Emergency Medicine Journal

NOVEMBER 28, 2023

This audit aims to investigate the relationship between time delay to treatment and its effect on HBOT efficacy and novelly, 30-day patient outcomes, to better support recommendations for healthcare providers. Method and Design The audit included 33 DCS patients treated at Whipps Cross Hospital, London (May 2021-December 2022).

Outcomes 40

Outcomes Hospitals 40

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.

Emergency Department 152

Emergency Department Hyperthermia / Hypothermia Seizures Pediatrics 152

University of Maryland CC Project

NOVEMBER 24, 2021

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

Resuscitation 52

Resuscitation Outcomes CPR Ultrasounds 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

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 96

Emergency Department Outcomes Research 96

Emergency Medicine Journal

JUNE 22, 2023

Methods This is a retrospective review of medical records of the ED of three public hospitals in Sydney, New South Wales, Australia from January 2016 to October 2021. The main outcome measures were ambulance transport, lumbar imaging, opioid administration and hospital admission.

Emergency Department 40

Emergency Department Administration Hospitals Outcomes 40

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 121

Sepsis Hospitals Administration Outcomes 121

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

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 124

Outcomes Research Wellness Hospitals 124

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 81

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 81

Don't Forget the Bubbles

SEPTEMBER 2, 2024

Infant deaths after Texas’ 2021 ban on abortion in early pregnancy. Long-term cardiovascular outcomes in children and adolescents with hypertension. Effect of early vs late inguinal hernia repair on serious adverse event rates in preterm infants: a randomized clinical trial. 2024 Mar 26;331(12):1035-44. JAMA Pediatrics. 2024 May 6.

Pediatrics 97

Pediatrics EMS Outcomes Hospitals 97

Emergency Medicine Journal

AUGUST 21, 2024

The Clinical Frailty Scale (CFS) is a 9-point frailty assessment instrument that has shown promise to identify frail emergency department (ED) patients at increased risk of adverse outcomes.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

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. NEJM 2021 […] The post SGEM#354: Everybody Walk the Dinosaur and Not Take the MSU first appeared on The Skeptics Guide to Emergency Medicine. Howie also has a Master of Public Health. Reference: Grotta JC et al.

Stroke 52

Stroke EMS Outcomes Administration 52

PulmCCM

JANUARY 22, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

Emergency Medicine Journal

NOVEMBER 28, 2023

Methods This was an observational, retrospective cohort study using data from October 2020 to July 2021 (training set) and October 2021 to December 2021 (validation set) from patients who underwent a SARS-CoV-2 rtPCR test within 7 days of an EMS call. PPV and NPV were 13.3% (95% CI 0.13 to 0.14) and 98.2% (95% CI 0.98

Operations 52

Operations EMS Hospitals Outcomes 52

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

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 129

Stroke Outcomes Ultrasounds Wellness 129

Emergency Medicine Journal

OCTOBER 26, 2023

Methods All cases of OHCA between 1 January 2016 and 31 December 2021 in the Helsinki University Hospital catchment area in which the ECPR protocol was activated were included in the study. Cases of hypothermic cardiac arrest were excluded. Results The prehospital ECPR protocol was activated in 73 cases of normothermic OHCA.

Hospitals 75

Hospitals CPR Resuscitation Outcomes 75

The Skeptics' Guide to EM

AUGUST 24, 2024

The evidence was not robust enough back in 2021 to confidently use this potential tool. Outcome: Primary Outcome: Composite pain score reduction 4 hours after enrollment, defined as a reduction in the pain score by 2 or more p. We have covered rib fractures twice on the SGEM.

Fractures 50

Fractures Emergency Department Ultrasounds Radiology 50

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 85

Hospitals Resuscitation Outcomes CPR 85

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

JournalFeed

OCTOBER 23, 2021

It’s the JournalFeed Podcast for the week of October 18-22, 2021. We cover intubating angioedema patients, inhaled steroids for COVID-19, non-operative management of appendicitis, part-time physician outcomes, and ECG diagnosis of wide complex tachycardia.

Operations 52

Operations EKG/ECG Outcomes 52

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 123

Ultrasounds Radiology Radiology Operations 123

JournalFeed

DECEMBER 18, 2021

It’s the JournalFeed Podcast for the week of December 13-17, 2021. We cover ETCO2 and trauma outcomes, ORIF vs cast for adult distal radius fractures, high or low/ 3 or 7 day treatment for pediatric community acquired pneumonia, a new pediatric CAP severity prediction tool, and how emergency physicians are coping with COVID stress.

Fractures 52

Fractures Pediatrics Outcomes 52

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 88

Sepsis Best Practices Hospitals Outcomes 88

PulmCCM

JANUARY 24, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Outcomes Hospitals Stroke 52

The Skeptics' Guide to EM

JUNE 5, 2021

Date: May 25th, 2021 Guest Skeptic: Dr. Garreth Debiegun is an emergency physician at Maine Medical Center in Portland, ME and clinical assistant professor with Tufts University School of Medicine. JAMA 2021 * Zi et al. JAMA 2021 Case: A 74-year-old woman presents to your emergency department with 1.5

Stroke 52

Stroke Urgent Care Critical Access Outcomes 52

ACEP Now

AUGUST 25, 2023

Primary Outcome: Discharged home from the ED Secondary Outcomes: There were several secondary outcomes. Another interesting secondary outcome that could confound the results is that children who received IN fentanyl received higher overall total parenteral opioid morphine equivalents. link] Published May 2021.

Administration 97

Administration Pediatrics Emergency Department Outcomes 97

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

EB Medicine

JUNE 20, 2022

2021 Jun 8;143(23):2214-2224. Epub 2021 Mar 23. Association of High-Sensitivity Cardiac Troponin I Concentration With Cardiac Outcomes in Patients With Suspected Acute Coronary Syndrome. 2021 Apr 23;22:100773. 2021 Jun 8;143(23):2214-2224. Epub 2021 Mar 23. 2021 Apr 23;22:100773. Circulation.

Outcomes 52

Outcomes 52

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. Do inhaled steroids improve Covid pneumonia? This study included a true blinded placebo control arm.

COPD 95

COPD Stroke Academics Urgent Care 95

ALiEM

AUGUST 21, 2023

Risk factors for poor outcomes include immunocompromise (HIV, diabetes, immunosuppression), intravenous drug use, peripheral vascular disease, and polymicrobial infection. McGraw Hill; 2021. Antibiotics should target gram-positive organisms (Staphylococcus, including MRSA, and Streptococcus). References Ritter K, Fitch R.

Academics 52

Academics Outcomes Hospitals Wellness 52

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

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. Date: May 7th, 2021 Guest Skeptic: Dr. Ryan Stanton is a community emergency physician with Central Emergency Physicians in Lexington, KY. first appeared on The Skeptics Guide to Emergency Medicine.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

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 58

Radiology Radiology Emergency Department Ultrasounds 58

Taming the SRU

MAY 5, 2023

2021, Jarczak, Kluge et al. 2021, Im, Kang et al. 2021), although this is based on low-quality evidence rather than high-quality randomized trials and has remained a controversial aspect of treatment of patients with sepsis given the potential harms of large-volume fluid administration. N Engl J Med. 2023;388(6):499-510.

Sepsis 52

Sepsis Shock Administration Resuscitation 52