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

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. Rates of congenital syphilis are increasing. Foles, 2024 ] In the US, from 2013-2018, cases increased from 362 to 1,306.

Hyperthermia / Hypothermia 152

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 152

Northwestern EM Blog

DECEMBER 27, 2021

Congratulations to all of the authors with the most popular posts of 2021! Combined with active rewarming strategies, tPA use results in significantly improved outcomes. Felon (381 views) Rounding out the top 10 for 2021 is the second procedural infographic, which is closely related to our Paronychia post.

Dislocations 52

Dislocations Emergency Department Burns Shock 52

Emergency Medicine Journal

AUGUST 21, 2024

Feasibility outcomes were recruitment, retention and adherence. Clinical end points (pulmonary complications, pain and frailty-specific outcomes) and patient questionnaires were collected to determine feasibility of data collection and inform health economic scoping. Pain and some frailty-specific outcomes were not feasible to collect.

Fractures 97

Fractures Research Outcomes Hospitals 97

PulmCCM

JUNE 3, 2024

The ASTER Trial Ware et al conducted a phase 2b randomized trial from 2021 to 2023 among 447 patients admitted with sepsis and organ failure at 40 US academic hospitals. Patients received either 1 g of acetaminophen IV every six hours or placebo for five days.

Sepsis 52

Sepsis Outcomes Academics Hospitals 52

Emergency Medicine Journal

NOVEMBER 21, 2024

million ED visits from 2016 to 2021. of self-injury-related ED visits in 2020 and 2021, respectively (pandemic years), compared with an average of 8.4% Results Our analysis covered 419.4 Individuals experiencing homelessness constituted 1.8% (7.4 million) of ED visits. Overall, 1.8% of ED visits (7.7 in the previous years.

Emergency Department 52

Emergency Department Outcomes Hospitals 52

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. Background: Sepsis remains one of the leading causes of morbidity and mortality. to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

Sepsis 129

Sepsis Hospitals Administration Outcomes 129

Emergency Medicine Journal

APRIL 22, 2024

Methods This was a multicentre prospective observational study of adult ED patients presenting to five Australian hospitals between November 2020 and September 2021. The primary outcome was index AMI, including type 1 or 2 non-ST segment elevation MI (NSTEMI) or ST-elevation MI (STEMI) following presentation.

Emergency Department 98

Emergency Department Outcomes EKG/ECG Hospitals 98

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

Don't Forget the Bubbles

NOVEMBER 29, 2023

In studies including patients with trauma or Glasgow Coma Scale less than 8, intubation without sedation led to poorer neurological outcomes. The Impact of Prehospital Intubation with and Without Sedation on Outcome in Trauma Patients With a GCS of 8 or Less. 2021 May;77(5):532-544. Epub 2021 Jan 21. Burgart, A.M.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

EM Literature of Note

JANUARY 9, 2022

The Annals of Emergency Medicine Podcast continues apace, with free monthly updates from the original research published in the journal: iTunes Link SoundCloud Link Likewise, the Annals of Emergency Medicine Journal Club has published several monthly installments: Predicting Outcomes in Pediatric Pneumonia: Are We Omnipotent or Incompetent?

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

RebelEM

DECEMBER 23, 2024

Within this population, over 90% of healthcare encounters are due to painful vaso-occlusive episodes (VOE) ( Kidwell 2021 ). The enrollment was multicenter, large, and adequately powered for clinically meaningful changes in outcome. Lactated Ringer (LR) and 0.9% Cross-validation was performed.

Fluid Resuscitation 121

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 121

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 119

Seizures Stroke Outcomes Research 119

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. Two investigators independently assessed and screened all studies for eligibility. AJR Am J Roentgenol. 2015 May;204(5):1064-8. PMID: 25905942. Ann Otol Rhinol Laryngol.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

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. CHEST 2024. PMID: 37611862 Evans L et al.

Administration 132

Administration Sepsis EMS Shock 132

University of Maryland CC Project

NOVEMBER 24, 2021

Maryland Critical Care Conference 2021 with various talks on the topic of Resuscitation.

Resuscitation 40

Resuscitation Outcomes CPR Ultrasounds 40

Sensible Medicine

NOVEMBER 6, 2023

Today I will tell you about one-year results of the SWISS-APERO trial—which compared outcomes with the two most common types of closure devices. The original SWISS APERO trial results came in 2021. This study report included only 45-day outcomes. They main outcome measure was patency of the left atrial appendage.

Stroke 122

Stroke Outcomes Ultrasounds Wellness 122

PulmCCM

OCTOBER 7, 2024

What’s the evidence for this practice, in terms of efficacy, outcomes, and safety? Observational Trials of Midodrine in the ICU At least six observational studies on midodrine in the ICU were published between 2016 and 2021. All but one were retrospective.

Shock 98

Shock Outcomes 98

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 122

Ultrasounds Outcomes COPD Hospitals 122

PulmCCM

SEPTEMBER 21, 2023

A 2015 meta-analysis of 13 randomized trials enrolling >12,000 patients suggested that active blood pressure management after ischemic strokes had little effect on eventual outcomes, and that delaying blood pressure control for three days did not lead to worse outcomes (death or disability).

Stroke 105

Stroke Outcomes 105

Emergency Medicine Journal

JANUARY 22, 2024

Methods This was an open-label randomised control trial conducted in a tertiary care teaching hospital in India from 11 November 2021 to 30 November 2022. The primary outcome was symptom resolution at 6 hours and 12 hours. Trial registration Clinical trial registry of India (CTRI/2021/11/037902).

Outcomes 75

Outcomes Hospitals 75

AENJ: Current Issue

SEPTEMBER 30, 2023

2021), comparing time to sedation, level of sedation, and adverse outcomes between intramuscular ketamine versus intramuscular midazolam and haloperidol among acutely agitated patients presenting to the emergency department (ED). Barbic et al.

Emergency Department 83

Emergency Department Outcomes Research 83

The Skeptics' Guide to EM

JUNE 3, 2023

The primary outcome was an 8% absolute increase in all-cause mortality at seven days for patients allocated to the etomidate group. This outcome was no longer statistically different at 28 days. There was a SRMA in 2021 that reported an associated increase in adrenal suppression and mortality with etomidate.

Outcomes 101

Outcomes Wellness 101

Don't Forget the Bubbles

JUNE 30, 2023

Extracorporeal life support rewarming rate is associated with survival with good neurological outcome in accidental hypothermia. The THAPCA-OH trial found that hypothermia did not result in a statistically significant benefit for survival with good functional outcomes at one year compared to normothermia. Saczkowski, R.,

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

Sensible Medicine

AUGUST 12, 2024

And that was the result of screening for just 5 cancers (breast, cervical, colorectal, lung and prostate) in the year 2021. What patients, doctors, hospitals and payers want to know is that does the $43 billion spent on screening lead to better outcomes in the average patient. It’s hard to grasp the idea of $43 billion.

Outcomes 122

Outcomes Research Wellness Hospitals 122

The Trauma Pro

NOVEMBER 21, 2023

A group of investigators from Jackson Memorial in Miami and Denver Health published a paper earlier this month that critically reviewed 187 trauma surgery RCTs published from 2000 to 2021. Among 30 studies that had a statistically significant binary outcome, the mean fragility index was 2.

Research 113

Research Outcomes Wellness 113

EMDocs

NOVEMBER 7, 2023

No difference in their primary outcome of complications and need for emergency surgery (1.9% Outcome measures were complicated diverticulitis, recurrent diverticulitis and sigmoid resection at 24 months’ follow up. No statistical difference in the primary outcome of hospital length of stay (40 vs 46 hours).

Sepsis 100

Sepsis Best Practices Hospitals Outcomes 100

Sensible Medicine

APRIL 14, 2024

For instance, CAR-T was given to myeloma patients in 2014, but we only learned it can cause Parkinsonism in 2021. Medicine has become a financial commodity with the rare adverse event of better health outcomes. It can take several years for the full safety profile of drugs to be known. The current system is broken.

Patient Safety 144

Patient Safety Academics Outcomes Wellness 144

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

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 ). Type 2 MI is common in the ED and can result from vigorous exercise (common in athletes after marathons), sepsis, trauma and tachydysrhythmias including SVT.

EKG/ECG 143

EKG/ECG Sepsis EMS Outcomes 143

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 88

Hospitals Resuscitation Outcomes CPR 88

ACEP Now

JUNE 21, 2023

2,3 In the 2021-2022 academic year, categorical (non-combined) EM residency lengths included 221 (80 percent) PGY 1-3 and 55 (20 percent) PGY 1-4 programs. The lack of differences in the observed outcomes do not suggest one EM training length is superior. 1 Curricula with non-EM internships (i.e., 11 What should we take away?

EMS 114

EMS Academics Telemedicine Operations 114

PulmCCM

JUNE 12, 2023

But the most recent TTM2 trial (NEJM 2021, n=1850) , which was included in the analysis, by itself cast significant doubt on any benefit of temperature management below normothermia. with acetaminophen) until temperatures reached 37.8 °C who then received external cooling to maintain a target temperature of 37.5 °C.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

RebelEM

NOVEMBER 25, 2024

1 Conversely, the 2021 BOUGIE trial—a larger, multicenter randomized clinical trial conducted by the same investigators—found no significant difference in first-attempt intubation success between the bougie and an endotracheal tube with stylet among critically ill adults. Exclusion criteria: Manikin and cadaver studies. in another study).

Outcomes 93

Outcomes Emergency Department Operations Hospitals 93

Emergency Medicine Journal

FEBRUARY 20, 2024

The objective of this study is to evaluate outcomes of reversal with these agents in patients with isolated traumatic brain injuries (TBI). Methods This is a retrospective review of 35 trauma centres from 2014 to 2021. Primary outcome includes rate of mortality/hospice at hospital discharge.

Hospice 74

Hospice Outcomes Hospitals 74

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

PulmCCM

AUGUST 7, 2023

In early 2021, as hospitals overflowed, deaths mounted, and the economy languished, these felt like vital national goals. We didn’t know all this in 2021. Reducing the severity of illness after infection is what the vaccines are so amazingly, miraculously good at, not prevention of transmission. university campuses.

CDC 98

CDC Hospitals Administration Research 98