Pediatric EM Morsels

JULY 26, 2024

Higher titers in both CSF and serum were associated with poor outcomes. Earlier diagnosis leads to better outcomes. Younger Age at Onset Is Associated With Worse Long-term Behavioral Outcomes in Anti-NMDA Receptor Encephalitis. 2022 Jul 6;9(5):e200013. It is best to assume the worst and cover for this possibility.

Psychiatric 271

Psychiatric Seizures Outcomes Pediatrics 271

EMDocs

OCTOBER 30, 2023

Pillai, MBBS (@sspillai01, EM Resident Physician, University of Kentucky) and Christopher N. ” – Musings of an American ED resident in July 2022 when US healthcare was affected simultaneously by supply chain issues from GE Healthcare (contrast media) and Abbott Laboratories (Similac baby formula). Authors: Saran S.

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

EMDocs

OCTOBER 21, 2023

We’ll keep it short, while you keep that EM brain sharp. The NIHSS cutoff that predicts outcomes is 4 points higher in AC compared with PC infarctions. Basilar artery occlusion remains a challenging diagnosis to make, and the delays in reaching the diagnosis can have considerable impact on health outcomes.

EMS 97

EMS Stroke Outcomes Hospitals 97

Dr. Smith's ECG Blog

SEPTEMBER 11, 2024

Here is the case: Report from EMS was witnessed syncope, his son did CPR, but the patient had pulses when EMS arrived. When the patient arrived in the ED, he was still hypotensive in 70s, slowly improving with EMS fluids. Smith : "What was the outcome?" Hope you’re doing well! No Chest Pain, but somnolent.

EMS 113

EMS CPR EKG/ECG Wellness 113

RebelEM

FEBRUARY 1, 2024

What they Did : Investigator-initiated, Multicenter, Parallel-ground, Open-label, Registry-linked, Randomized, Controlled, Non-Inferiority trial 22 Canadian Primary and Comprehensive Stroke Centers from December 2019 to January 2022 Eligible ischemic stroke patients randomized 1:1 to receive intravenous tenecteplase (0.25 vs Alteplase 34.8%

Stroke 135

Stroke Blood Transfusions Outcomes EMS 135

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. 2022 May 11;10:864766. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). 2022 Apr;29(4):406-414. Epub 2022 Jan 12.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

Pediatric EM Morsels

AUGUST 11, 2023

This is the 601st Ped EM Morsel ! Infections there become complicated very quickly and the outcomes can be very poor. 2022 Sep;68(9):661-663. The post Perichondritis of the Ear in Children appeared first on Pediatric EM Morsels. ” Those areas have very important and delicate structures. Can Fam Physician.

Burns 130

Burns Pediatrics EMS Outcomes 130

RebelEM

JANUARY 18, 2024

It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Health Sci Rep 2022. Three outcomes were evaluated, with none being deemed the primary outcome. Health Sci Rep 2022. appeared first on REBEL EM - Emergency Medicine Blog. Paper: Varney J et al.

Sepsis 132

Sepsis Hospitals Administration Outcomes 132

The Skeptics' Guide to EM

JANUARY 6, 2024

She is an executive lead for the EMS for Children Innovation and Improvement Center. She is the co-Principal Investigator for the EMS for Children Data Center. She is nationally known for her work as an EMS researcher and educator. Background: Back in August of 2022, we announced the start of #SGEMPeds for SGEM Season 11.

Emergency Department 137

Emergency Department Pediatrics Anaphylaxis Leadership 137

RebelEM

SEPTEMBER 7, 2023

About 30% of patients experience early seizures within seven days following the onset of a stroke ( Peter-Derex 2022 ). Lancet Neurology 2022; 21:781-91. OUTCOMES Primary: Occurrence of at least one clinical or electrographic seizure recorded on continuous EEG within 72 hours after inclusion. PMID: 35963261. OR 0.07, 95% CI 0.01-0.38,

Seizures 131

Seizures Stroke Outcomes Research 131

Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Written by Pendell Meyers Two adult patients in their 50s called EMS for acute chest pain that started within the last hour. Both cases had an EMS ECG that was transmitted to the ED physician asking "should we activate the cath lab?" 25 minutes later, EMS called back with this new ECG: Super obvious STEMI(+) OMI.

EKG/ECG 124

EKG/ECG EMS Outcomes Wellness 124

RebelEM

SEPTEMBER 19, 2022

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. Over the years, we as a scientific community have worked extensively to find other interventions that improve outcomes. Resuscitation 2022; 179: 9-17.

CPR 52

CPR Outcomes Resuscitation EMS 52

RebelEM

MAY 27, 2024

What they did: Prospective randomized controlled trial, unblinded, multicenter study Conducted from January 2017 to December 2022 Patients with confirmed PSVT were randomly assigned to receive MVM, IV Adenosine, or combined therapy. The unblinded nature of the study could influence outcomes due to observer bias.

Outcomes 137

Outcomes Research Operations Hospitals 137

RebelEM

SEPTEMBER 2, 2024

Published 2022 Sep 10. Device-Oriented Outcomes : While suction rate improvements were significant, the clinical relevance of these findings remains uncertain. While the suction rates observed are impressive, it is unclear whether using the DuCanto catheter would lead to improved clinical outcomes. Published 2022 Sep 10.

Airway Management 115

Airway Management Outcomes EMS Research 115

Broome Docs

OCTOBER 6, 2024

Mols EM, Haak H, Holland M, Schouten B, Ibsen S, Merten H, Christensen EF, Nanayakkara PWB, Nickel CH, Weichert I, Kellett J, Subbe CP, Kremers MNT; Safer@Home Research Consortium. Can acutely ill patients predict their outcomes? doi: 10.1136/emermed-2022-213000. Can patients predict the future? A scoping review. Emerg Med J.

Emergency Department 102

Emergency Department EMS Research Outcomes 102

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St.

Stroke 101

Stroke Outcomes EMS Seizures 101

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

Pediatric EM Morsels

JUNE 9, 2023

Epub 2022 Dec 26. Long-term Outcomes and Health Perceptions in Pediatric-onset Portal Hypertension Complicated by Varices. The post Acute Esophageal Variceal Bleeding in Children appeared first on Pediatric EM Morsels. Beyond Varices: Complications of Cirrhotic Portal Hypertension in Pediatrics. Semin Liver Dis. PMID: 36572031.

Pediatrics 154

Pediatrics Head Injuries Airway Management Resuscitation 154

RebelEM

JULY 24, 2023

This approach has been shown to benefit patients when agents like propofol and midazolam are used. ( Russotto 2022 , Choi 2004 ). Outcomes: Primary: Postintubation hypotension (SBP < 100 mm Hg) 15 minutes post-intubation. appeared first on REBEL EM - Emergency Medicine Blog. Paper: Driver BE et al. mg/kg 1.33 mg/kg 1.33

Resuscitation 98

Resuscitation Outcomes Emergency Department EMS 98

ALiEM

OCTOBER 30, 2024

Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. Our experience: It was not long ago that we instructed our staff that: ‘COWS >8, give ’em 8 (mg of buprenorphine).’ Drug Checking Quarterly Report (Q3 2022). 2022; 06/26/2023. 2022 May;14(5). 2011 Dec;6:1-4.

Emergency Department 64

Emergency Department Operations Psychiatric EMS 64

RebelEM

AUGUST 24, 2023

Historical practice recommends rest to prevent adverse outcomes; however, evidence suggests strict rest is harmful. What They Did: The authors performed a systematic review up to October of 2022, meta-analyses were conducted where appropriate for RCTs included in the review. PMID: 37073681. to 5.94]; I2, 0%; P 5.79).

Pediatrics 94

Pediatrics Outcomes Research Hospitals 94

Taming the SRU

NOVEMBER 3, 2023

41, 2695–2701 (2022). Broad strokes In this prospective, non-randomized study published by Kring et al in January 2022 out of Maine Medical Center, researchers compared mean pain scores at rest and during incentive spirometry before, at 15 minutes after, and then 60 minutes after treatment with a serratus anterior plane block.

Fractures 99

Fractures Ultrasounds Research Outcomes 99

RebelEM

JUNE 8, 2023

2022 Sep 5. Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose. Prior literature primarily focused on safety and medication errors, and while this study did the same, they also assessed variables associated with PDP response.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. Atrial fibrillation is also a predictor of worse outcomes in this case (Alborzi). Retrieved July 2, 2022, from [link] Moyé, D. References Alborzi, Z.,

EKG/ECG 114

EKG/ECG Wellness Fractures Emergency Department 114

ACEP Now

JULY 7, 2023

2,3 In general, patients who develop cardiac arrest with an initial rhythm of VT or VF tend to have favorable outcomes compared to patients who develop cardiac arrest from either asystole or pulseless electrical activity. Heart disease and stroke statistics-2022 update: A report from the American Heart Association. Circulation.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Taming the SRU

SEPTEMBER 25, 2023

This places a significant responsibility on the EM physician to diagnose and treat fractures. Specifically, EM physicians should be able to recognize fractures that will likely require operative management and facilitate close follow up, such as a Maisonneuve fracture. 2022 May 16;10(14):4684-4690. screws for medial malleolus.

Fractures 102

Fractures Operations Emergency Department EMS 102

RebelEM

APRIL 17, 2023

A repeat search was completed in May 2021 & November 2022. appeared first on REBEL EM - Emergency Medicine Blog. Two investigators independently assessed and screened all studies for eligibility. Two reviewers independently assessed study quality using the QUADAS-2 tool Authors were contacted for any missing or unreported data.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

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 ). 2022 PMID: 35206981 2.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Dr. Smith's ECG Blog

NOVEMBER 14, 2023

Outcome: All 4 serial hs troponin I, out to 6 hours, were undetectable. For examples of this phenomenon — See My Comment in the February 14, 2018 — July 21, 2020 — and December 22, 2022 posts in Dr. Smith's ECG Blog ). EMS arrived — and recorded 2 ECGs. 14 minutes later — ECG #2 was recorded by EMS.

EKG/ECG 115

EKG/ECG EMS Stroke Outcomes 115

ALiEM

JULY 17, 2023

sought to identify program factors associated with unfilled post-graduate year 1 (PGY-1) emergency medicine (EM) positions in the 2023 Match [1]. Many of these findings were similar to a study of the 2022 EM Match results by Murano et al., What does this mean for the future of EM? Is student disinterest the problem?

EMS 52

EMS Burns Emergency Department Shock 52

RebelEM

SEPTEMBER 22, 2022

We have already covered issues with pulse oximetry potentially missing hypoxemia in Black patients on REBEL EM ( Link is HERE ). This could lead to delays in antibiotics and medical care all of which could be associated with worsened patient outcomes Race is a social construct and patients self-identified to race (which is appropriate).

EMS 52

EMS Hospitals Outcomes Wellness 52

The Skeptics' Guide to EM

JULY 30, 2022

Date: July 28th, 2022 Reference: Brower et al. AEM July 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Date: July 28th, 2022 Reference: Brower et al. Charles Brower is a second-year resident training in Emergency Medicine at the University of Cincinnati.

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

The Skeptics' Guide to EM

JUNE 12, 2022

Date: June 12th, 2022 Reference: Finfer et al. Date: June 12th, 2022 Reference: Finfer et al. Case: A 62-year-old man is brought in by EMS from home with lethargy and hypotension. There was no interaction between fluid type or rate of infusion with the primary outcome of 90-day survival. Reference: Finfer et al.

Fluid Resuscitation 53

Fluid Resuscitation Resuscitation Outcomes Administration 53

EM Literature of Note

MARCH 2, 2023

There are only four effective interventions in Emergency Medicine An incorrect report on Emergency Department diagnostic errors Finally, not every article relevant to Emergency Medicine lands in an EM journal – hence the Annals of Emergency Medicine Journal Club.

Emergency Department 52

Emergency Department Resuscitation Shock EMS 52

ACEP Now

NOVEMBER 16, 2023

emergency medicine (EM) residency training length has been a decades-long dilemma: four versus three years. First, is three years enough time to become an EM physician? But critical questions remain unanswered when it comes to specialization, career trajectory, and actual competence as an EM physician. percent versus 90.8

Academics 52

Academics EMS Telemedicine Research 52

The Skeptics' Guide to EM

JULY 23, 2022

Date: July 22nd, 2022 Reference: Perry et al. Date: July 22nd, 2022 Reference: Perry et al. The Lancet 2022 Guest Skeptic: Dr. Tessa Davis is a Paediatric Emergency Consultant at the Royal London Hospital, Senior Lecturer at Queen Mary University of London, Co-founder of Don’t Forget The Bubbles ( DFTB ).

Fractures 52

Fractures Pediatrics Emergency Department Outcomes 52

Emergency Medicine Journal

JUNE 20, 2024

Methods This unblinded randomised trial compared emergency medicine (EM) pharmacist involvement in trauma callouts versus standard care at an Australian level 1 trauma centre. Eligible patients included those managed with a trauma callout during working hours of an EM pharmacist. to 1.71; p=0.042).

Resuscitation 40

Resuscitation EMS Outcomes Hospitals 40