RebelEM

MAY 18, 2023

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. The secondary outcome of mortality was not statistically different however numerically favored the early use of norepinephrine. This resulted in better shock control by 6hrs (76.1%

Sepsis 100

Sepsis Shock Resuscitation Outcomes 100

The Skeptics' Guide to EM

JUNE 6, 2020

Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Respir Crit Care Med 2019. Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Respir Crit Care Med 2019. Date: June 2nd, 2020 Reference: Permpikul et al. increase in MAP).

Sepsis 52

Sepsis Shock Resuscitation Outcomes 52

The Skeptics' Guide to EM

MAY 25, 2019

Date: May 23rd, 2019 Reference: Joseph et al. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. JAMA Surgery March 2019. Date: May 23rd, 2019 Reference: Joseph et al. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma.

Military 52

Military Resuscitation PPE Emergency Department 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.

Stroke 73

Stroke Outcomes EMS Seizures 73

PHARM

SEPTEMBER 21, 2023

Maintaining physiology of brain tissue to the greatest extent possible through optimal management of blood pressure, airway, ventilation, and oxygenation, improves patient outcome. We assessed systolic blood pressure (SBP), end-tidal partial pressure of CO2 (PetCO2), and PaCO2 at hospital admission as well as prehospital and on-scene time.

Hospitals 40

Hospitals Resuscitation Wellness Outcomes 40

Don't Forget the Bubbles

JUNE 30, 2023

Elsa was found face down in the family pool 20 minutes after last visual contact and was picked up without resuscitation. She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. Ann Cardiothorac Surg 2019; 8:137–142 But Elsa’s temperature is 30.1⁰C. Saczkowski, R.,

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

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

Don't Forget the Bubbles

MAY 10, 2023

Resuscitation is a team sport. Role stickers or role aprons with names on them are simple measures to highlight resuscitation roles. A study in Denmark in 2021 explored barriers to effective resuscitation in over 900 in-hospital resuscitations across six hospitals in Denmark. It was the most phenomenal resuscitation.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

Dr. Smith's ECG Blog

AUGUST 2, 2024

the investigators reviewed outcomes in 118 patients presenting with NSTEMI. Yet recognition of acute RV MI is extremely important clinically — because emergency treatment will often require different priorities (ie, avoidance of nitroglycerine; fluid resuscitation for hypotension ). 118.007305) from Heitner et al. ,

EKG/ECG 112

EKG/ECG Fluid Resuscitation Academics Resuscitation 112

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. There are few data on the outcomes of UGIB when balloon tamponade is used as a temporizing measure. Stable Patients For both stable and resuscitated patients, high-dose IV proton pump inhibitor therapy (i.e., 2019:94(4):697-703. 2019:37(2):277-280. Mayo Clin Proc.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

The Skeptics' Guide to EM

MARCH 2, 2019

Date: February 26th, 2019 Reference: Benger et al. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Date: February 26th, 2019 Reference: Benger et al. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Effect of a Strategy of a Supraglottic Airway Device
vs.

Airway Management 52

Airway Management CPR Outcomes Hyperthermia / Hypothermia 52

Northwestern EM Blog

APRIL 15, 2024

2019): 109-119. Tracheostomy: Epidemiology, Indications, Timing, Technique, and Outcomes.” Tracheotomy outcomes and complications: a national perspective. As with any high stress situation in resuscitation, it helps to fall back onto our ABCs, airway being of principle importance here. References 1.Bontempo, and Sara L.

Emergency Department 98

Emergency Department Resuscitation Pediatrics Outcomes 98

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

Northwestern EM Blog

SEPTEMBER 26, 2022

In this post, we will give a brief overview of a landmark study in the ED debrief literature, which advocates for a “hot” debrief model in resuscitation cases using the STOP5 model. Any team member of the resuscitation may lead the hot debrief. No potential resuscitation cases were formally excluded. References 1. Www.Heart.Org.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 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

PHEM Cast

JULY 27, 2021

link] ResusMe bibliography of PH ultrasound papers 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism Kenji Inaba. 2015 Marik PE, Cavallazzi R. Does central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Intensive Care Med 2010; 36: 1475-83.

Ultrasounds 52

Ultrasounds Fractures Resuscitation EMS 52

The Skeptics' Guide to EM

JANUARY 25, 2020

NEJM February 2019 Guest Skeptic: Andrew Merelman is a critical care paramedic and second year medical student at Rocky Vista University in Colorado. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults.

EMS 40

EMS Airway Management Administration Resuscitation 40

Don't Forget the Bubbles

MARCH 18, 2024

She receives fluid resuscitation, and you organise some tests to find out why she is so tired. 2019 [cited 2023 Nov 30]. Early Volume Expansion and Outcomes of Hemolytic Uremic Syndrome. 2019 Sep 25;8:1690. 2019 [cited 2023 Nov 30]. 2019 [cited 2023 Dec 3]. Oct 30 2019. Rch.org.au. 2016 Jan 1;137(1).

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

EMDocs

SEPTEMBER 7, 2023

2,10 Initial stabilization of DEG toxicity includes correcting acid-base abnormalities, electrolyte abnormalities, and volume resuscitation. Volume resuscitation as needed while adjusting for any developing acute kidney injury. McGraw Hill, 2019. McGraw Hill, 2019. CDC’s Morbidity and Mortality Weekly Report.

Poisoning 66

Poisoning CDC Administration Emergency Department 66

ACEP Now

NOVEMBER 16, 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. Published 2019.

Academics 52

Academics EMS Research Telemedicine 52

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Date: January 28th, 2019 Reference: Chu DK et al. Date: January 28th, 2019 Reference: Chu DK et al. In neonatal resuscitation oxygen is treated like a drug that should be appropriately dosed, with careful attention to limit its use to the minimum required amount out of a fear of harm from its excess use. The Lancet 2018.

Administration 52

Administration Poisoning Hospitals Outcomes 52

EMDocs

JUNE 27, 2024

2019 Jan 24;14:263-292. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Factors associated with adverse outcome among children with sickle cell disease admitted to the pediatric intensive care unit: an observational cohort.

Pediatrics 75

Pediatrics EMS Dehydration Hospitals 75

Downeast Emergency Medicine

APRIL 26, 2021

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Lancet 2019; Vol 394, Iss 10210, P 1713-1723[ Full Text ]. There were no differences found in the secondary outcomes.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

PHEM Cast

APRIL 21, 2021

The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. Resuscitation. Resuscitation. Positioning From: [link] Recommended Rich Levitan resources Podcast 70 – Airway Management with Rich Levitan Airway axes From: McGuire B, Hodge K. Tracheal intubation. 20(12);681-686.

Airway Management 52

Airway Management Resuscitation Hospitals EMS 52

Taming the SRU

OCTOBER 1, 2023

As these patients are typically already at a high risk for poor health outcomes, secondary spontaneous PTX is often more serious in presentation and management more complex [11]. Unsuspected tension pneumothorax as a hidden cause of unsuccessful resuscitation. Published 2019 Dec 3. Resuscitation. Ann Emerg Med.

Fractures 94

Fractures COPD Hospitals Emergency Department 94

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

RebelEM

NOVEMBER 30, 2023

This systematic review and meta-analysis attempts to elucidate whether a more conservative fluid resuscitation approach is warranted in volume sensitive sepsis patients, such as those with congestive heart failure (CHF). Outcomes: Primary Outcome: In-hospital mortality. Am J Emerg Med. 2023;73:34-39. 2.89, p = 0.01.

Sepsis 113

Sepsis Fluid Resuscitation Resuscitation Administration 113

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12].

Resuscitation 89

Resuscitation Outcomes Operations Hospitals 89

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Am J Med 2019, 132(5):622-630. Now there is a paper published in 2019 that proves the point beyond doubt, though makes it clear that this pattern is associated with very high mortality. American Journal of Medicine 132(5):622-630; May 2019. Knotts RJ, Wilson JM, Kim E, Huang HD, Birnbaum Y. J Electrocardiol 2013;46:240-8 2.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

EMDocs

JUNE 7, 2023

Further management and resuscitation were required, and she had a lengthy ICU stay of 21 days until she was extubated. Indira M, Andrews MA, Rakesh TP: Incidence, predictors, and outcome of intermediate syndrome in cholinergic insecticide poisoning: a prospective observational cohort study. Br J Clin Pharmacol. 2016;81(3):462-470.

Poisoning 83

Poisoning Airway Management Seizures PPE 83

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

However, in multiple studies, even in the absence of AMI, both acute and chronic myocardial injury (as diagnosed by any elevated cTn) are powerful markers of adverse outcomes in both the short and long term. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). 3–8 Shi et al.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

Taming the SRU

MARCH 30, 2023

Diastolic shock index and clinical outcomes in patients with septic shock. Background Early recognition and resuscitation of patients in septic shock are critical skills for an emergency medicine physician. the diastolic shock index) could provide providers a tool to quickly identify patients that are at risk for unfavorable outcomes.

Shock 52

Shock Outcomes Sepsis Resuscitation 52

ACEP Now

APRIL 3, 2024

Targeted temperature management (TTM) for patients following cardiac arrest resuscitation has gone through several dosing iterations in the past two decades. 3,4 The Hyperion trial in 2019 demonstrated that TTM at 33 degrees Celsius was efficacious for non-shockable rhythms, reinforcing the guidelines recommendation for post-arrest TTM.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

RebelEM

MARCH 30, 2023

Background: Previous observational studies published in 2015 (Geri 2015)(Vyas 2015) indicated that early cardiac catheterization in patients with out-of-hospital cardiac arrest (OHCA) might improve mortality and result in more favorable neurological outcomes. Article: How-Berlemont C, Lamhaut L, Diehl J, et al.

Hospitals 63

Hospitals Outcomes EKG/ECG Resuscitation 63

RebelEM

JUNE 26, 2023

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy. Severe acute traumatic coagulopathy = PT >1.5

Administration 144

Administration Outcomes Resuscitation Radiology 144

RebelEM

MARCH 13, 2023

Nevertheless, mortality of prehospital traumatic cardiac arrest (TCA), and survivability with good neurologic outcome, remain the gold standards of trauma care in and out of the hospital and are effectively the criterion by which we measure outcomes in the trauma literature. Discussion: Dead On Scene: The 96.2% mortality rate and 43.5%

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52