Pediatric EM Morsels

SEPTEMBER 20, 2024

HUS findings: Microangiopathic hemolytic anemia , Renal failure , and Thrombocytopenia The most dreaded outcomes of HUS include need for renal replacement therapy both short and long term and unfortunately death. It is critical to detect HUS early in its disease course to ensure the best outcomes. 2021 May;232:200-206.e4.

Pediatrics 164

Pediatrics Ultrasounds Dehydration Emergency Department 164

ACEP Now

NOVEMBER 7, 2024

Wound management in the ED is only a starting point, and appropriate referral and follow-up are key to an improved outcome. Implementing a thoughtful, cost-effective approach to ED wound care centered on optimizing wound healing and referral may improve patient outcomes, reduce admissions, and optimize resources. 2020;95(9):2021-2034.

Burns 97

Burns Documentation/Coding Outcomes Emergency Department 97

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

Emergency Medicine Journal

JULY 24, 2023

This study aimed to examine the association between COVID-19-related hospital bed-strain during this time and patient outcomes. In-hospital mortality was the primary outcome of interest and length of stay a secondary outcome. Methods This was a retrospective observational study using Hospital Episode Statistics data for England.

Outcomes 69

Outcomes Hospitals 69

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 132

COPD Emergency Department Outcomes EMS 132

The Skeptics' Guide to EM

FEBRUARY 20, 2021

Date: February 19th, 2021 This is an SGEM Xtra episode. I had the honour of presenting at the Lehigh Valley Health Network Grand Rounds on February 4th, 2021. Date: February 19th, 2021 This is an SGEM Xtra episode. I had the honour of presenting at the Lehigh Valley Health Network Grand Rounds on February 4th, 2021.

Fractures 52

Fractures Outcomes Hospitals 52

EMDocs

JANUARY 11, 2025

Stercoral Colitis in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes. Fecal Impaction and Nonperforated Stercoral Colitis: Red Flags for Poor Outcomes. (May 18, 2023) Stercoral Colitis: A Diagnostic Challenge and Therapeutic Approach in an Elderly Patient With Chronic Constipation. Mathis, K.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

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 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

Canadian EM

APRIL 4, 2023

Although some COVID-19 survivors report persistent symptoms months after resolution of the acute infection, we do not know much about their long-term physical and psychological health outcomes. 1​ We used data from 22 CCEDRRN EDs across 5 provinces between March 2020 to July 2021.

Outcomes 52

Outcomes 52

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

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

PulmCCM

JANUARY 15, 2025

Clinical Outcomes Associated With Overestimation of Oxygen Saturation by Pulse Oximetry in Patients Hospitalized With COVID-19. Analysis of Discrepancies Between Pulse Oximetry and Arterial Oxygen Saturation Measurements by Race and Ethnicity and Association With Organ Dysfunction and Mortality. Nature (news). January 2024. Fawzy et al.

Academics 81

Academics Documentation/Coding Administration Research 81

PulmCCM

JANUARY 6, 2025

A 2021 analysis of Epic’s sepsis model revealed atrocious false positive and negative rates. A cluster randomized trial using all-cause mortality as an outcome was always needed to determine whether EMR alerts improve outcomes for suspected severe infection. 2021 Aug 1;181(8):1065-1070. 2021 Aug 1;181(8):1144.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

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

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 132

Sepsis Hospitals Administration Outcomes 132

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 129

Seizures Stroke Outcomes Research 129

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

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

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

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 137

Administration Sepsis EMS Shock 137

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 130

Ultrasounds Radiology Radiology Operations 130

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 133

Stroke Outcomes Ultrasounds Wellness 133

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 111

Outcomes Wellness 111

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 133

Outcomes Research Wellness Hospitals 133

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

Don't Forget the Bubbles

MAY 31, 2023

What outcomes did they look at? Was the outcome accurately measured to minimise bias? The inability to test for SARS-CoV-2 antibodies may have led to an underestimation of the impact of the virus on the reported outcomes. All ED visits that met the criteria for ‘new onset diabetes’ or DKA (‘decompensation’) were included.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

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

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 114

Sepsis Best Practices Hospitals Outcomes 114

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

Don't Forget the Bubbles

MARCH 31, 2025

This was a secondary analysis of the Management and Outcome of Fever in Children in Europe (MOFICHE) study. The primary outcome measure was SBI, and 1854 children included were diagnosed with an SBI. However, excessive fluid administration can lead to fluid overload, which has been linked to worse clinical outcomes.

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

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

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

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 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