EMDocs

NOVEMBER 13, 2024

Older age, recurrent episodes of SBP, hepatorenal syndrome, hepatic encephalopathy, acute kidney injury (AKI), concurrent GI bleeding, and higher MELD scores are predictors of worse outcomes. Spontaneous bacterial peritonitis in patients with cirrhosis: incidence, outcomes, and treatment strategies. 2022 Mar-Apr;12(2):519-532.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Ultrasounds Shock Hospitals 105

Dr. Smith's ECG Blog

MARCH 10, 2025

They concluded, "Our findings increase confidence in the normal automated GE Marquette 12 SL ECG software interpretation to predict a benign outcome. Smith comment: this is a very stupid outcome measure) What if we use that methodology for the ECG above? What is the gold standard for ECG interpretation: patient outcome!!!

EKG/ECG 89

EKG/ECG Outcomes Documentation/Coding Emergency Department 89

PulmCCM

JANUARY 15, 2025

In 2022, a class-action lawsuit was filed against Apple in New York alleging that the pulse oximeter on Apple Watches was inaccurate in dark-toned patients. Clinical Outcomes Associated With Overestimation of Oxygen Saturation by Pulse Oximetry in Patients Hospitalized With COVID-19. ABC News December 29 2022 Fawzy et al.

Academics 81

Academics Documentation/Coding Administration Research 81

Pediatric EM Morsels

SEPTEMBER 22, 2023

Updated 2022 Feb 10]. Orenstein JB, Klein BL, Gotschall CS, Ochsenschlager DW, Klatzko MD, Eichelberger MR. Age and outcome in pediatric cervical spine injury: 11-year experience. Updated 2022 Mar 3]. Tenenbein M, Macias CG, Sharieff GQ, et al, eds. In: Strange and Schafermeyer’s: Pediatric Emergency Medicine. 5 th Edition.

Shock 304

Shock Pediatrics Dislocations Hyperthermia / Hypothermia 304

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

Emergency Medicine Journal

JANUARY 21, 2025

This study compares the treatment outcomes of HDICS as add-on therapy to the outcomes of standard treatment in adult patients with acute asthma exacerbation in the ED. Methods This was a single-centre, triple-blind, randomised controlled trial conducted in the ED in Thailand between March 2022 and April 2023.

Hospitals 52

Hospitals Outcomes 52

The Skeptics' Guide to EM

FEBRUARY 22, 2025

Clinical Chemistry and Laboratory Medicine 2022; 60(5):786-792 Clin Chem Lab Med. 2022 Date: February 21, 2025 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Vice Chair of Critical Care Medicine at Mayo Clinic Arizona.

Sepsis 61

Sepsis Infectious Diseases Emergency Department Pediatrics 61

Pediatric EM Morsels

JULY 28, 2023

Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. ISPAD Clinical Practice Consensus Guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. 2022; 23( 7): 835- 856. Is your patient hyperglycemic, acidotic, with ketonuria? Then we’ve likely got DKA.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

PulmCCM

MARCH 4, 2025

In 1999, the Transfusion Requirements in Critical Care (TRICC) trial demonstrated that in a mix of patients with critical illness, restricting red blood cell transfusion to those with hemoglobin <7 g/dL did not worsen outcomes. In its evidence review, a U.S. society found no adverse effects of restrictive transfusion strategies (Hb 7.0

Outcomes 52

Outcomes Hospitals 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

EMDocs

JANUARY 25, 2025

0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. Philadelphia, PA: Elsevier; 2022:1-11. 101,33 (2022): e30116. Updated 2022 Nov 14]. Curr Opin Hematol. 2017;24(1):46-53. doi:10.1097/MOH.0000000000000305 J Blood Disord Transfus. 14:559 Tilahun, M.,

EMS 96

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 96

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. Background: Sepsis remains one of the leading causes of morbidity and mortality.

Sepsis 132

Sepsis Hospitals Administration Outcomes 132

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 129

Seizures Stroke Outcomes Research 129

Pediatric EM Morsels

AUGUST 9, 2024

If not treated early, then increased risk of poor outcomes and death. Early Congenital Syphilis Present before 2 years of age [ Hussain, 2023 ; Foles, 2024; Fang, 2022; Morrisroe, 2021 ] Only ~33% of newborns present with symptoms at birth and can be subtle. 2022 Dec 27;14(12):e33009. Most will develop signs by 3 months of age.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome was 28-day mortality – TXA improved survival with no increased risk of cerebral clots. Survival was better, both at 24 hours and six months, in the TXA group, although the primary outcome, a quality of life score at six months, called the Glasgow Outcome Scale Extended (GOS-E), was the same in both groups ( 53.7%

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

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. Mathis, K. L., & Lindor, R. Annals of emergency medicine, 82(1), 3746. link] Chakravartty, S., Chang, A., & Nunoo-Mensah, J.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

Don't Forget the Bubbles

MAY 31, 2023

2023 May 17:archdischild-2022-325280. doi: 10.1136/archdischild-2022-325280. 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. Arch Dis Child.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

Emergency Medicine Journal

DECEMBER 30, 2024

Background Calls to emergency departments (EDs) from ambulances to alert them to a critical case being transported to that facility that requires a special response (‘pre-alerts’) have been shown to improve outcomes for patients requiring immediate time-critical treatment (eg, stroke).

Emergency Department 52

Emergency Department Stroke Documentation/Coding Outcomes 52

The Trauma Pro

JANUARY 5, 2024

The group at the Medical College of Wisconsin performed a trial of thoracic cavity irrigation and compared the outcomes with patients who did not undergo irrigation. The only prior study I could find was published in 2022 by a group at the University of Nevada at Las Vegas. 2022 Nov;279:62-71. EAST 2024, Podium paper #17.

Hospitals 133

Hospitals Wellness Outcomes 133

Pediatric EM Morsels

AUGUST 11, 2023

Infections there become complicated very quickly and the outcomes can be very poor. 2022 Sep;68(9):661-663. Inpatient Vs Outpatient Therapy No standard approach… but… here is what I say: “ Always Fear Infections in the Hands, Feet, or Face.” ” Those areas have very important and delicate structures.

Burns 130

Burns Pediatrics EMS Outcomes 130

EMDocs

SEPTEMBER 8, 2024

Delaying treatment of elevated BP in patients may lead to worse outcomes, and an optimal IV antihypertensive medication will reach the BP goal rapidly while avoiding hypotension and causing end organ injury. Authors extracted proportions dichotomous outcomes (in-hospital mortality) and calculated risk ratios. clevidipine).

Stroke 105

Stroke Outcomes Hospitals 105

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

RebelEM

SEPTEMBER 21, 2023

Up to 80% of patients will have at least one troponin sent ( Gabrielli 2022 ). 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 ). Additionally, they found that up to 30% of the troponins sent are positive.

EKG/ECG 143

EKG/ECG Sepsis EMS Outcomes 143

Sensible Medicine

MAY 28, 2024

In October 2022 , the USPSTF recommended childhood anxiety screening starting at eight years old. A 2008 Cochrane review found adult depression screening does not improve outcomes. The last two trials convincingly demonstrate that when patients with postpartum depression have better access to mental health services, outcomes improve.

Military 144

Military Outcomes Psychiatric Wellness 144

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Tessa Davis covered the FORCE trial on SGEM #372 which looked at buckle fractures and compared immobilization in a cast or splint vs. a soft bandage and they found no difference in pain scores or functional outcomes. Reference: Snelling et al. Ultrasonography or radiography for suspected pediatric distal forearm fractures.

Fractures 139

Fractures Ultrasounds Pediatrics Outcomes 139

The Trauma Pro

OCTOBER 3, 2023

There was no difference in pain, return to work, functional outcome, or instrumentation failure. Int J Burns Trauma 12(4):168-174, 2022. It looked at loss of deformity correction, return to work, functional improvement, instrumentation failure rate, pseudoarthrosis, and postop complications. A total of 76 studies were included.

Fractures 203

Fractures Dislocations Operations Burns 203

EMDocs

SEPTEMBER 3, 2024

Secondary: % change from baseline in anti-factor Xa activity during the first 2 hours from randomization Safety (assessed at 30 days): thrombotic events (ischemic stroke, VTE, myocardial infarction), mortality Results: 452 patients analyzed for the primary outcome. 530 patients analyzed for safety outcome. Blinded outcome assessors.

Stroke 98

Stroke Outcomes Hospitals 98

PulmCCM

OCTOBER 16, 2024

This is a remarkable example of the differences between societies, which might influence the processes of clinical trials and their outcomes. RIPC has not been shown to improve cardiovascular outcomes more generally after cardiac surgery. 2022 Mar 1;134(3):592-605. Long YQ, Feng XM, Shan XS, Chen QC, Xia Z, Ji FH, Liu H, Peng K.

Outcomes 52

Outcomes Operations Research Hospitals 52

PulmCCM

DECEMBER 11, 2023

Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid bolus) led to similar outcomes as the usual practice of bolusing large volumes of fluids first. Vitamin C did not improve outcomes among patients hospitalized with Covid-19.

Sepsis 94

Sepsis Stroke Shock Infectious Diseases 94

The Trauma Pro

AUGUST 25, 2023

They tried to perform a systematic review and meta-analysis of studies that compared outcomes in splenectomy vs. angioembolization patients. Injury 53:3569-3574, 2022. If a distal embolization were performed, I would eyeball the amount of devascularized spleen and give the vaccines if it looked like more than half was dark.

Sepsis 187

Sepsis Research Outcomes Hospitals 187

Emergency Medicine Journal

JUNE 22, 2023

The primary outcome was intubation or non-invasive ventilation, death or intensive care unit admission at 30 days. Results Of the 446 084 patients, 15 397 (3.45%, 95% CI 34% to 35.1%) experienced the primary outcome. Clinical decision-making for inpatient admission achieved a sensitivity of 0.77 (95% CI 0.76

Outcomes 98

Outcomes 98

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

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

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

MAY 29, 2023

What They Did: Single-center, parallel, double blind, randomized controlled trial performed in a medical-surgical ICU (Mexico) Both groups received: Adjunctive vasopressin initiated at a dose of 0.03 NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9% 95% CI 15.4 NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9% 95% CI 15.4

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

EMDocs

SEPTEMBER 2, 2023

hours of onset, dual antiplatelet therapy (DAPT) is non-inferior to intravenous alteplase for excellent neurologic outcome at 90 days. 2022 Aug 1;93(2):157-165. Epub 2022 Mar 28. #3: Spoon Feed In minor acute ischemic stroke (AIS) patients presenting within 4.5 2023 Jun 27;329(24):2135-2144. doi: 10.1001/jama.2023.7827.

Stroke 96

Stroke Pediatrics Outcomes 96

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