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

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

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 123

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 123

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 Ultrasounds 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

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 135

Administration Sepsis EMS Ultrasounds 135

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 131

Sepsis Hospitals Administration Outcomes 131

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

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

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 125

Seizures Stroke Outcomes Research 125

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

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 126

Ultrasounds Outcomes COPD Hospitals 126

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

Intensive Blog

MARCH 13, 2024

The last ELSO Registry Report cumulatively reports over 12,000 ECPR runs with a 30% survival rate through to the end of 2021 6. This showed a similar rate of survival to discharge (27%), of whom approximately 50% had a favourable neurological outcome on discharge (CPC 1 or 2). Image source: File:Steps of CPR-1964.jpg The early years….

CPR 130

CPR Resuscitation Outcomes Hospitals 130

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

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

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

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 118

Stroke Outcomes Ultrasounds Wellness 118

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

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

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

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

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 98

Outcomes Wellness 98

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. to 1.12; p = 0.03 to 0.99; p <0.01 to 1.09; p = 0.01 to 1.37; p <0.01

Resuscitation 119

Resuscitation Outcomes EMS Sepsis 119

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 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 93

Hospitals Resuscitation Outcomes CPR 93

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 117

Outcomes Research Wellness Hospitals 117

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

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

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

Don't Forget the Bubbles

JANUARY 24, 2024

Mortality is high, between 16-43.5% , and neurological outcomes are generally poor amongst survivors. These poor outcomes are related to both the SRSE itself and as a result of the prolonged PICU stay. One study suggests remission in 6 out of 7 patients where it was used, but long-term clinical outcomes remained poor.

Seizures 111

Seizures Pediatrics Outcomes Hyperthermia / Hypothermia 111

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