RebelEM

DECEMBER 23, 2024

There has been ongoing study about the clinical significance of these effects, as well as whether and for whom LR might provide meaningfully better clinical outcomes ( Myburgh 2013 , Self 2018 , Semler 2018 , Self 2020 ). The enrollment was multicenter, large, and adequately powered for clinically meaningful changes in outcome.

Fluid Resuscitation 121

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 121

Taming the SRU

MARCH 27, 2024

The parent trial was conducted from October 2020 to July 2022 in the capital region of Denmark. The primary outcome was cumulative norepinephrine use during the first 48 hours of admission. That said, outcomes for these patients are generally poor and the use of steroids as a one-time dose likely has little risk. Hill, J.

Resuscitation 98

Resuscitation Outcomes CPR Hospitals 98

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 128

EKG/ECG EMS Outcomes Wellness 128

ACEP Now

JULY 11, 2024

Deaths from drinking increased 25 percent from 2019 to 2020 and another 10 percent in 2021. The percentage of suicides while intoxicated with alcohol has increased, particularly among women, and traffic fatalities in 2020 were at their highest point in over a decade. 2020:8;279. problem drinking has reached a steady state.

Emergency Department 98

Emergency Department Psychiatric Outcomes Wellness 98

RebelEM

MAY 25, 2023

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. Ann Emerg Med 2017 [6] This was a retrospective database review of 7521 traumatic brain injury patients SBP target ≥90mmHg resulted in a mortality of 7.8%

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

PulmCCM

SEPTEMBER 28, 2023

Systemic corticosteroids (such as intravenous dexamethasone) improve outcomes in severe pneumonia due to SARS-CoV-2 infection. It makes sense that inhaled steroids might improve outcomes from less severe infections. Predominant SARS-CoV-2 strains during that trial’s enrollment (July-December 2020) were Wuhan, Alpha and Delta.

COPD 95

COPD Stroke Academics Urgent Care 95

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

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 100

Sepsis Best Practices Hospitals Outcomes 100

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

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

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 100

CDC Hospitals EMS Emergency Department 100

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 98

Hospitals PPE Urgent Care Academics 98

Don't Forget the Bubbles

JULY 19, 2023

Olivia, a previously well 13-year-old girl, is referred to the paediatric ED from the Ophthalmology ED. This data was collected over a five-year period (2016-2020) had true papilloedema. 2020 and Hyde et al. Outcome of pediatric patients referred for papilledema. 2020 Oct [cited 2023 May 14];10:966–7.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 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. 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 Dehydration Outcomes 98

ACEP Now

JULY 7, 2023

1 Ventricular tachycardia (VT) and ventricular fibrillation (VF) represent the most common initial rhythms for patients presenting to the ED in out-of-hospital cardiac arrest, as well as for patients who develop cardiac arrest while in the ED. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. Circulation. 2018;137(12).

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

ACEP Now

DECEMBER 6, 2024

1 Relatively little literature on the clinical characteristics and outcomes of out-of-hospital cardiac arrest (OHCA) patients complicated by coronary vasospasm exists beyond anecdotal reports, however. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented. N Engl J Med. 1992;326(22):1451-1455.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

Don't Forget the Bubbles

JULY 22, 2024

Randomised controlled trials addressing the benefit of steroids in preschool wheeze have compared different cohorts, used different trial designs and measured different outcomes. This is a way to overcome different trial outcomes. This paper’s primary outcome was a change in wheeze severity score (WSS). What does this mean?

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

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 Outcomes Research 98

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

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

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

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. TXA vs. 19.8% to 1.02]).

Head Injuries 52

Head Injuries Academics EMS Outcomes 52

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. The authors reported no statistical superiority of TXA compared to placebo for the primary outcome of head injury-related deaths within 28 days.

EMS 52

EMS Head Injuries Outcomes Hospitals 52

Dr. Smith's ECG Blog

AUGUST 6, 2024

There may be hyperacute T waves from V2-V5, as well as in leads I and II. As a result, this 45-year old man did not experince any delay in treatment — and a large diagonal branch of the LAD was stented with good outcome. The ECG shows ST depression in lead V3. Compared to the QRS amplitude, the ST change in aVL is very abnormal.

EKG/ECG 106

EKG/ECG Wellness Hospitals EMS 106

EMDocs

OCTOBER 19, 2024

Leukocytosis, as well as mild leukopenia, are common. 2][3][9] Glucocorticoid were not shown to alter clinical course or patient outcomes. [2][3] Published 2020. Care Variations and Outcomes for Children Hospitalized With Bacterial Tracheostomy-Associated Respiratory Infections. Georgiaemsacademy.com. Published 2023.

EMS 99

EMS Pediatrics Sepsis Airway Management 99

EMDocs

JANUARY 25, 2025

Well keep it short, while you keep that EM brain sharp. 0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. 10^9/L) Moderate (0.50.9 10^9/L) Severe (< 0.5 10^9/L) Generalized leukopenia (i.e. Most common causes of leukopenia Infections: 36.4% Medications: 25.6%

EMS 80

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 80

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 129

Research Outcomes Wellness 129

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 122

EKG/ECG Fluid Resuscitation Academics Resuscitation 122

Don't Forget the Bubbles

NOVEMBER 27, 2023

And lastly, it’s actually quite hard to see how well the cardiovascular system is working, and this is one of its measurable features. This works well for a while, but eventually, the heart beats too fast to fill adequately. It’s only a piece of the puzzle, though. The next element of stroke volume is the emptying. 2021;25(1):146.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

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? Reference: Grunau et al.

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

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

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 94

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 94

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 105

Resuscitation Administration Emergency Department Ultrasounds 105

Dr. Smith's ECG Blog

MAY 23, 2023

And they of course activated the cath lab immediately, where he was found to have acute thrombotic occlusion (TIMI 0) of the proximal LAD, as well as embolic D1 occlusion. LAD and D1 were stented, but flow unfortunately could not be well restored despite efforts (they list the post intervention TIMI flow still as 0). Am J Emerg Med.

EKG/ECG 98

EKG/ECG Wellness Emergency Department EMS 98

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

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 Administration 40

Sensible Medicine

SEPTEMBER 26, 2023

adults say they have a great deal of confidence in medical scientists to act in the best interests of the public, down from 40% who said this in November 2020.” Researchers would know that whatever they publish is eventually going to be linked to a list of replication attempts and their outcomes.” Overall, 29% of U.S.

Research 120

Research Hospitals Documentation/Coding Outcomes 120