EMDocs

AUGUST 22, 2024

Certified interpreter use can improve communication and patient outcomes. Conducting research regarding best practices for improving health outcomes for NELP patients. Pearls NELP patients have worse health outcomes despite widespread language-access policies. April 2019. 45:446-458. Taira B, et al. 23:1214-1222.

Documentation/Coding 81

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 81

Pediatric EM Morsels

SEPTEMBER 22, 2023

McGraw Hill Education; 2019:104-109 Dave S, DAHLSTROM JJ. Orenstein JB, Klein BL, Gotschall CS, Ochsenschlager DW, Klatzko MD, Eichelberger MR. Age and outcome in pediatric cervical spine injury: 11-year experience. McGraw Hill Education; 2019:125-138 Ziu E, Mesfin FB. References Coleman-Satterfield, TT. 5 th Edition.

Shock 300

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 300

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 123

Stroke Blood Transfusions Outcomes EMS 123

Pediatric EM Morsels

JUNE 9, 2023

Specific Therapies for Variceal Hemorrhage : [ Luoto, 2020 ; Castillo, 2019; Garcia-Tsao, 2007 ] Antibiotic prophylaxis (usually for 7 days) Ceftriaxone is reasonable 1st choice. Castillo, 2019 ] Somatostatin (or its analogues, like Octreotide) Guidelines do recommend this… There is great variability in its administration, though.

Pediatrics 152

Pediatrics Head Injuries Airway Management Administration 152

Emergency Medicine Journal

MARCH 21, 2024

’ –Audre Lorde It has been over 4 years since 14 November 2019 when the first documented case of COVID-19 emerged. This has exposed deep-seated racial inequalities that persist in disease burden, healthcare access and outcomes in patients and healthcare professionals alike. ‘It is not our differences that divide us.

Documentation/Coding 52

Documentation/Coding Outcomes 52

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. Ann Emerg Med.

Stroke 73

Stroke Outcomes EMS Seizures 73

Emergency Medicine Journal

JUNE 20, 2024

The associations between where you live and your health outcomes are increasingly understood. In 2019, it was estimated that the extra costs to the NHS of socioeconomic inequality were £4.8 Healthy life expectancy is more than 18 years lower for people living in the most deprived areas compared with the least deprived.

Outcomes 40

Outcomes 40

PulmCCM

SEPTEMBER 21, 2023

But there’s been surprisingly little data from randomized trials to identify more precise targets in the middle: The MAPAS trial (2019) suggested rapid lowering of blood pressure in acute ischemic stroke was unhelpful, a target of 161-180 mm Hg might be beneficial, and pressures 181-200 mm Hg resulted in more intracranial hemorrhage.

Stroke 105

Stroke Outcomes 105

RebelEM

APRIL 22, 2024

Intervention: Target PaO2 = 60 mm Hg Control: Target PaO2 = 90 mm Hg Outcome (primary): Absolute number of days without life support in 90 days defined as the absence of mechanical ventilation, circulatory support, or kidney replacement. Outcomes (secondary): 90-day all-cause mortality. CI) Secondary Outcomes 90-day Mortality 34.7%

Outcomes 67

Outcomes Best Practices EMS Shock 67

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

American Medical Compliance

APRIL 16, 2024

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve healthcare outcomes. A medication safety fact file released by the World Health Organization (WHO) in 2019 shows that medication errors harm millions of patients yearly.

Patient Safety 84

Patient Safety Administration Outcomes 84

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

Pediatric EM Morsels

AUGUST 9, 2024

2019, there were 1,875 and this trend has continued to increase (2,157 case in 2020; 2,855 cases in 2021). 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.

Emergency Department 152

Emergency Department Hyperthermia / Hypothermia Seizures Pediatrics 152

Emergency Medicine Journal

NOVEMBER 28, 2023

Method and Design All patients ≥16 years old attending the East of England Major Trauma Centre (2016-2019) who met Trauma Audit Research Network (TARN) criteria were included. The primary outcome was 30-day mortality; secondary outcomes included admission clotting profile (PT/aPTT).

Outcomes 40

Outcomes Research 40

Emergency Medicine Journal

NOVEMBER 28, 2023

Methods We conducted a pragmatic randomised controlled feasibility trial in two EDs in England over a 6-month period (7 October 2019 to 6 April 2020). The primary outcome for this study was trial recruitment rate. Other measures were recorded to assess potential future definitive trial outcomes and feasibility.

Fractures 40

Fractures Ultrasounds Outcomes Research 40

PulmCCM

JANUARY 22, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

PulmCCM

JUNE 12, 2023

TTM2 found no improvement in survival or neurologic outcome among patients randomized to cooling to a target of 33 °C, as compared to controls receiving fever prevention (e.g. Elsevier boasted a 40% profit margin in 2019. Elsevier explained that their fees are justified to maintain open access (i.e.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

Taming the SRU

MAY 5, 2023

2019, Bauer, Gerlach et al. 2019, Evans, Rhodes et al. The ANDROMEDA-SHOCK trial published in 2019 demonstrated that only one-quarter (25%) of patients were fluid-responsive at baseline, as determined most frequently by velocity time integral or passive leg raise methods (Hernández, Ospina-Tascón et al. 2021, Im, Kang et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Emergency Medicine Journal

DECEMBER 22, 2023

Methods Emergency Department (ED) attenders and hospital inpatients between 2015 and 2019 were automatically screened for their risk of hospitalisation within 6 months of discharge using a locally trained CPM on routine data. Co-primary outcomes were emergency hospitalisation and ED attendances, which will be reported separately.

Emergency Department 52

Emergency Department Hospitals Outcomes 52

Emergency Medicine Cases

AUGUST 25, 2020

Barbara Tatham, EM colleague and educator, died of metastatic sarcoma at the age of 32 in October 2019. In August 2019 we met at my summer cottage to record this podcast. We explored the evidence that compassionate care improves patient outcomes and staves off physician burnout.

EMS 52

EMS Outcomes 52

PulmCCM

JANUARY 24, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

The Skeptics' Guide to EM

OCTOBER 5, 2019

Date: September 25th, 2019 Reference: Bath PM et al. The Lancet March 2019. Date: September 25th, 2019 Reference: Bath PM et al. The Lancet March 2019. Hypertension is common in acute stroke and is a predictor of poor outcome [ 1 ]. first appeared on The Skeptics Guide to Emergency Medicine.

Stroke 52

Stroke Hospitals EMS Outcomes 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Primary outcomes were the number of CT abdomens performed, CT outcome and the proportion of scans that adhered to NWCMTN guidelines. Results and Conclusion Intra-abdominal injury was found in 20.9% of all scans. of CT abdomen requisitions adhered to NWCMTN guidelines.

Outcomes 40

Outcomes Hospitals 40

ACEP Now

JUNE 21, 2023

The lack of differences in the observed outcomes do not suggest one EM training length is superior. The additional year may improve career trajectory or longevity, entrance into fellowship or academic practice, or other longer-term outcomes including successful development of a niche in the specialty. 11 What should we take away?

EMS 114

EMS Academics Telemedicine Research 114

The Skeptics' Guide to EM

NOVEMBER 23, 2019

Date: November 21st, 2019 Reference: Daley et al. AEM November 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Date: November 21st, 2019 Reference: Daley et al. AEM November 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: Daley et al.

Ultrasounds 52

Ultrasounds Emergency Department Academics Outcomes 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? 2019; 380:1795-1803. 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.

Stroke 77

Stroke Administration Outcomes Documentation/Coding 77

Dr. Smith's ECG Blog

AUGUST 2, 2024

the investigators reviewed outcomes in 118 patients presenting with NSTEMI. We've highlighted a considerable number of acute RV MI cases in Dr. Smith's ECG Blog ( See the October 7, 2019 and May 10, 2024 posts , to name just two ). In this important paper (DOI: 10.1161/CIRCINTERVENTIONS.118.007305) 118.007305) from Heitner et al. ,

EKG/ECG 108

EKG/ECG Fluid Resuscitation Academics Resuscitation 108

EMDocs

FEBRUARY 12, 2024

There is well-documented evidence that low systolic blood pressure, a low Glasgow Coma Score (GCS), and a high Injury Severity Score (ISS) are known predictors of poor outcomes, and in combination with serum lactate provide adequate prognostic value. Journal of Trauma and Injury 2019; 32(4): 238-242. Epub 2019 Dec 30.

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

Sensible Medicine

AUGUST 4, 2024

The authors obtained incidence data for 34 types of cancer and mortality data for 25 types of cancer for individuals aged 25–84 years for the period Jan 1, 2000, to Dec 31, 2019 from the North American Association of Central Cancer Registries and the US National Center for Health Statistics, respectively.

Academics 88

Academics Outcomes Wellness 88

Don't Forget the Bubbles

JUNE 30, 2023

Ann Cardiothorac Surg 2019; 8:137–142 But Elsa’s temperature is 30.1⁰C. Extracorporeal life support rewarming rate is associated with survival with good neurological outcome in accidental hypothermia. Ann Cardiothorac Surg 2019; 8:137–142 Saczkowski, R., Mazur P, Kosinski S, Podsiadlo P, et al.: The “sweet spot” is between 0.5-2⁰C

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

The Skeptics' Guide to EM

JUNE 6, 2020

Respir Crit Care Med 2019. Respir Crit Care Med 2019. However, it has become evident that patients are often over-resuscitated with IV fluids which adversely impacts outcome. Oddly enough, however, shortening the duration of shock time-to-shock-resolution hasn’t translated to any measurably better outcomes.

Sepsis 52

Sepsis Shock Resuscitation Outcomes 52

ACEP Now

MAY 10, 2024

Primary Outcome: Diagnostic accuracy of identifying Stanford type A and Stanford type B AoDs Secondary Outcomes: Test characteristics of each of the three individual sonographic findings for diagnosing Stanford type A and Stanford type B AoDs. Acad Emerg Med. 2024;31(2):112-118. Eur Heart J. 2014;35:2873-2926. J Am Coll Cardiol.

Ultrasounds 52

Ultrasounds Outcomes Documentation/Coding Academics 52

EMDocs

MAY 11, 2024

Endovascular and Clinical Outcomes of Vertebrobasilar Intracranial Atherosclerosis-Related Large Vessel Occlusion. 2019 Mar 19;10:215. Epub 2019 Dec 9. Salim Rezaie, “Thrombolysis in Acute Ischemic Stroke: Now We Have No Positive RCTs”, REBEL EM blog, July 27, 2020. Available at: [link]. Front Neurol. 2019.00215.

Stroke 88

Stroke EMS EKG/ECG Radiology 88

The Skeptics' Guide to EM

DECEMBER 14, 2019

Date: December 13th, 2019 Reference: Belisle et al. AEM December 2019 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: December 13th, 2019 Reference: Belisle et al. first appeared on The Skeptics Guide to Emergency Medicine. Reference: Belisle et al.

Outcomes 52

Outcomes Emergency Department Pediatrics Hospitals 52

Taming the SRU

APRIL 22, 2023

For treatment, the American Heart Association’s 2019 guidelines recommend limiting use of non-dihydropyridiine CCB due to potential for negative inotropic effects. There were similar lengths of say overall and no significant difference in safety outcomes. There was no difference in safety outcomes.

Outcomes 52

Outcomes Documentation/Coding Stroke Fractures 52

EMDocs

MAY 25, 2023

Outcome: No statistically significant difference in primary outcome, which was absence of clinically apparent seizures without the need for additional anti-convulsant medications AND improving responsiveness at 60 minutes after the start of trial-drug infusion, as determined by the treating physician. 2019; 381(22): 2103-2113.

Seizures 63

Seizures Administration Anaphylaxis Outcomes 63

The Skeptics' Guide to EM

MAY 25, 2019

Date: May 23rd, 2019 Reference: Joseph et al. JAMA Surgery March 2019. Date: May 23rd, 2019 Reference: Joseph et al. JAMA Surgery March 2019. Clinical Question: What are the outcomes of trauma patients after REBOA placement? JAMA Surgery March 2019. This is Bob’s tenth visit to the SGEM.

Military 52

Military Resuscitation PPE Emergency Department 52