Don't Forget the Bubbles

JUNE 17, 2024

High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. At its heart lies an unpleasant reality- a critically unwell child with an anxious carer hoping for a positive outcome. 2020 Aug 20. 2020 Jan 1;35(1):70-6. Conclusion Critical care resuscitation is stressful.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

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

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

The Skeptics' Guide to EM

DECEMBER 12, 2020

Date: December 10th, 2020 Reference: Ladde et al. AEM December 2020 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). Date: December 10th, 2020 Reference: Ladde et al.

Operations 52

Operations Outcomes Research Academics 52

The Skeptics' Guide to EM

NOVEMBER 21, 2020

Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. AEM November 2020. Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. AEM November 2020. AEM November 2020. Reference: Pines et al. Reference: Pines et al.

Emergency Department 52

Emergency Department Telemedicine Academics Outcomes 52

EMDocs

SEPTEMBER 7, 2024

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 75

EMS Fluid Resuscitation Resuscitation Radiology 75

Taming the SRU

NOVEMBER 3, 2023

The primary outcome in this study was a change in pain score at rest 60 minutes after block. 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. Mean and median pain score at rest prior to SAPB were 5.4 (SD SD 3.28) and 6.5,

Fractures 97

Fractures Ultrasounds Outcomes Research 97

Don't Forget the Bubbles

JANUARY 8, 2024

This led to her death at 19, an outcome ruled as homicide at inquest, indicating others’ contribution to her demise. Verbal de-escalation not only helps in avoiding the need for physical intervention but also fosters a therapeutic relationship, crucial for successful treatment outcomes in these sensitive situations. Mulraney, M.,

Research 105

Research Emergency Department Psychiatric Outcomes 105

Don't Forget the Bubbles

JANUARY 17, 2024

After Meshram et al, 2020 When Orbeez are exposed to water, the water molecules diffuse into the polymer network through osmosis. They passed away a few days after a second operation. There have been reports of the Orbeez Challenge leading to serious outcomes. Unfortunately, the anastomosis broke down. It’s beads, too!

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

The Skeptics' Guide to EM

JULY 30, 2022

Background: Somewhere between two and four percent of patients presenting to US EDs with abdominal pain have a small bowel obstruction (SBO) – those who are managed operatively (who are only 20-30%) account for 60,000 hospitalizations and 565,000 inpatient care days per year. sensitivity and 96.6% specificity with ultrasound [1].

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. Resuscitation. 9 Zhang W et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

ACEP Now

SEPTEMBER 3, 2024

These stakeholders are similarly shielded in court when adverse patient outcomes, such as negligent deaths, occur under their management or when the bought-out companies are challenged for anticompetitive business practices overseen by the PE firm. Published March 15, 2020. Published April 20, 2020. Accessed August 25, 2024.

Hospitals 113

Hospitals Radiology Radiology Administration 113

PulmCCM

SEPTEMBER 4, 2024

OP is operating point, the operating point defines the cardiac output on the y-axis and Pra on the x-axis; Rcardiac is cardiac resistance (i.e., OP1 is operating point 1 at baseline. With tamponade, operating point 2 (OP2) is formed. Might this novel measure predict outcome in critically-ill patients [ @ross_prager ]?

Ultrasounds 84

Ultrasounds Operations Research Outcomes 84

Taming the SRU

MAY 22, 2023

Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED. A comparison between pre-operative ultrasonography and surgical findings. 2020 Apr 15;28(8):309-315. Injuries discussed are shown in Image 1. Acta Radiol.

Fractures 76

Fractures Dislocations Operations Radiology 76

Don't Forget the Bubbles

JANUARY 1, 2024

However, children who had an operation experienced improvements in behaviour, symptoms, and quality of life and had lower blood pressure. During the COVID-19 pandemic (2020-2021), the incidence of IPD reached its lowest level in 20 years. Outcomes From a Randomized Clinical Trial. They enrolled 459 children aged 3 to 12.9

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

Taming the SRU

OCTOBER 23, 2023

At this point, the patient is taken to the operating room for a diagnostic laparoscopy. Discrimination between an IUP and an interstitial pregnancy is critical as interstitial pregnancies can have devastating outcomes. She was taken to the operating room and found to have a right tubal ectopic pregnancy with a pseudogestational sac.

Ultrasounds 97

Ultrasounds Operations Radiology Radiology 97

SheMD

MAY 4, 2023

What were their outcomes: The median number of years to first appointment to a chair position was 7 years after graduation. Women were more likely to be first appointed to educational rather than operational roles (52.6% Categorical analyses were conducted to compare demographics, qualifications, and achievements by gender.

Leadership 52

Leadership Academics Operations Administration 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Methods This multicentre randomised controlled trial was undertaken between December 2018 and July 2020 in the ED of four hospitals in the Netherlands. The primary outcome was the proportion of patients requiring more than one reduction attempt.

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40

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. These questionable practices led to a rash of bad outcomes.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

The Skeptics' Guide to EM

JANUARY 23, 2021

That SGEMHOP episode asked how the productivity of APPs compare to emergency physicians and what is its impact on ED operations? The SGEM bottom line was that increasing APP coverage has minimal effect on ED flow and safety outcomes based on the data. Intervention: Evaluated by an APP * Comparison: Evaluated a physicial * Outcome:

Poisoning 52

Poisoning Research Documentation/Coding Outcomes 52

The Skeptics' Guide to EM

NOVEMBER 20, 2021

There are three other GEAR 1.0 Reference: Hammouda et al.

Geriatric Emergencies 52

Geriatric Emergencies Elder Abuse Research Academics 52

RebelEM

NOVEMBER 3, 2022

Van Berkel 2017) In 2020 the NEAR study reported peri-intubation hypotension rates of 18.3% April 2020 ) RebelEM recently reviewed The EvK trial , which found a higher 7-day survival rate with ketamine but no difference in 28-day survival. April 2020 NEAR registry study represents 1/3rd the weight of this meta-analysis.

Outcomes 52

Outcomes Emergency Department Sepsis Operations 52

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). Improved Visualization: Video laryngoscopes allow for the use of standard or hyperangulated geometry, essentially allowing the operator to “look around the corner” on an anterior airway.

Emergency Department 66

Emergency Department Soft Tissue Injuries Airway Management Operations 66

EMDocs

NOVEMBER 18, 2023

OPTN/SRTR 2020 Annual Data Report: Liver. Liver Transplantation: Operative Techniques and Medical Management. Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors. Pediatr Radiol. 2021;51(2):248-256. Am J Transplant. 2022;22 Suppl 2:204-309. doi:10.1111/ajt.16978

EMS 69

EMS Ultrasounds Emergency Department Outcomes 69

Taming the SRU

JANUARY 29, 2024

Variations in sensitivity are thought to be related to operator technique, patient habitus, and difficulty evaluating the subclavian vein beneath the clavicle. [12] Phlegmasia Cerulea Dolens in the Upper Extremity: A Case Report and Systematic Review and Outcomes Analysis. Epub 2020 Nov 25. Vasc Endovascular Surg. Phlebology.

Emergency Department 92

Emergency Department Fractures Hospitals Operations 92

PulmCCM

FEBRUARY 28, 2022

What they did Adult patients admitted to one of 53 intensive care units in New Zealand or Australia between September 2017 and December 2020 were eligible. Death, from any cause, within 90 days of randomization was the primary outcome. The analysis was performed as an intention-to-treat.

Fluid Resuscitation 40

Fluid Resuscitation Resuscitation Outcomes Sepsis 40

AED Leader

NOVEMBER 27, 2024

Stryker has confirmed that all AEDs purchased prior to October 31, 2020, will continue to be protected under the manufacturers limited warranty. Regular monthly checks help ensure the device is fully operational when its needed most. Replace worn or expired components promptly.

CPR 52

CPR Pediatrics Operations Outcomes 52

Taming the SRU

AUGUST 30, 2023

Significantly elevated CRP (>122mg/L) and PCT (>0.5ng/mL) levels are predictors of bad outcomes, and are useful for tracking therapy progress, but are not specific enough to rule-in infectious endocarditis [38-39]. However, these observations have failed to be validated at a larger level and should be taken with caution.

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

EMDocs

JUNE 3, 2023

4 This is the framework the ED resuscitationist should be operating under, as hemodynamically unstable pelvic trauma patients require a different approach compared to stable patients who will undergo CT, routine pelvic fixation, and definitive surgical repair. An x-ray in the trauma bay demonstrated an AP grade III fracture.

Fractures 54

Fractures Resuscitation Operations EMS 54

EMDocs

SEPTEMBER 9, 2023

Published 2020 Dec 21. Results of primary extensor tendon repair in relation to the zone of injury and pre-operative outcome estimation. Effect of Time to Hand Therapy following Zone II Flexor Tendon Repair. Plast Reconstr Surg Glob Open. 2020;8(12):e3278. doi:10.1097/GOX.0000000000003278 Arch Orthop Trauma Surg.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

ALiEM

OCTOBER 30, 2023

The same goes for clinical operations and research – interesting, but there hasn’t been any “a ha” moment to illuminate her calling. 2020; 42(6):663-672. Garcia finds herself at a bit of a crossroad. She likes teaching, but are not sure residency or medical student education leadership is for her. What should I look for in a coach?

Academics 64

Academics Leadership Wellness Research 64

Cook County EM Blog

MARCH 20, 2023

2020 Nov;26(6):899-904. Latex paint-gun injuries of the hand: are the outcomes better? Ulus Travma Acil Cerrahi Derg. doi: 10.14744/tjtes.2020.26751. 2020.26751. PMID: 33107958. Rosenwasser MP, Wei DH. High-pressure injection injuries to the hand. J Am Acad Orthop Surg. 2014 Jan;22(1):38-45. doi: 10.5435/JAAOS-22-01-38.

Documentation/Coding 52

Documentation/Coding Fractures Operations Research 52

Taming the SRU

MARCH 14, 2023

Ultimately, definitive management is in the operating room with revision or replacement of the VP shunt. Estimated incidence of normal pressure hydrocephalus and shunt outcome in patients residing in assisted-living and extended-care facilities. Lumbar puncture is an option with limited data for success. Fluids and Barriers of the CNS.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

The fire department, who operate at an EMT level in this municipality, arrived before us and administered 324 mg of baby aspirin to the patient due to concern for ACS. Medical Therapy for Secondary Prevention and Long-Term Outcome in Patients With Myocardial Infarction With Nonobstructive Coronary Artery Disease. References: 1.

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

EMDocs

NOVEMBER 16, 2024

4 Pain is the most common reason for presentation in the early post operative period. 5 Highest risk of dislocation early in the post operative course due to laxity of the soft tissue after surgery. 6 Hip flexion or adduction in the early post-operative period can cause atraumatic dislocations (typically avoided for 6 weeks post-op).

EMS 76

EMS Dislocations Fractures Operations 76

Don't Forget the Bubbles

FEBRUARY 7, 2024

This week, NCEPOD (National Confidential Enquiry into Patient Outcomes and Death) produced a much-anticipated report on how we manage acute testicular torsion in young people. One systematic review of 1283 patients showed that if you got to the operating room within 6 hours, you had a 97% chance of saving the testicle. Ghadban, T.,

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

ALiEM

OCTOBER 30, 2024

Your patient ultimately is diagnosed with a spinal epidural abscess requiring operative care. Emergency department-initiated buprenorphine for opioid dependence with continuation in primary care: outcomes during and after intervention. Microdosing Methods Help, 2020. 2022 May;14(5). Journal of general internal medicine.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64