EMDocs

APRIL 27, 2024

We’ll keep it short, while you keep that EM brain sharp. However, the bioavailability of antipseudomonal antibiotics has improved outcomes, limiting surgery as a confirmatory diagnostic procedure and as needed for granulation tissue removal. Otology & Neurotology 41(8):p 1004-1011, September 2020. | DOI: 10.1097/MAO.0000000000002723

EMS 102

EMS Infectious Diseases Radiology Radiology 102

EMDocs

NOVEMBER 18, 2023

We’ll keep it short, while you keep that EM brain sharp. OPTN/SRTR 2020 Annual Data Report: Liver. Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors. Pediatr Radiol. 2021;51(2):248-256. doi:10.1007/s00247-020-04811-0 2) Kwong AJ, Ebel NH, Kim WR, et al.

EMS 89

EMS Ultrasounds Emergency Department Outcomes 89

Pediatric EM Morsels

JUNE 9, 2023

Luoto, 2020 ] Increase resistance can be related to pre-hepatic , intra-hepatic , or post-hepatic etiologies. Luoto, 2020 ] Increase resistance can be related to pre-hepatic , intra-hepatic , or post-hepatic etiologies. Banc-Husu, 2023 ; Luoto, 2020; Carneiro de Moura, 2018 ] Basics are best (always)! 2020 May;70(5):628-634.

Pediatrics 154

Pediatrics Head Injuries Airway Management Administration 154

Pediatric EM Morsels

AUGUST 11, 2023

This is the 601st Ped EM Morsel ! Infections there become complicated very quickly and the outcomes can be very poor. 2020 Oct 24;12(10):e11141. The post Perichondritis of the Ear in Children appeared first on Pediatric EM Morsels. ” Those areas have very important and delicate structures. Can Fam Physician.

Burns 130

Burns Pediatrics EMS Outcomes 130

Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Written by Pendell Meyers Two adult patients in their 50s called EMS for acute chest pain that started within the last hour. Both cases had an EMS ECG that was transmitted to the ED physician asking "should we activate the cath lab?" 25 minutes later, EMS called back with this new ECG: Super obvious STEMI(+) OMI.

EKG/ECG 127

EKG/ECG EMS Outcomes Wellness 127

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. appeared first on REBEL EM - Emergency Medicine Blog. Background: Sepsis remains one of the leading causes of morbidity and mortality.

Sepsis 130

Sepsis Hospitals Administration Outcomes 130

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. doi: 10.1136/bcr-2020-240532. The post Congenital Syphilis appeared first on Pediatric EM Morsels. Rates of congenital syphilis are increasing.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

RebelEM

APRIL 17, 2023

An extensive systematic review with more than 30,000 patients found no difference in the odds of treatment failure for patients with PTA managed with medical intervention alone or surgically (Forner 2020). 2020 Nov;163(5):915-922. Epub 2020 Jun 2. 2020, August 18). appeared first on REBEL EM - Emergency Medicine Blog.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

The Skeptics' Guide to EM

OCTOBER 17, 2020

Date: October 14th, 2020 Guest Skeptic: Dr.Salim Rezaie is a community emergency physician at Greater San Antonio Emergency Physicians (GSEP), where he is the director of clinical education. Salim is probably better known as the creator and founder of the wonderful knowledge translation project called REBEL EM. Reference: Rowell et al.

EMS 52

EMS Head Injuries Outcomes Hospitals 52

RebelEM

FEBRUARY 8, 2024

patients with more discrepant readings had NIBP checked more frequently) Some patients were on multiple vasopressors, but for an unclear reason the authors decided to only evaluate the dose of norepinephrine MAP discrepancy is not a patient oriented outcome (i.e. J Crit Care 2020. to 1.12; p = 0.03 to 0.99; p <0.01 to 2.47; p – 0.04

Resuscitation 117

Resuscitation Outcomes EMS Sepsis 117

The Skeptics' Guide to EM

JULY 8, 2023

Managing editor of EM:RAP and Associate Editor at REBEL EM. Managing editor of EM:RAP and Associate Editor at REBEL EM. There was a large unblinded RCT of over 3,000 patients published in the Lancet in 2020. Case: A 57-year-old woman with hypertension, […] The post SGEM#409: Same as it Ever Was – Tamiflu for Influenza?

CDC 107

CDC Hospitals EMS Emergency Department 107

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? first appeared on The Skeptics Guide to Emergency Medicine.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

RebelEM

MAY 25, 2023

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. Intensive Care Med 2020. [13]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Taming the SRU

SEPTEMBER 25, 2023

This places a significant responsibility on the EM physician to diagnose and treat fractures. Specifically, EM physicians should be able to recognize fractures that will likely require operative management and facilitate close follow up, such as a Maisonneuve fracture. 2020 Feb 12;4(2):e20.00005. 2020 Dec;12(6):1644-1651.

Fractures 101

Fractures Operations Emergency Department EMS 101

RebelEM

OCTOBER 2, 2023

No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 tests/hr (0.8 Traditional: 1.0 tests/hr (0.8 Pre-Intervention: 1.0 tests/hr (0.9

Operations 97

Operations Academics Outcomes Fluid Resuscitation 97

Dr. Smith's ECG Blog

NOVEMBER 14, 2023

Outcome: All 4 serial hs troponin I, out to 6 hours, were undetectable. For examples of this phenomenon — See My Comment in the February 14, 2018 — July 21, 2020 — and December 22, 2022 posts in Dr. Smith's ECG Blog ). EMS arrived — and recorded 2 ECGs. How Would YOU Interpret the Serial Tracings in Figure-1?

EKG/ECG 118

EKG/ECG EMS Stroke Outcomes 118

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.,

CDC 111

CDC Radiology Radiology Head Injuries 111

RebelEM

NOVEMBER 30, 2023

Outcomes: Primary Outcome: In-hospital mortality. Secondary Outcomes: Delayed hypotension, increased ICU stay, and other relevant outcomes. There was no specified time-frame for the primary outcome, potentially affecting the precision of the findings. Mayo Clin Proc Innov Qual Outcomes. 2.89, p = 0.01.

Sepsis 118

Sepsis Fluid Resuscitation Resuscitation Administration 118

The Skeptics' Guide to EM

JANUARY 25, 2020

Date: January 9th, 2020 Reference: Casey et al. Case: A 60-year-old male is […] The post SGEM#281: EM Docs Got an AmbuBag – The PreVent Trial first appeared on The Skeptics Guide to Emergency Medicine. Date: January 9th, 2020 Reference: Casey et al. Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults.

EMS 40

EMS Airway Management Administration Resuscitation 40

The Skeptics' Guide to EM

JANUARY 1, 2022

He became double board certified in Emergency Medicine (EM) and Emergency Medical Services (EMS). He became double board certified in Emergency Medicine (EM) and Emergency Medical Services (EMS). Date: December 21st, 2021 Guest Skeptic: Dr. Howard “Howie” Mell began his career as a firefighter / paramedic in Chicago.

Stroke 52

Stroke EMS Outcomes Administration 52

The Skeptics' Guide to EM

AUGUST 14, 2021

Circulation 2020 Guest Skeptic: Missy Carter is a PA practicing in emergency medicine in the Seattle area and an adjunct faculty member with the Tacoma Community College paramedic program. This was a critical appraisal of an observational study published in Annals of EM ( Kawano et al 2018 ). Reference: Daya et al.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

The Skeptics' Guide to EM

MAY 30, 2020

Date: May 29th, 2020 Reference: Erramouspe et al. AEM May 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Date: May 29th, 2020 Reference: Erramouspe et al. AEM May 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is hypotensive and tachycardic.

Head Injuries 52

Head Injuries Academics EMS Outcomes 52

The Skeptics' Guide to EM

MAY 15, 2021

Daniel Schwerin is employed with Prisma Health-Upstate as a clinical assistant professor, emergency medicine GME director for emergency medical services and medical director for several local EMS agencies and has lectured on prehospital stroke management. Their local EMS service arrives quickly with a conventional ambulance.

Stroke 52

Stroke EMS Outcomes 52

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.

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52

Taming the SRU

NOVEMBER 3, 2023

The thought with introducing the serratus anterior plane block was that regional anesthesia is well within the purview of EM physicians and can offer a safe alternative to systemic pain medications. The primary outcome in this study was a change in pain score at rest 60 minutes after block.

Fractures 98

Fractures Ultrasounds Research Outcomes 98

ACEP Now

OCTOBER 30, 2023

One case report highlighted an unfortunate outcome from aspiration pneumonia, later found to be due to crayons rather than the expected culprits such as food, secretions, or beverages. With this model, there will hopefully be improved patient satisfaction and better outcomes. Published September 16, 2020. EM Resident.

Sexual Assault 98

Sexual Assault Teamwork Dehydration Outcomes 98

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Date: September 16th, 2020 Guest Skeptics: Dr. Robert Goulden and Dr. Audrey Marcotte are Chief Residents from the Royal College of Emergency Medicine Program at McGill University. Alongside his EM residency, he is doing a PhD in epidemiology. Alongside his EM residency, he is doing a PhD in epidemiology.

Academics 52

Academics Resuscitation EMS Stroke 52

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

Emergency Medicine Journal

NOVEMBER 28, 2023

Background The regional emergency medical service (EMS) in Lombardy (Italy) developed clinical algorithms based on operator-based interviews to detect patients with COVID-19 and refer them to the most appropriate hospitals. PPV and NPV were 13.3% (95% CI 0.13 to 0.14) and 98.2% (95% CI 0.98 to 0.98), respectively.

Operations 52

Operations EMS Hospitals Outcomes 52

ACEP Now

JULY 7, 2023

2,3 In general, patients who develop cardiac arrest with an initial rhythm of VT or VF tend to have favorable outcomes compared to patients who develop cardiac arrest from either asystole or pulseless electrical activity. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. Circulation. 2018;137(12). Kimblad H, et al.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

The Skeptics' Guide to EM

JUNE 6, 2020

Date: June 2nd, 2020 Reference: Permpikul et al. Date: June 2nd, 2020 Reference: Permpikul et al. Max is then going to Georgetown to be an attending in both EM and ICU. However, it has become evident that patients are often over-resuscitated with IV fluids which adversely impacts outcome. Respir Crit Care Med 2019.

Sepsis 52

Sepsis Shock Resuscitation Administration 52

The Skeptics' Guide to EM

JANUARY 29, 2020

Date: January 25th, 2020 SGEM#281: EM Docs Got an AmbuBag Statistically Significant: Dan Lane We want to make the SGEM even better and address some of the criticisms from the ClinEpi world about clinicians trying to do critical appraisal.

EMS 52

EMS Outcomes 52

RebelEM

APRIL 29, 2024

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ). Resuscitation. Resusc Plus.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

EMDocs

SEPTEMBER 25, 2023

Still, there are those that believe that FPS is more of a physician-centered endpoint that does not fully reflect important patient-centric outcomes (16). Epub 2020 Dec 9. 2020 Jul;158(1):45-47. Epub 2020 Jul 2. We don’t want to go backwards! J Emerg Med. 2021 Mar;60(3):265-272. doi: 10.1016/j.jemermed.2020.10.042.

Emergency Department 84

Emergency Department Soft Tissue Injuries Airway Management Operations 84

Emergency Medicine Journal

NOVEMBER 28, 2023

It can be challenging and time consuming to access the information required to reflect upon their clinical practice by reviewing the outcomes of their individual patients, referred to as patient follow-up. Patient outcomes are commonly documented in electronic health records (EHR). It was implemented in December 2020.

EMS 40

EMS Documentation/Coding Outcomes Hospitals 40

The Skeptics' Guide to EM

MAY 2, 2020

Date: April 24th, 2020 Reference: Watanabe et al. A Contemporary Analysis Using National EMS Information System (NEMSIS) Data. Date: April 24th, 2020 Reference: Watanabe et al. A Contemporary Analysis Using National EMS Information System (NEMSIS) Data. Annals of Emergency Medicine. Annals of Emergency Medicine.

Documentation/Coding 40

Documentation/Coding EMS EKG/ECG Outcomes 40

The Skeptics' Guide to EM

APRIL 25, 2020

Date: April 21st, 2020 Reference: Juergens et al. Date: April 21st, 2020 Reference: Juergens et al. He has been practicing in Emergency Medicine for over 40 years and involved in EMS services for over 30 years. The neurology led stroke team is not available and you wonder if that will affect her outcome.

Stroke 40

Stroke Emergency Department Outcomes Administration 40