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. He says the pain is worse at night and when he is chewing. link] Trevino Gonzalez, J.

EMS 105

EMS Infectious Diseases Radiology Radiology 105

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. 2021 Jun;31(6):713-719. Epub 2021 Apr 11. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). 0.41), p < 0.001.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

RebelEM

JULY 1, 2024

Balkan Med J 2021. Balkan Med J 2021. Cureus 2021. Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20 AVAPS: 0.07 AVAPS: 10.20

COPD 133

COPD Emergency Department Outcomes EMS 133

EMDocs

NOVEMBER 18, 2023

We’ll keep it short, while you keep that EM brain sharp. McGraw Hill; 2021. Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors. Sonographic diagnosis and outcome of hepatic artery thrombosis after orthotopic liver transplantation in adults.

EMS 95

EMS Ultrasounds Emergency Department Outcomes 95

RebelEM

FEBRUARY 19, 2024

The 2021 Surviving Sepsis Campaign Guidelines suggest starting vasopressors peripherally rather than delaying infusion until a CVC is placed [2]. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med 2021. REBEL EM: Peripheral Vasopressors – Safe or Dangerous?

Administration 137

Administration Sepsis EMS Shock 137

Emergency Medicine Cases

JANUARY 18, 2022

The post EM Quick Hits 35 – 10 Best Papers of 2021, Peripartum Cardiomyopathy, Crashing Asthmatic, Febrile Neutropenia, Anaphylaxis update appeared first on Emergency Medicine Cases.

Anaphylaxis 52

Anaphylaxis EMS Outcomes Hyperthermia / Hypothermia 52

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. 2021 Feb 5;14(2):e240532. 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

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 132

Sepsis Hospitals Administration Outcomes 132

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. NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

RebelEM

SEPTEMBER 7, 2023

However, guidelines offer no strong recommendations for its use, specifically in spontaneous ICH ( Fang 2021 ). OUTCOMES Primary: Occurrence of at least one clinical or electrographic seizure recorded on continuous EEG within 72 hours after inclusion. The primary outcome was patient-oriented. OR 0.07, 95% CI 0.01-0.38,

Seizures 132

Seizures Stroke Outcomes Research 132

ACEP Now

NOVEMBER 8, 2024

Emergency medical services (EMS) scope of practice is governed by the state, but national scope of practice guidelines are available for the four different EMS provider levels. Conclusion EGAs offer multiple benefits in managing patient airways and have found generally wide acceptance in the protocols of numerous EMS provider levels.

Airway Management 40

Airway Management EMS Hospitals Administration 40

RebelEM

APRIL 17, 2023

A repeat search was completed in May 2021 & November 2022. 2021 May 12:34894211015590. Published on October 25, 2021. Accessed on December 3, 2021. appeared first on REBEL EM - Emergency Medicine Blog. Two investigators independently assessed and screened all studies for eligibility. AJR Am J Roentgenol.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch. 2009;338:b2085.

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

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. appeared first on REBEL EM - Emergency Medicine Blog. to 1.12; p = 0.03

Resuscitation 125

Resuscitation Outcomes EMS Sepsis 125

RebelEM

SEPTEMBER 21, 2023

The available literature shows that SVT is not associated with ACO, Type I MI or serious outcomes either in the short term or after prolonged follow up ( Gabrielli 2022 ). appeared first on REBEL EM - Emergency Medicine Blog. Who should have troponins sent? PMID: 33779692 Post Peer-Reviewed By: Salim R.

EKG/ECG 143

EKG/ECG Sepsis EMS Outcomes 143

The Skeptics' Guide to EM

JANUARY 9, 2021

Date: January 5th, 2021 Reference: Grunau et al. 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?

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

RebelEM

JANUARY 25, 2024

What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021. Outcomes: Primary Outcome: Reduction of dyspnea measured on a verbal dyspnea scale (VDS) from 0 to 10 recorded at enrollment, then at 2, 4, and 5 hours after arrival.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

The Skeptics' Guide to EM

JANUARY 1, 2022

Date: December 21st, 2021 Guest Skeptic: Dr. Howard “Howie” Mell began his career as a firefighter / paramedic in Chicago. 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).

Stroke 52

Stroke EMS Outcomes Administration 52

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 104

Operations Academics Fluid Resuscitation Outcomes 104

RebelEM

AUGUST 14, 2023

days 2 most common sites of infection were lung (44.8%) and inta-abdominal (32.1%) Majority of infections were community-acquired (≈84%) Over half the patients were on mechanical ventilation (≈53%) Primary Outcome Results: 28-day mortality rate: Placebo 26.1% (230/882) vs. XBJ 18.8% (165/878); P<0.001 The risk difference was 7.3% (95% CI, 3.4-11.2)

Sepsis 98

Sepsis Outcomes Administration EMS 98

RebelEM

AUGUST 21, 2023

This trial aimed to assess whether targeted therapeutic mild hypercapnia (TTMH) applied during the initial 24 hours of mechanical ventilation in the ICU can enhance neurological outcomes at the 6-month mark, as compared to standard care, which involves targeted normocapnia (TN). Paper: Eastwood G, et al.

Hospitals 98

Hospitals Resuscitation Outcomes CPR 98

Don't Forget the Bubbles

JUNE 30, 2023

In 2021, Evans and colleagues (1) compared adolescent mortality rates in adult, children’s and mixed major trauma centres across the UK. In 2021, Kulvatunyou, Bauman and colleagues compared the insertion of traditional 28-32Fr chest tubes with 14Fr pigtail catheters for drainage of traumatic haemothorax. Is he going to be OK?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St.

Stroke 99

Stroke Outcomes EMS Seizures 99

The Skeptics' Guide to EM

MAY 8, 2021

Date: May 7th, 2021 Guest Skeptic: Dr. Ryan Stanton is a community emergency physician with Central Emergency Physicians in Lexington, KY. He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR […] The post SGEM#329: Will Corticosteroids Help if…I Will Survive a Cardiac Arrest? Reference: Shah and Mitra.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

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

RebelEM

AUGUST 22, 2024

hours of symptom onset appears to be the most promising approach for improving visual outcomes, supported by multiple studies and meta-analyses. What They Did: Retrospective review of consecutive RAO cases managed as part of a remote ophthalmology consult protocol activated on May 1, 2021, at three stroke centers across a health system.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

RebelEM

FEBRUARY 12, 2024

Chang 2021 ) This systematic review was used as the basis for a 9 member panel to develop consensus guidelines on CT imaging for patients with suspected renal colic in 29 scenarios. 2021 Sep;47:70-73. Epub 2021 Mar 22. CT in Detecting Urinary Tract Calculi: Influence on Patient Imaging and Clinical Outcomes Radiology.

Radiology 77

Radiology Radiology Emergency Department Ultrasounds 77

EMDocs

AUGUST 22, 2024

Certified interpreter use can improve communication and patient outcomes. Conducting research regarding best practices for improving health outcomes for NELP patients. Pearls NELP patients have worse health outcomes despite widespread language-access policies. December 2021. 45:446-458. Taira B, et al. 23:1214-1222.

Documentation/Coding 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

The Skeptics' Guide to EM

MAY 15, 2021

Date: May 6th, 2021 Guest Skeptic: Dr. 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. Reference: Fatima et al.

Stroke 52

Stroke EMS Outcomes 52

PulmCCM

APRIL 18, 2024

This outcome measure was less robust than intubation attempts, because the “failure” definition included simply switching devices, which the intubator was permitted to do at any time for any reason. Intubations for over 8,400 surgical procedures (85% elective, 15% emergent) in 7,736 patients were studied.

Airway Management 98

Airway Management Operations EMS Research 98

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. Date: September 8th, 2021 Reference: Desch et al. The TOMAHAWK Investigators. The TOMAHAWK Investigators.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

RebelEM

JUNE 5, 2023

from 2019 to 2021 (from 48,000 to 81,400 annual deaths), which includes prescription opioids (natural and semi-synthetic opioids and methadone), heroin, and synthetic opioids other than methadone including fentanyl (1). Updated August 2, 2021. The national number of overdose deaths from any opioid has increased 62.5% Am J Addict.

Emergency Department 97

Emergency Department Hospitals Outcomes EMS 97

Emergency Medicine Journal

OCTOBER 23, 2024

Participants were recruited via the DFTB social media accounts between 17 August and 14 September 2021. The primary outcome was correct diagnosis. The primary outcome was correct diagnosis. Participants with EM or PEM background were equally likely to have more correct answers than those from paediatric or GP backgrounds.

EMS 52

EMS Outcomes 52

The Skeptics' Guide to EM

OCTOBER 3, 2021

Date: September 28th, 2021 Reference: Zampieri et al. JAMA 2021 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Consultant in […] The post SGEM#347: It Don’t Matter to Me – Balanced Solution or Saline first appeared on The Skeptics Guide to Emergency Medicine.

Outcomes 52

Outcomes Sepsis Administration Resuscitation 52

The Skeptics' Guide to EM

AUGUST 14, 2021

Date: August 12th, 2021 Reference: Daya et al. Date: August 12th, 2021 Reference: Daya et al. This has included the classic paper from Legend of EM Dr. Ian Stiell on BLS vs. ACLS ( SGEM#64 ), the use of mechanical CPR ( SGEM#136 ), and pre-hospital hypothermia ( SGEM#183 ).

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

The Skeptics' Guide to EM

DECEMBER 25, 2021

Date: December 21st, 2021 Guest Skeptic: Dr. Spencer Greaves is an Emergency Medicine resident at Florida Atlantic University. Date: December 21st, 2021 Guest Skeptic: Dr. Spencer Greaves is an Emergency Medicine resident at Florida Atlantic University. Spencer completed his medical doctorate at the Medical College of Wisconsin.

CPR 52

CPR Administration Outcomes Hospitals 52

Dr. Smith's ECG Blog

APRIL 2, 2024

Angiogram in 2021 was normal. Patient received 11 shocks by ICD and was in V-fib when EMS arrived. The patient awoke and had a good outcome! "Old records still had not appeared. Around 1015 we were able to access Care everywhere and this showed that he has a non-ischemic cardiomyopathy with EF of 15%. Initial trop ~200.

EKG/ECG 133

EKG/ECG Shock CPR Stroke 133