ACEP Now

MARCH 6, 2024

The Sisyphean task remains to try to keep up—and, in that vein—here is a light round of the emergency medicine literature from 2023. 4 Repeated trials have not shown alteplase to have any signal of better outcomes, nor tenecteplase to have an association with increased adverse events. How Best to Stop the Bleeding in Trauma?

Research 52

Research Airway Management Stroke Outcomes 52

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. 2023 Jul 17. It is best to assume the worst and cover for this possibility. doi: 10.1212/NXI.0000000000200013.

Psychiatric 265

Psychiatric Seizures Outcomes Pediatrics 265

AENJ: Current Issue

MAY 8, 2024

The article titled “Using Artificial Intelligence to Predict Adverse Outcomes in Emergency Department Patients With Hyperglycemic Crises in Real Time,” authored by C.

Emergency Department 41

Emergency Department Outcomes Sepsis Research 41

Total Medical ComplianceHIPAA

APRIL 14, 2023

On April 11, 2023, the HHS published a notice on upcoming new rules to add greater protection to reproductive health care because of new state laws passed due to the outcome of the Supreme Court ruling on Roe v. You should always keep the “minimum necessary” rule in mind whenever you are giving out information.

Documentation/Coding 83

Documentation/Coding Outcomes Wellness 83

Stop and Think

JANUARY 10, 2024

Let’s do two topics on the RCT that I covered in my Top Ten Stories of 2023 piece. They found no significant improvement in the primary endpoint of survival with a favorable neurologic outcome. The primary outcome of all-cause death occurred in 48% and 49% of the ECLS and control group, respectively (RR, 0.98; 95% CI, 0.80-1.19;

CPR 45

CPR Shock Outcomes Resuscitation 45

Pediatric EM Morsels

AUGUST 9, 2024

Hussain, 2023 ] Leads to >300,000 perinatal deaths / year globally. Congenital syphilis differs from syphilis contracted by an “adult” in that: [ Hussain, 2023 ] T. Hussain, 2023 ] Excellent prognosis if treated early. If not treated early, then increased risk of poor outcomes and death. Epub 2023 Aug 18.

Emergency Department 152

Emergency Department Hyperthermia / Hypothermia Seizures Pediatrics 152

Broome Docs

JANUARY 30, 2023

Association of Chest Pain Protocol-Discordant Discharge With Outcomes Among Emergency Department Patients With Modest Elevations of High-Sensitivity Troponin. Does wound eversion improve cosmetic outcome?: Outcomes of patients discharged from the pediatric emergency department with abnormal vital signs. Epub 2021 Apr 29.

Emergency Department 52

Emergency Department Outcomes Ultrasounds Pediatrics 52

Don't Forget the Bubbles

SEPTEMBER 2, 2024

2023 Nov 14. Long-term cardiovascular outcomes in children and adolescents with hypertension. 2023 Jul;29(7):1681-91. 2023 Apr 1;110(4):432-8. 2023 May;182(5):2205-14. 2023 Oct;4(5):e13041. 2023 Apr 3;218:S5-12. Here are their recommendations for a little light reading. The Lancet. JAMA Pediatrics.

Pediatrics 97

Pediatrics EMS Outcomes Hospitals 97

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]. as well as an analysis of the 2023 Match by Pupazan and Cook in Emergency Medicine News [3,4]. A staggering 131 (47%) EM residency programs had unfilled PGY-1 positions among in 2023 [7].

EMS 52

EMS Burns Emergency Department Shock 52

ACEP Now

AUGUST 13, 2024

Studies consistently show that having a diverse physician workforce leads to improved patient outcomes, lower mortality, reduced morbidity rates, and, ultimately, a more robust health care system. Published June 6, 2023. Published April 20, 2023. Diversity improves performance and outcomes. Published June 29, 2023.

Leadership 111

Leadership Outcomes Academics Emergency Department 111

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. New England Journal of Medicine June 2023 Reference: Snelling et al. He is also a fully-fledged ultrasonographer.

Fractures 124

Fractures Ultrasounds Pediatrics Outcomes 124

The Skeptics' Guide to EM

JUNE 8, 2024

WJEM December 2023 Date: May 30, 2024 Guest Skeptic: Dr. Kay Dingwell is a rural emergency physician working in Prince County, PEI with a special interest in gender-affirming care and improving the care of trans and gender-diverse patients. Yes The outcomes were clinically relevant. Unsure The assessment of studies were reproducible.

Best Practices 122

Best Practices Emergency Department Research Outcomes 122

Pediatric EM Morsels

JUNE 9, 2023

Banc-Husu, 2023 ] Cholestastis Inflammatory conditions Genetic and Metabolic diseases Pediatric cirrhotic liver disease has many complications. Banc-Husu, 2023 ; Luoto, 2020; Carneiro de Moura, 2018 ] Basics are best (always)! 2023 Feb;43(1):100-116. Portal Hypertension in children is a heterogenous disease ]. Semin Liver Dis.

Pediatrics 152

Pediatrics Head Injuries Airway Management Administration 152

The Skeptics' Guide to EM

DECEMBER 16, 2023

AEM Dec 2023 Date: December 14, 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. AEM Dec 2023 Date: December 14, 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary.

Emergency Department 117

Emergency Department Research Outcomes 117

The Skeptics' Guide to EM

JULY 2, 2023

Date: July 1, 2023 Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Date: July 1, 2023 Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Most of the times the RCTs we critically appraised did not demonstrate superiority for their primary outcome.

EMS 124

EMS Outcomes Hospitals Research 124

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). 2023 Dec 22. 2023 Dec 21. 2023 Dec 19. 2023 Dec 12 Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Pediatrics.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

EM Ottawa

MAY 20, 2024

2023 Jun 29;388(26):2411-2421. Question and Methods: RCT at 103 sites to compare outcomes at 30 days for early versus late DOAC initiation among patients with ischemic stroke and atrial fibrillation. Methodology: 3/5 Usefulness: 2/5 Fischer U, et al. N Engl J Med.

Stroke 57

Stroke Outcomes 57

EMDocs

AUGUST 17, 2024

Spoon Feed In ICU patients with traumatic brain injury (TBI) and anemia, transfusing blood to a liberal hemoglobin threshold (10 g/dL) compared to a restrictive threshold (7 g/dL) did not lead to better neurological outcomes at 6 months. 2023 Mar 1;80(3):233-243. 2023 Apr 1;80(4):422. N Engl J Med. 2024 Jun 13. JAMA Neurol.

Stroke 69

Stroke Administration Outcomes 69

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

Pediatric EM Morsels

SEPTEMBER 22, 2023

Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Orenstein JB, Klein BL, Gotschall CS, Ochsenschlager DW, Klatzko MD, Eichelberger MR. Age and outcome in pediatric cervical spine injury: 11-year experience. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. 5 th Edition. Neurogenic Shock. Updated 2022 Feb 10].

Shock 300

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 300

EMDocs

JANUARY 13, 2024

Spoon Feed High-dose nitroglycerin improves outcomes in patients with sympathetic crashing acute pulmonary edema (SCAPE) without significant side effects when compared to low-dose nitroglycerin. 2023 Nov 28:emermed-2023-213285. doi: 10.1136/emermed-2023-213285. 2023 Nov 28:emermed-2023-213285. Emerg Med J.

Stroke 61

Stroke Shock Pediatrics Resuscitation 61

EM Ottawa

NOVEMBER 6, 2023

Lancet 2023 Jul 1;402(10395):27-40. Question and Methods: Do 6 month outcomes improve after implementation of a goal-directed care bundle that corrects prognostically poor physiological abnormalities (systolic hypertension, fever, hyperglycemia, abnormal anticoagulation) for acute intracranial hemorrhage?

Outcomes 107

Outcomes 107

EMDocs

NOVEMBER 29, 2023

2023 May 25;388(21):1931-1941. Included 584 patients > 18 years admitted to ICU with severe PNA based on IDSA/ATS criteria Primary Outcome: 60-day all-cause mortality Hydrocortisone 16% vs. placebo 18%, adjusted OR 0.90 (95% CI 0.57-1.40) 2023 Jul 8;27(1):274. 2023 May 31;27(1):212. #4: 2023 Jul;188:109785.

Outcomes 80

Outcomes Resuscitation EKG/ECG 80

RebelEM

JUNE 1, 2023

Post-ROSC management is nuanced and challenging but helps to ensure good outcomes. In theory, rapid identification of the underlying cause should improve outcomes by allowing clinicians to tailor management. Diagnostic yield, safety, and outcomes of Head-to-pelvis sudden death CT imaging in post arrest care: The CT FIRST cohort study.

Outcomes 140

Outcomes Resuscitation Hospitals CPR 140

EM Ottawa

MAY 6, 2024

2023 Jun 1;388(22):2025-2036. Methodology: 4/5 Usefulness: 3/5 Zi W, et al. N Engl J Med. Editorial: Expanding Treatment for Acute Ischemic Stroke beyond Revascularization.

Stroke 62

Stroke Outcomes 62

Broome Docs

SEPTEMBER 3, 2024

Epub 2023 Jul 31. Use and Outcomes of Peripheral Vasopressors in Early Sepsis-Induced Hypotension Across Michigan Hospitals: A Retrospective Cohort Study. Use and Outcomes of Peripheral Vasopressors in Early Sepsis-Induced Hypotension Across Michigan Hospitals: A Retrospective Cohort Study. Epub 2023 Oct 26. 2023.07.004.

Sepsis 109

Sepsis Emergency Department Outcomes Hospitals 109

EMDocs

AUGUST 5, 2023

Source Diagnostic yield, safety, and outcomes of Head-to-pelvis sudden death CT imaging in post arrest care: The CT FIRST cohort study. 2023 Jul;188:109785. Epub 2023 Apr 3. #2: Source Adverse Clinical Outcomes Among Patients With Acute Low-risk Pulmonary Embolism and Concerning Computed Tomography Imaging Findings.

Resuscitation 63

Resuscitation Outcomes Hospitals 63

PulmCCM

MAY 3, 2024

While outcomes from acute ischemic stroke due to large vessel occlusion in the anterior circulation have improved substantially in the era of thrombolytics and mechanical thrombectomy, overall outcomes remain poor. ” However, that was in the era before mechanical thrombectomy. Along with endovascular thr… Read more

Stroke 52

Stroke Outcomes Hospitals 52

The Skeptics' Guide to EM

JANUARY 20, 2024

Aug 2023 Date: October 30, 2023 Guest Skeptic: Dr. Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University School of Medicine and Health Sciences. Reference: Zaoutis T, et al. JAMA Pediatr.

Pediatrics 69

Pediatrics Anaphylaxis Emergency Department Outcomes 69

RebelEM

JUNE 22, 2023

Lancet Infect Dis 2023 PMID: 37302406 Clinical Question: Does outpatient treatment with ivermectin, fluvoxamine or metformin soon after SARS-CoV-2 infection reduce the risk of developing long-COVID in overweight patients? Outcomes: Primary: The development of long-COVID up to 300 days after enrollment. Lancet Infect Dis 2023.

Outcomes 131

Outcomes Research Documentation/Coding Wellness 131

The Skeptics' Guide to EM

JUNE 22, 2024

December 2023 Guest Skeptic: Dr. Anireddy Reddy is a pediatric intensive care attending physician in the Department of Anesthesiology and Critical Care Medicine at Children’s Hospital of Philadelphia. Using the term “risk” implies that a negative outcome may or may not happen. While the term “benefits” implies a positive outcome.

Pediatrics 51

Pediatrics Outcomes Emergency Department Resuscitation 51

ACEP Now

AUGUST 1, 2023

As your council officer, I commit to ensuring your voice contributes to the best outcome for our College, our members, EM residents, and our patients. The post 2023 ACEP Elections Preview: Meet the President-Elect and Council Officer Candidates appeared first on ACEP Now.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Don't Forget the Bubbles

SEPTEMBER 16, 2023

2023 Aug 23:e2023062806. 2023 Aug 23. 2023 Aug 16. 2023 Aug 2. 2023 Aug 10:e2023062307 Rosacea in children: a review. 2023 Aug 9. 2023 Aug 2. 2023 Aug 30:archdischild-2023-325441. 2023 Aug 21. 2023 Aug 25:e2022057627. 2023 Aug 21:113679. 2023 Aug 24:e2022058674.

Pediatrics 75

Pediatrics Ultrasounds Outcomes Hospitals 75

The Skeptics' Guide to EM

JANUARY 6, 2024

July 2023 Date: Dec 11, 2023 Guest Skeptic: Dr. Rachel Hatcliffe is a pediatric emergency medicine attending at Children’s National Hospital in Washington, DC. July 2023 Date: Dec 11, 2023 Guest Skeptic: Dr. Rachel Hatcliffe is a pediatric emergency medicine attending at Children’s National Hospital in Washington, DC.

Emergency Department 104

Emergency Department Pediatrics Anaphylaxis Leadership 104

The Skeptics' Guide to EM

OCTOBER 21, 2023

Date: October 20, 2023 Reference: Cai et al. AEM October 2023. Date: October 20, 2023 Reference: Cai et al. AEM October 2023. AEM October 2023. Implementation of a Clinical Management Tool for Spinal Epidural Abscess Early Diagnosis. Reference: Cai et al.

Emergency Department 106

Emergency Department Radiology Radiology Hospitals 106

EM Ottawa

MARCH 25, 2024

2023 May 1;136(5):913-919. Findings: The primary outcome was incidence of peri-intubation hypoxia. Methodology: 3/5 Usefulness: 3/5 Bandyopadhyay A, et al. Anesth Analg. Question and Methods: This is the first RCT looking at DSI vs RSI in adult trauma patients with no difficult airway features.

Outcomes 57

Outcomes 57

Taming the SRU

SEPTEMBER 21, 2023

2023) doi:10.1016/j.annemergmed.2023.05.014. Exclusion criteria were pre-intubation hypotension, use of topical anesthesia, or missing data including primary outcome, patient weight, etomidate / ketamine dose. Primary outcome was post-intubation hypotension, defined as SBP < 100mg Hg within the first 15 minutes post-intubation.

Outcomes 85

Outcomes Emergency Department Shock 85