PulmCCM

NOVEMBER 6, 2023

The therapy was approved for emergency use in 2020 by FDA after an observational study of 10 patients showed likely benefit (yes, 10, which should remind us of our collective desperation). patients infected with the Wuhan/Delta variants in 2020-2021). Only it turns out, it did help. Or could, anyway. Thromboelastometry (e.g.,

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

RebelEM

APRIL 17, 2023

However, It is unclear how well POCUS performs in ruling in or ruling out the diagnosis of PTA. Question: How well does the US perform in diagnosing PTA compared to CT, needle aspiration, or Incision and Drainage? 2020 Nov;163(5):915-922. Epub 2020 Jun 2. 2020, August 18). Article: Kim DJ et al. Acad Emerg Med.

Ultrasounds 123

Ultrasounds Radiology Radiology Operations 123

Dr. Smith's ECG Blog

DECEMBER 13, 2023

And she learned it well: She is not highly confident, but she does diagnose OMI. Outcome: 100% LAD Occlusion Here the Queen explains why: The dark blue tells us that she is looking especially at the QRS in V3 and the T-wave in V2 and V3. Not OMI, and we (Pendell and I) always take proportionality into account.

EKG/ECG 116

EKG/ECG COPD Wellness Outcomes 116

EMDocs

NOVEMBER 7, 2023

Antibiotics are recommended for those with complicated diverticulitis, as well as surgical specialist consult if necessary (e.g., No difference in their primary outcome of complications and need for emergency surgery (1.9% 2020 Mar 30:S1542-3565(20)30426-2. perforation). 623 patients included. 5.0%; p = 0.085).

Sepsis 88

Sepsis Best Practices Hospitals Outcomes 88

Don't Forget the Bubbles

MAY 31, 2023

The DIMPLES study by PERUKI sought to investigate the incidence of new-onset diabetes in the paediatric population across the UK and Ireland, as well as the characteristics of these ED presentations, and to determine if SARS-CoV2 infection was involved. What outcomes did they look at? Which patients were involved?

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Queen of hearts interpretations: Patient 1, ECG1: Patient 2, ECG1: Patient 1 Clinical Course and Outcome: The EM physician did not see that the S wave voltage has been truncated and squared off at 10 mm, thereby greatly limiting the assessment of proportionality. But he did well.

EKG/ECG 119

EKG/ECG EMS Outcomes Wellness 119

The Skeptics' Guide to EM

NOVEMBER 28, 2020

Date: November 25th, 2020 Guest Skeptic: Dr. Joe Vipond has worked as an emergency physician for twenty years, currently at the Rockyview General Hospital. Date: November 25th, 2020 Guest Skeptic: Dr. Joe Vipond has worked as an emergency physician for twenty years, currently at the Rockyview General Hospital. Should they do it?

Infectious Diseases 52

Infectious Diseases Outcomes Wellness Operations 52

The Skeptics' Guide to EM

JULY 8, 2023

She looks well enough to go home but asks if she should be prescribed oseltamivir (Tamiflu) because some of her friends have been given it recently by their doctors. Safety issues popped up soon after widespread use of the drug including neuropsychiatric effects as well as the more common adverse effects of nausea and vomiting.

CDC 97

CDC Hospitals EMS Emergency Department 97

Sensible Medicine

JULY 28, 2023

MJ is a 24-year-old man who presents to his primary care physician on March 16, 2020 with fever, myalgia, and sore throat. March 2020: COVID strips a veteran physician of his invincibility. Early 2020 was scary. July 2020: A reprieve. June and July of 2020 felt like February 2020. Case rates were low.

Hospitals 85

Hospitals PPE Urgent Care Academics 85

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). While ABGs and VBGs usually correlate well, there are a few situations where this correlation is disturbed.

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

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. Using the EQUAL model will hopefully improve our care of patients living with disabilities, as well as their experience in the ED and accessing healthcare.

Sexual Assault 98

Sexual Assault Teamwork Outcomes Dehydration 98

Northwestern EM Blog

SEPTEMBER 26, 2022

It is well-documented that ED physicians have historically high rates of burnout compared to other specialties as well as a high incidence of post-traumatic stress disorder (PTSD) compared to the general population. PTSD is 2 times more prevalent in physicians (14.8%), with EM resident physicians falling in the range from 11.9%-21.5%.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

EMDocs

JULY 3, 2023

Introduction SAH has the potential for rapid progression and devastating outcomes. All patients with concern for SAH need a rapid primary survey to assess the airway, breathing, and circulation as well as a comprehensive neurologic exam to create a baseline for the patient. What are the next steps in the management of this patient?

Seizures 85

Seizures Stroke Outcomes EMS 85

Don't Forget the Bubbles

JUNE 30, 2023

American Thoracic Society, 2020 c) Rewarm and give IV K+ As the infusion is put up, Elsa goes into a VF rhythm due to a rapid shift in potassium and arrests soon after. Extracorporeal life support rewarming rate is associated with survival with good neurological outcome in accidental hypothermia. ” In C44. A5175-A5175.

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

The Skeptics' Guide to EM

APRIL 3, 2021

He was last seen well when going to bed at 10pm the night before. Background: We have talked about stroke management a number of times recently including SGEM#297 on the reanalysis of ECASS-3 by Alper et al 2020. Of the 13, eleven failed to show benefit for their primary outcome and four were stopped early due to harm or futility.

Stroke 52

Stroke Research Outcomes Hospitals 52

ACEP Now

OCTOBER 15, 2023

prescriptions annually per 100 persons in 2020. Patients were prescribed a schedule of twice-daily analgesia, and were allowed to increase the dose from 5 mg to 10 mg if pain was not initially well-controlled. The primary outcome was a more relevant seven-day outcome, rather than six-week follow-up.

Emergency Department 52

Emergency Department Outcomes CDC Research 52

The Skeptics' Guide to EM

MARCH 27, 2021

Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures. 2020 Case: A 74-year-old woman who suffered a fall earlier today presents to the emergency department (ED) and is found to have five rib fractures to her right thorax, but no other injury. J Trauma Acute Care Surg. Reference: Schuster et al.

Fractures 40

Fractures Outcomes Hospitals Emergency Department 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. She was last seen well two hours prior. The neurology led stroke team is not available and you wonder if that will affect her outcome. Her past medical history includes hypertension and type II diabetes.

Stroke 40

Stroke Emergency Department Outcomes Hospitals 40

EMDocs

AUGUST 22, 2024

Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Certified interpreter use can improve communication and patient outcomes. Providers should respect and utilize this mode of communication, as well as document the patient’s request for a non-certified interpreter.

Documentation/Coding 82

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 82

The Skeptics' Guide to EM

AUGUST 22, 2020

Date: August 18th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. AEM August 2020 Case: You are working in the emergency department during the […] The post SGEM#299: Learning to Test for COVID19 first appeared on The Skeptics Guide to Emergency Medicine. Reference: Carpenter et al.

Emergency Department 52

Emergency Department Academics Research Administration 52

The Skeptics' Guide to EM

DECEMBER 11, 2021

. * Fujii et al ( VITAMINS RCT) JAMA 2020: n=216 patients with septic shock. No statistical difference in their primary outcome for duration of time alive and free of vasopressor administration up to day 7 or the secondary outcome of 90-day mortality. Moskowits et al ( ACTS RCT) JAMA 2020: n=205 patients with septic shock.

Sepsis 40

Sepsis Shock Outcomes Research 40

Don't Forget the Bubbles

AUGUST 7, 2023

The study also did not assess outcomes for each patient, and as such, the impact on deviation from the normal range was not explored. Yes Was the outcome accurately measured to minimize bias? 2020 Sep 17;8:548154. CASP checklist for Cohort studies Does this address a clearly focused issue? Front Pediatr.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

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. Point-of-care ultrasound may show well-demarcated, round, and hypoechoic material in the stomach and first part of the duodenum, though it can underestimate the number of beads present. From Mullens et al.,

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

SheMD

SEPTEMBER 17, 2023

What were their outcomes: Female scientists were rated as significantly more likely to be teachers. So for #womeninstem, feminine appearance may erroneously signal that they are not well suited for science. Epub 2020 Jan 3. Past research has suggested that femininity and attractiveness are viewed as INCOMPATIBLE with science!

Research 59

Research Outcomes Wellness 59

Ken Grauer, MD

FEBRUARY 28, 2023

As a result — IF the 1 lead you are monitoring happens to be one in which P waves are not well seen — then you might assume the irregular rhythm in front of you was AFib. These cases provide insight to assessment for MAT: The January 5, 2020 post in Dr. Smith’s ECG Blog — for an example of MAT. Remember — 12 leads are better than one!

EKG/ECG 195

EKG/ECG Documentation/Coding Sepsis COPD 195

SheMD

JULY 27, 2023

What were their outcomes: Physician mothers report having more domestic responsibilities than their partners. Unequal distribution of domestic responsibility has been documented as a factor in the underrepresentation in female physicians in leadership roles in academic medicine as well as contributing to career satisfaction.

Academics 52

Academics Leadership Documentation/Coding Research 52

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. Published 2020 Jul 23. Published 2020 Jan 21. Institutional resources and specialty services may further dictate the management of PTX. Ann Emerg Med.

Fractures 94

Fractures COPD Hospitals Emergency Department 94

Stop and Think

DECEMBER 4, 2022

Rebecca Woodruff, a scientist from CDC, presented a study that found a spike in deaths due to heart disease in 2020. The spike in 2020 essentially wiped out the previous five years of progress. You’ve now created a patient who was previously a well person. Journalist Marlene Busko covered the abstract. SARS-CoV-2 was bad.

CDC 40

CDC Hospitals Outcomes Wellness 40

Dr. Smith's ECG Blog

AUGUST 2, 2024

The LCx and OM branches are not as well seen. the investigators reviewed outcomes in 118 patients presenting with NSTEMI. This is the right anterior oblique cranial view Here is a representative still. This shot is typically best for viewing the LAD and its diagonal branches. There is non-obstructive disease here.

EKG/ECG 112

EKG/ECG Fluid Resuscitation Academics Resuscitation 112

The Skeptics' Guide to EM

JANUARY 23, 2021

The SGEM bottom line was that increasing APP coverage has minimal effect on ED flow and safety outcomes based on the data. A joint statement on the issue was published in 2020 by AAEM/RSA, ACEP, ACOEP/RSO, CORD, EMRA, and SAEM/RAMS. The difference in training between and emergency medicine physician and APPs is well recognized.

Research 52

Research Poisoning Documentation/Coding Outcomes 52

Sensible Medicine

JANUARY 16, 2024

The journal asks that submissions be “well focused, scholarly, and clearly presented but should not include the findings of new research or data that have not been previously published.” If you appreciate our work (and would like to comment on this post) become a paid subscriber. Not getting these vaccines is a terrible decision.”

Research 136

Research Outcomes Wellness 136

ALiEM

OCTOBER 30, 2023

Well, instead of passively waiting for Godot, you can seize the initiative and bend the arc of your career into alignment with your values, strengths, and passions, and, by extension, toward fulfillment. The most supportive data for coaching in medicine is for physician wellness and mitigating burnout [7]. 2020; 42(6):663-672.

Academics 64

Academics Leadership Wellness Research 64

Don't Forget the Bubbles

JANUARY 1, 2024

While adenotonsillectomy may not directly impact cognitive functions, it can benefit other aspects of health and well-being in children with mild sleep-disordered breathing. During the COVID-19 pandemic (2020-2021), the incidence of IPD reached its lowest level in 20 years. Outcomes From a Randomized Clinical Trial.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

The Skeptics' Guide to EM

FEBRUARY 25, 2023

The latest guidelines from the AHA in 2020 state, “clinical trials and observational studies since the 2010 guidelines have yielded no new evidence that routine administration of sodium bicarbonate improves outcomes from undifferentiated cardiac arrest and evidence suggests that it may worsen survival and neurological recovery.” [4]

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

Don't Forget the Bubbles

JANUARY 10, 2024

Some wonder if giving blood to children with a haemoglobin <6g/dl will improve outcomes. Outcomes Primary outcome Mortality at 28 days after randomisation. The authors chose a patient-centred, primary outcome in keeping with their pragmatic design. Groups were well matched at baseline. Was blinding achieved?

Blood Transfusions 78

Blood Transfusions Outcomes Research Hospitals 78

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. 2020 Feb 12;10(1):2470. C or 100.4 mg/kg, max 0.4 PMID: 32051480; PMCID: PMC7015921.

Pediatrics 75

Pediatrics EMS Dehydration Hospitals 75

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. Studies have compared IO to peripheral intravenous (PIV) and central venous (CVC) access for resuscitation.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102