Holladay and Peksa. AEM January 2019. In the hands of experienced operators, indirect ophthalmoscopy has an LR+ 44 and LR- of 0.23. Remember, you need a LR- of less than 0.01

Ultrasounds 52

Ultrasounds Operations Emergency Department 52

ACEP Now

NOVEMBER 14, 2023

In 1901, UVA opened its first hospital with 25 beds and three operating rooms. The emergency department (ED) at UVA was rebuilt in 2019 and the department had not fully optimized its operations when COVID-19 hit. She is a consultant with Quality Matters Consulting, and her expertise is in ED operations.

Academics 52

Academics Emergency Department Leadership Operations 52

The Skeptics' Guide to EM

MAY 11, 2019

Date: May 6th, 2019 Reference: Sceats et al. Date: May 6th, 2019 Reference: Sceats et al. This is an example of why things in evidence-based medicine can be “complicated” ( SGEM#115 and SGEM#180 Clinical Question: Operative treatment or non-operative treatment of acute Grade 1 (uncomplicated) appendicitis?

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

Emergency Medicine Journal

OCTOBER 26, 2023

Methods We undertook a retrospective diagnostic cohort study involving adult emergency medical cases transported to Sheffield Teaching Hospitals ED by Yorkshire Ambulance Service in 2019. Results We linked 12 870/24 955 (51.6%) cases and identified 348/12 870 (2.7%) with a positive reference standard.

Sepsis 52

Sepsis Ambulance Services Operations Hospitals 52

Don't Forget the Bubbles

JANUARY 17, 2024

They passed away a few days after a second operation. A six-month-old infant presented with sub-acute obstruction and needed an enterostomy. Unfortunately, the anastomosis broke down. Insertion It’s not just fingers that children like to stick in their noses or ears. It’s beads, too! Darracq, M.A., Rentmeester, L., Cantrell, F.L.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

RebelEM

JUNE 8, 2023

Epub 2019 Jul 3. Am J Emerg Med. 2022 2022 Sep 5. PMID: 36108346 Cole JB, et al. Human Errors and Adverse Hemodynamic Events Related to “Push Dose Pressors” in the Emergency Department. J Med Toxicol. PMID: 31270748 Maheshwari K, et al. Intensive Care Med. 2018;44(6):857–67. Am J Emerg Med.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

ACEP Now

DECEMBER 11, 2023

The overall length of stay for all ED patients increased to 211 minutes in 2022, up from 194 minutes in 2021, 184 minutes in 2020, and 182 minutes in 2019. Patients who require inpatient boarding remain a significant challenge to ed operations. percent in 2019. percent in 2019, to 2.7 percent in 2021, 2.8 percent in 2022.

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

ACEP Now

SEPTEMBER 3, 2024

Hahnemann University Hospital in Philadelphia closed in 2019, a year and a half after it was acquired along with St. While secrecy surrounds the operations of many PE-owned groups, Envision serves as a case study. Published September 5, 2019. Published July 22, 2019. J Hosp Med. 2020;15(5):318-320. Ayash B, Rastad M.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

PulmCCM

SEPTEMBER 20, 2024

This process can’t be trusted to operate in China. The first layer of protection against fabricated data comes from the nearby peers and colleagues at a researcher’s own institution or competing institutions. Second, the Chinese government ultimately controls research production there.

Academics 105

Academics Forensics Research Operations 105

RebelEM

AUGUST 12, 2024

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

Outcomes 81

Outcomes Hospitals Operations Shock 81

PulmCCM

JANUARY 6, 2025

The SCREEN Trial SCREEN was a stepped-wedge cluster randomized trial of an EMR alert for organ failure, conducted at 45 wards of 5 hospitals in Saudi Arabia from 2019 to 2021. Instead of clinical micromanagement, in its new form it would incentivize continuous improvement in systemwide operational processes.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

Taming the SRU

NOVEMBER 3, 2023

Results 24 patients were eligible during the study period from January 2019 to June 2020 and 20 patients age 33-95 were ultimately enrolled by the 6 operators. Secondary outcomes were changes in pain scores at rest at 15 minutes, during incentive spirometry at both time points and then change in maximum vital capacity. SD 3.28) and 6.5,

Fractures 98

Fractures Ultrasounds Research Outcomes 98

Don't Forget the Bubbles

MAY 22, 2023

In 2019, there were 2,383 LTV patients in the UK. These can be operated and maintained by patients and their families at home. There has been a 2.5x increase in the use of LTV in children in the UK over the last 10 years. Advances in technology have also led to more portable ventilators.

Radiology 98

Radiology Radiology Hospitals Wellness 98

Mind The Bleep

JUNE 21, 2024

This will not be an issue if oil is used, though this will require another operation to be removed and gain full visual potential. Laser/cryotherapy is applied to seal the break intra-operatively. Note: vitrectomy is associated with a very rapid post-operative progression/development of a cataract which will then necessitate surgery.

Operations 52

Operations Emergency Department Ultrasounds 52

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. 1 The Rise of the Miami BBL An entire industry has emerged around gluteal AFTs in Miami.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

PulmCCM

JANUARY 8, 2024

Twenty-five ICUs in Canada were switched to small-volume blood collection tubes at randomly assigned times (a so-called stepped-wedge cluster design) from 2019-2021. The Red Cross funds a large portion of its operations through its ~$2 billion transfusion business , and would seem to be unlikely to advocate for reducing its size.

Blood Transfusions 96

Blood Transfusions Hospitals Outcomes Operations 96

Taming the SRU

AUGUST 30, 2023

The 2019 Journal of Arthroplasty practice guidelines to screen for periprosthetic joint infections recommend using ESR at 30mm/hr and CRP at 10mg/L, citing pooled sensitivities and specificities ranging from 75%-86% and 70-72.3%, respectively, for ESR and 88% and 73-74%, respectively, for CRP [32]. 2019 Feb;34(2S):S187-S195.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89