Taming the SRU

JANUARY 10, 2024

Phenobarbital has been proven to be equivalent to benzodiazepines with regard to clinical, pharmacologic and utilization outcomes. The treatment of alcohol withdrawal should be proactive as opposed to reactive with consideration of which patients are at the highest risk. Phenobarbital should be dosed based on IBW and patient risk factors.

EKG/ECG 93

EKG/ECG Shock Fractures Emergency Department 93

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 ). Resusc Plus. Resuscitation.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

ALiEM

OCTOBER 30, 2024

A trans-esophageal echocardiogram showed a normal ejection fracture, normal right ventricular function, and no vegetations. 2021 Aug 1;94:103086. Emergency department-initiated buprenorphine for opioid dependence with continuation in primary care: outcomes during and after intervention. I am happy to help how I can.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

Taming the SRU

JANUARY 29, 2024

Notable Diagnostics CBC : unremarkable, BMP : unremarkable X-ray imaging of the left hand, wrist, and forearm: chronic degenerative changes without acute fracture or bony abnormality. 2021 Oct;76:601.e7-601.e11. Epub 2021 Jun 25. 2021 Jun;36(5):392-400. The remainder of the physical examination is unremarkable.

Emergency Department 94

Emergency Department Fractures Hospitals Operations 94

Broome Docs

APRIL 6, 2023

2022 Dec 16:emermed-2021-211946. doi: 10.1136/emermed-2021-211946. Renal outcomes following intravenous contrast administration in patients with acute kidney injury: a multi-site retrospective propensity-adjusted analysis. Emerg Med J. Epub ahead of print. PMID: 36526335 Yarter JT, Racht J, Michels KS. Am J Emerg Med.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

RebelEM

JANUARY 30, 2023

What They Did: Used a medical librarian to search for randomized control trials of the following databases: PubMed, OVID, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and electronic bibliographic databases up to Sep 2021. Heterogeneity (I 2 ) for the primary outcome was 69%, representing a moderate value.

Dislocations 58

Dislocations Emergency Department Outcomes Research 58

PulmCCM

JANUARY 16, 2024

This looks like the major fracture between the two expert panels. Their effects on meaningful patient outcomes are unclear, though, and their appropriate use continues to be debated. This would trigger routine steroid treatment in an enormous number of ICU patients—a big practice change.

Research 87

Research Documentation/Coding Outcomes Fractures 87

Don't Forget the Bubbles

OCTOBER 2, 2024

He is diagnosed with a traumatic brain injury and a fracture to his right tibia and fibula. Significantly, it should be noted that the study does not cover long-term outcomes, including survival. There was also a meta-analysis on this topic in the adult population by Schwimmbeck et al [6] in 2021. 2023 [cited 2024 Apr 10].

Administration 49

Administration Pediatrics Outcomes Research 49

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]. 2021; 93: 4358–4369. 2021 Jan;25(1):466-479. Epub 2021 Oct 1. J Med Virol. Medicine (Baltimore).

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Taming the SRU

NOVEMBER 14, 2023

A thorough trauma history and physical exam should be performed including evaluation for bony fracture in the surrounding structures of the face. Complications of auricular hematoma drainage include pain, paresthesia, bleeding, infection, poor cosmetic outcome, scar formation, and re-accumulation of hematoma after the procedure.

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

EMDocs

NOVEMBER 16, 2024

6 Periprosthetic fracture Occurs at an estimated rate of 3.5-4.1%. 5 CT if concern for occult fracture. Periprosthetic Fractures Pain prior to injury may point toward underlying pathology like infection, implant loosening, etc. Unified classification system used to describe periprosthetic hip fractures. 10% of patients.

EMS 98

EMS Dislocations Fractures Operations 98

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

Don't Forget the Bubbles

NOVEMBER 29, 2023

Ben has a possible skull fracture and has been intubated, but his oxygen requirement is minimal. In studies including patients with trauma or Glasgow Coma Scale less than 8, intubation without sedation led to poorer neurological outcomes. 2021 May;77(5):532-544. Epub 2021 Jan 21. His name is Ben. Burgart, A.M.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

Taming the SRU

OCTOBER 1, 2023

As these patients are typically already at a high risk for poor health outcomes, secondary spontaneous PTX is often more serious in presentation and management more complex [11]. Blunt trauma can cause rib fracture or dislocation that may injure the visceral pleura. Published 2021 Jun 24. Respir Med. 1998;92(5):757-761.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

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

The Skeptics' Guide to EM

JANUARY 30, 2021

Date: January 22nd, 2021 Guest Skeptic: Dr. Steve Joseph. Date: January 22nd, 2021 Guest Skeptic: Dr. Steve Joseph. The X-ray demonstrates a fracture of the distal radius that is in an acceptable position and does not require a reduction. He served with the Canadian Forces as a Medical Officer and Flight Surgeon.

Fractures 52

Fractures Documentation/Coding Outcomes 52

ACEP Now

MAY 9, 2024

The procedure has soared in popularity as beauty standards have shifted and cosmetic surgery has become increasingly transparent on social media platforms, with reported cases in the United States increasing from 614 in 2002 to 61,387 by 2021, a nearly 10,000 percent increase. These questionable practices led to a rash of bad outcomes.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Taming the SRU

MARCH 14, 2023

Obtain shunt imaging (“shunt series,” CTH non-con) Shunt series shows no migration of the shunt catheters or fractures of the tubing. Estimated incidence of normal pressure hydrocephalus and shunt outcome in patients residing in assisted-living and extended-care facilities. Lancet Neurol. Marmarou, Young, Aygok. Neurosurg Focus.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Taming the SRU

FEBRUARY 22, 2023

doing the little things right, with the understanding that small gains are additive, and that details can be the difference between a good outcome and a poor one. Lesson 11 Find what you love to do and surround yourself with people who make you better at doing it. Paske et al.

Hospice 40

Hospice EKG/ECG Resuscitation Seizures 40

EMDocs

NOVEMBER 4, 2024

Costochondritis, rib fractures, and pericarditis are common causes of chest pain that can be treated with multimodal regimens. 7 Rib and Sternal Fractures: Rib fractures are often caused by blunt chest trauma. Up to two-thirds of rib fractures are missed on initial chest radiographs. 2021 Apr;28(4):444-454.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

EMDocs

JUNE 3, 2023

How should pelvic fractures be identified in unstable trauma patients? Pelvic fractures can involve disruptions in any of the bony or ligamentous structures of the pelvic ring. Due to the round shape of the pelvic ring, multiple fractures typically occur concurrently. 2 Vertical shear fractures are also unstable.

Fractures 64

Fractures Resuscitation Operations EMS 64

EMDocs

JULY 3, 2023

Introduction SAH has the potential for rapid progression and devastating outcomes. 3 Common associated injuries may include skull fractures, intracerebral contusion, cervical spine injuries, and vascular injuries of the head and neck. Short- and long-term outcome of patients with aneurysmal subarachnoid hemorrhage.

Seizures 98

Seizures Stroke Outcomes EMS 98

PHEM Cast

SEPTEMBER 14, 2022

A comparison of the demographics, injury patterns and outcome data for patients injured in motor vehicle collisions who are trapped compared to those patients who are not trapped. Scand J Trauma Resusc Emerg Medicine 29 , 17 (2021). Do entrapment, injuries, outcomes and potential for self-extrication vary with age? Nutbeam, T.

Fractures 52

Fractures Operations Outcomes Academics 52

EMDocs

NOVEMBER 13, 2023

2 Outcomes of patients presenting with ischemic stroke who received MRI as initial imaging modality have demonstrated similar outcomes to those with initial CTA, with Kim et al. demonstrating that functional outcome at 3 months did not differ between the CTA and MRI groups (38.5% vs. 38.1%) with a good functional outcome.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

Taming the SRU

MAY 22, 2023

Ankle fractures are the third most common fracture in the ED [2] and more than 20,000 patients are seen in the ED for ankle sprains each day [3]. Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED.

Fractures 77

Fractures Dislocations Operations Radiology 77

Don't Forget the Bubbles

AUGUST 10, 2023

This is partly because the hands (including fingers) of children & young people have a tendency to fracture without as much compressive force being applied to the bones when compared with adult hands. The resulting injuries include crush injuries, fractures, avulsions, lacerations and amputations. No bone is exposed.

Fractures 52

Fractures Soft Tissue Injuries Emergency Department Operations 52

EMDocs

SEPTEMBER 9, 2023

McGraw Hill; 2021. The value of ultrasound for detecting hand fractures: A meta-analysis. Rosh Review Website Link References Park CW, Juliano ML, Woodhall D. Tendon Lacerations. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. Accessed June 24, 2023. link] Dy CJ, Rosenblatt L, Lee SK. doi:10.1097/MD.0000000000017823

EMS 103

EMS Fractures Soft Tissue Injuries Ultrasounds 103

Don't Forget the Bubbles

SEPTEMBER 23, 2024

Kidney transplant recipients have a higher risk of fractures. Consider CMV, EBV and BK-polyoma virus infections: Patients are often on prophylaxis for a variable length of time, with differing outcomes. Obesity: Obesity, whether before or after transplant, is linked to worse outcomes. Any history of injury? and Hirsch, H.H.,

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52