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

OCTOBER 16, 2024

Animal studies have suggested that the body could be prepped or trained to better withstand ischemic-reperfusion injury, by inducing mild ischemia in another tissue bed before the operation. This is a remarkable example of the differences between societies, which might influence the processes of clinical trials and their outcomes.

Outcomes 52

Outcomes Operations Research Hospitals 52

Taming the SRU

MARCH 12, 2024

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. The study’s primary outcomes were the operational impacts of the SQuID protocol on EDLOS and ICU admission rates. Secondary outcomes included fidelity to and safety of the intervention. Acad Emerg Med 2023;30(8):800–8.

Operations 96

Operations Hospitals Best Practices Wellness 96

RebelEM

NOVEMBER 6, 2024

2022 Aug 2. Acute elbow dislocation: evaluation and management. J Am Acad Orthop Surg. 1998 Jan-Feb;6(1):15-23. doi: 10.5435/00124635-199801000-00002. PMID: 9692937 Decker N, Norse A. Anterior Elbow Dislocation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. Simple elbow dislocation. Shoulder Elbow.

Dislocations 109

Dislocations Fractures Soft Tissue Injuries Outcomes 109

RebelEM

APRIL 17, 2023

A repeat search was completed in May 2021 & November 2022. While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage. Two investigators independently assessed and screened all studies for eligibility. Ultrasound has become an extended part of our physical exam.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. They stratified patients according to the ratio of FFP: PRBC received (1:1, 1:2, 1:3 and 1:3+) and performed logistic regression analyses for various outcomes. These procedures require an experienced operator.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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

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. Disruption of these structures yields an unstable ankle fracture, thus making close follow up for operative management imperative. 2022 May 16;10(14):4684-4690.

Fractures 100

Fractures Operations Emergency Department EMS 100

RebelEM

AUGUST 12, 2024

Epub 2022 Aug 28. Intravenous amino acid therapy for kidney protection in cardiac surgery a protocol for a multi-centre randomized blinded placebo controlled clinical trial. The PROTECTION trial. Contemp Clin Trials.

Outcomes 81

Outcomes Hospitals Operations Shock 81

PulmCCM

NOVEMBER 6, 2023

open label) at 17 sites in Belgium in 2020-2022, 35% of those receiving plasma died at 28 days, vs. 45% of the usual care patients — a number needed to treat of 10 to save one life. Among 475 patients with ARDS due to Covid-19, randomized within 5 days of ventilation to receive convalescent plasma or usual care (i.e.,

Blood Transfusions 98

Blood Transfusions Operations Infectious Diseases Resuscitation 98

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 97

Fractures Ultrasounds Outcomes Research 97

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

RebelEM

NOVEMBER 25, 2024

2 Moreover, the American Society of Anesthesiologists’ 2022 Practice Guidelines for Management of the Difficult Airway recommend the use of adjuncts like bougies in anticipated difficult airways but stop short of endorsing their routine universal use. Randomized controlled trials or comparative non-randomized observational studies.

Outcomes 76

Outcomes Emergency Department Operations Hospitals 76

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

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. 2022 PMID: 35206981 2.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

American Medical Compliance

NOVEMBER 30, 2022

In operating rooms, HAIs can cause surgical site infections, which threaten the health and safety of patients. According to the Emergency Care Research Institute, staffing shortages posed the greatest threat to patient safety in 2022. Many care providers are forced to operate without the necessary materials to do their jobs.

Patient Safety 52

Patient Safety CDC Operations Outcomes 52

Taming the SRU

MAY 22, 2023

Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED. Updated 2022 Nov 23]. A comparison between pre-operative ultrasonography and surgical findings. Updated 2022 Apr 7]. Updated 2022 Mar 16]. Acta Radiol.

Fractures 76

Fractures Dislocations Operations Radiology 76

Don't Forget the Bubbles

JUNE 17, 2024

High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. At its heart lies an unpleasant reality- a critically unwell child with an anxious carer hoping for a positive outcome. 2022 May 12;46(3):319-24. Civility Saves Lives The impact of incivility in healthcare cannot be understated.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Don't Forget the Bubbles

JANUARY 1, 2024

Data from the Nurse-Family Partnership program involving 60,171 families were analysed across four cohorts, including pre-pandemic and three pandemic cohorts (from July 2022 to October 2023). However, children who had an operation experienced improvements in behaviour, symptoms, and quality of life and had lower blood pressure.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

ACEP Now

SEPTEMBER 3, 2024

These stakeholders are similarly shielded in court when adverse patient outcomes, such as negligent deaths, occur under their management or when the bought-out companies are challenged for anticompetitive business practices overseen by the PE firm. 2022:3(9):e222886. Published December 14, 2022. JAMA Health Forum.

Hospitals 113

Hospitals Radiology Radiology Administration 113

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. These questionable practices led to a rash of bad outcomes.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

EMDocs

JANUARY 11, 2025

Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. 2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation. Mathis, K.

EMS 72

EMS Sepsis Shock Fluid Resuscitation 72

SheMD

MAY 4, 2023

What were their outcomes: The median number of years to first appointment to a chair position was 7 years after graduation. Women were more likely to be first appointed to educational rather than operational roles (52.6% Dig Dis Sci 67, 364–366 (2022). Female chairs obtained more advanced degrees (47.4% vs 31.6%, p=0.12).

Leadership 52

Leadership Academics Operations Administration 52

The Skeptics' Guide to EM

APRIL 16, 2022

Date: April 16th, 2022 Reference: Blom et al. Date: April 16th, 2022 Reference: Blom et al. Before we answer that question, let’s remind everyone that only a small number (2.8%) of interventions published in SRMA and relevant to emergency medicine have unbiased and strong evidence for improved outcomes ( SGEM#361 ).

Military 40

Military Operations Emergency Department Pediatrics 40

Don't Forget the Bubbles

MAY 17, 2023

Post-operative pain in children: Comparison of pain scores between parents and children. 2023 Apr 20:fetalneonatal-2022-324835. Early Antibiotic Use and Neonatal Outcomes Among Preterm Infants Without Infections. 2023 Apr 4:archdischild-2022-325281. J Pediatr Gastroenterol Nutr. 2023 Apr 24. Cetinkaya PG, et al.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Taming the SRU

JUNE 11, 2023

Utilized in the pre-hospital setting, ICU and the Operating Room, it is a non-invasive measurement that reflects a patient’s current state of metabolism, circulation and ventilation. The primary outcome was in-hospital mortality. The secondary outcome focused on ICU admissions. 2023;(December 2022):1-10. Acad Emerg Med.

Hospitals 86

Hospitals Emergency Department EMS Outcomes 86

Taming the SRU

MAY 23, 2023

Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED. Updated 2022 Nov 23]. Updated 2022 May 14]. This post will cover some of the most common and important injuries, but is not comprehensive. Foot & Ankle Int.

Fractures 57

Fractures Dislocations Operations EMS 57

RebelEM

NOVEMBER 6, 2023

Methylene Blue for Vasoplegic Syndrome After Cardiac Operation: Early Administration Improves Survival. 2022 Aug 22. PMID: 37586951 Mehaffey JH, et al. Ann Thorac Surg. Epub 2017 May 24. PMID: 28551045 Bak MA, et al. High-Dose Hydroxocobalamin for Refractory Vasoplegia Post Cardiac Surgery.

Shock 71

Shock Administration Academics Hospitals 71

Emergency Medicine Journal

NOVEMBER 28, 2023

There is little research in the Irish setting, specifically regarding the outcomes of patients who receive chest drains in Irish EDs. This study was conducted by the Irish Trainee Research Network (ITERN) from May 2022 until February 2023. No association was found between drain type, indication or operator and first past success.

Emergency Department 40

Emergency Department EMS Research Operations 40

Dr. No

JANUARY 3, 2022

We must avoid at all costs that most awful of medical outcomes: the operation — all the counter-measures — was a great success, but unfortunately the patient — society — died. This brings Dr No to his final, and perhaps most important point, in this first post of 2022.

Operations 52

Operations Shock Outcomes 52

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. This is a critical error that leads to poorer outcomes for patients in need of critical care. More pertinent and relevant takeaway messages have to do with staffing and operations.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

ACEP Now

NOVEMBER 16, 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. Residency length has varied since the inception of the specialty of EM.

Academics 52

Academics EMS Telemedicine Research 52

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? However, with ultrasonography becoming more prevalent in EDs, it may be possible that initial imaging may avoid this radiation risk and still have similar outcomes for patients. Would you be satisfied with only US and no follow-up CT?

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

EMDocs

SEPTEMBER 9, 2023

Treasure Island (FL): StatPearls Publishing; November 15, 2022. Dec 21, 2022. Emergency Medicine Residents’ Association; 2022:10-11. Results of primary extensor tendon repair in relation to the zone of injury and pre-operative outcome estimation. August 29, 2022. In: StatPearls. Amirtharajah M, Lattanza L.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

Don't Forget the Bubbles

MAY 10, 2023

In May 2022, Holly and Joe, two students on the joint QMUL and DFTB PEM MSc , created video presentations on human factors. Then the patient is rapidly moved to the operating theatre. The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre. Resuscitation.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

PulmCCM

APRIL 1, 2024

Both a 2019 meta-analysis and a large 2022 trial by the ANZICS group raised concerns about increased adverse events among patients receiving intensive physical therapy in the ICU. Physical therapy is probably under-provided to critically ill patients, and improving this might improve outcomes for many. Is this safe?

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

RebelEM

AUGUST 31, 2023

Primary Outcome – Bleeding (Grade 2 to 4) Transfusion 4.8% Primary Outcome – Bleeding (Grade 2 to 4) Transfusion 4.8% Key Secondary Outcome – Severe Bleeding (Grade 3 to 4) Transfusion 2.1% Key Secondary Outcome – Severe Bleeding (Grade 3 to 4) Transfusion 2.1% Median hemoglobin: 8.2 g/dl vs 8.5

Ultrasounds 58

Ultrasounds Outcomes Wellness Research 58