Broome Docs

MARCH 28, 2024

If you want to see Justin in the video format and his new Youtube series then click here: [link] If you would like to check out my current ultrasound training project then click here: WACHS Ultrasound Otherwise – enjoy the show and see you in a few weeks. doi: 10.1136/emermed-2023-213285. 2023 Sep 21:ciad571.

PPE 96

PPE Ultrasounds Resuscitation Administration 96

RebelEM

JUNE 26, 2023

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy. Severe acute traumatic coagulopathy = PT >1.5

Administration 135

Administration Outcomes Resuscitation Radiology 135

RebelEM

JANUARY 29, 2024

Clin Exp Emerg Med 2023. REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE? Click here for Direct Download of the Podcast Paper: Aykan AC et al. Reduced-Dose Systemic Fibrinolysis in Massive Pulmonary Embolism: A Pilot Study. in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7%

Stroke 130

Stroke Outcomes Hospitals Administration 130

Broome Docs

APRIL 6, 2023

2023 Jan 21. Clinical risk factors for testicular torsion and a warning against falsely reassuring ultrasound scans: a 10-year single-centre experience. 2023 Feb;64:206.e1-206.e3. 2023 Jan 30. Clinical Outcomes After Intensifying Antihypertensive Medication Regimens Among Older Adults at Hospital Discharge.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

ACEP Now

JUNE 21, 2023

The lack of differences in the observed outcomes do not suggest one EM training length is superior. The additional year may improve career trajectory or longevity, entrance into fellowship or academic practice, or other longer-term outcomes including successful development of a niche in the specialty. 11 What should we take away?

EMS 114

EMS Academics Telemedicine Operations 114

RebelEM

JUNE 19, 2023

PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy? 1.00 (0.9 – 1.12) Secondary Outcome Mortality 24h 9.7% Prehospital Tranexamic Acid for Severe Trauma.

Blood Transfusions 104

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 104

Taming the SRU

NOVEMBER 3, 2023

Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. Ultrasound Med. The primary outcome in this study was a change in pain score at rest 60 minutes after block. 11/3/2023 41, 2695–2701 (2022). Serratus Anterior Plane Blocks for Rib Fractures in the ED.

Fractures 98

Fractures Ultrasounds Outcomes Research 98

Don't Forget the Bubbles

NOVEMBER 13, 2023

Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation. However, ultrasound is gaining popularity due to its portability, affordability, and lack of ionising radiation. N Engl J Med.

Fractures 64

Fractures Ultrasounds Emergency Department Pediatrics 64

RebelEM

APRIL 29, 2024

The current standard of practice has moved away from landmark-based central line placement given the efficacy and safety of ultrasound-based techniques. World J Emerg Surg 2023 PMID: 36918947 3. 2023 PMID: 37502742 11 Schwalbach KT et al. This study also showed the median time for IO placement was only 1.2 minutes CVC group.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

The Skeptics' Guide to EM

JULY 22, 2023

Date: July 21, 2023 Reference: Prekker et al. NEJM 2023 Guest Skeptic: Dr. Jeff Jarvis is the Chief Medical Officer and System Medical Director for the Metropolitan Area EMS Authority in Fort Worth, Texas, also known as MedStar. Date: July 21, 2023 Reference: Prekker et al.

EMS 74

EMS CPR Ultrasounds Research 74

PulmCCM

JUNE 26, 2023

They announced this at the American Thoracic Society meeting in May 2023. No outcomes regarding the delirium itself were reported (i.e., Private equity-backed firms are buying and expanding physician practices and squeezing them for profit, with little regard for patient outcomes, professional standards, or ethics.

Outcomes 98

Outcomes Ultrasounds Hospitals Wellness 98

PulmCCM

JULY 3, 2023

If those grizzled veterans give you a hard time, remember, they’re also the ones who dispensed attaboys in the pre-ultrasound era like “if you’re not cannulating the carotid artery or dropping lungs, you’re not doing enough central lines!”) (Who themselves would be less experienced at video.) (If

Airway Management 105

Airway Management Outcomes Hospitals Emergency Department 105

ALiEM

JANUARY 29, 2024

Case Question: What treatments can you perform in the ED for this diagnosis and do they improve outcomes? Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine vol. This has the potential to expedite consultations with specialty teams and treatment. 39,1 (2020): 197-202.

Stroke 64

Stroke Ultrasounds Academics Outcomes 64

Mount Sinai EM

OCTOBER 11, 2024

2023) of 17 studies with 812 patients (all cohort studies aside from one small RCT), intraoral US was 91% sensitive and 75% specific for PTA, while transcervical US was 80% sensitive and 81% specific. There was significant heterogeneity among studies and outcomes were not measured consistently.

Ultrasounds 100

Ultrasounds Wellness Outcomes Hospitals 100

Don't Forget the Bubbles

JANUARY 31, 2024

Edelman J, Taylor H, Goss A, et al Point-of-care ultrasound as a diagnostic tool in respiratory assessment in awake paediatric patients: a comparative study Archives of Disease in Childhood Published Online First: 14 December 2023 What’s it about? Article 1: What predicts parental anxiety in the Paediatric Emergency Department?

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

I sent it to 5 of my OMI friends without any clinical information or outcome and all 5 independently responded with exactly the same diagnosis: "reperfused inferior OMI". That is what Emergency Medicine is all about. == MY Comment , by K EN G RAUER, MD ( 9/3 /2023 ): == I’ve seen a “common theme” with many of the ECGs that Drs.

EKG/ECG 138

EKG/ECG Resuscitation CPR Emergency Department 138

RebelEM

AUGUST 31, 2023

CVC placement under ultrasound guidance has decreased overall complication rates and there is increased awareness of transfusion reactions, alloimmunization, acute lung injury, circulatory overload, as well as infection. Primary Outcome – Bleeding (Grade 2 to 4) Transfusion 4.8% N Engl J Med. later adjusted to INR > 3.0)

Ultrasounds 58

Ultrasounds Outcomes Wellness Research 58

Dr. Smith's ECG Blog

OCTOBER 18, 2023

1-3] But these studies were very short duration and used cardiology interpretation of ECGs or emergent angiography rather than patient outcomes. Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. have published a number of warnings about the previous reassuring studies.[4,5]

EKG/ECG 122

EKG/ECG Documentation/Coding Emergency Department Outcomes 122

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. Point-of-care ultrasound (POCUS) can evaluate for Achilles tendon rupture with a high sensitivity (96-100%) and specificity (83-100%) [8,9]. Accessed March 5, 2023.

Fractures 77

Fractures Dislocations Operations Radiology 77

PulmCCM

APRIL 1, 2024

Physical therapy is probably under-provided to critically ill patients, and improving this might improve outcomes for many. That could (and should) change if improved functional outcomes, persisting for months after hospital discharge, are ever confirmed in large, well-conducted trials.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

Don't Forget the Bubbles

SEPTEMBER 5, 2024

doi: 10.1136/archdischild-2023-326407. Obesity is considered a contributing factor for some musculoskeletal outcomes. The main outcome measure was a GP consultation with a recorded musculoskeletal symptom or diagnosis. 2023 Aug 23;11:1225087. 2023 Aug;108(8):632-639. doi: 10.1136/archdischild-2023-325343.

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52

Taming the SRU

JUNE 3, 2024

CESAR Trial Published in 2009 Found that even those who didn’t get ECMO, but were transported to a tertiary care center had better outcomes No matter where you go, critical care transport will be part of your life as a sending physician, receiving physician, or both.

Shock 91

Shock Seizures Airway Management Stroke 91

Taming the SRU

JANUARY 10, 2024

2768 aka the SAVE act (introduced for the 3rd time 9/12/2023) which establishes a new criminal offense for knowingly assaulting or intimidating hospital personnel during the performance of their official duties in a manner that interferes with their performance of the duties or limits their ability to perform the duties. 2663 & S.1176

EKG/ECG 93

EKG/ECG Shock Fractures Dislocations 93

EMDocs

FEBRUARY 26, 2024

4 Early diagnosis is key to allow for early treatment to improve outcomes. 15 Diagnostic considerations Timely diagnosis of PJP is absolutely essential for effective management and improved disease outcomes. Lung Ultrasound Effectively Detects HIV-Associated Interstitial Pulmonary Disease. A recent study by Gaborit et al.

Radiology 100

Radiology Radiology Outcomes Ultrasounds 100

ACEP Now

MAY 9, 2024

These questionable practices led to a rash of bad outcomes. 6 Theoretically, ultrasound guidance should decrease this risk, which formed the basis for the 2022 Florida Medical Board regulation. 7 The impact of this latest set of regulations on the complication rate has yet to be reported. References Garcia SE. Butt Lifts Are Booming.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Taming the SRU

OCTOBER 16, 2024

Ultrasound can be used to support the diagnosis by identifying anechoic or hypoechoic fluid within the flexor tendon sheath. Major contributing factors for poor outcomes in this patient population (Dalton et. These findings are highly sensitive (91-97%). X-ray imaging should be performed to evaluate for foreign body or bony injury.

Airway Management 74

Airway Management Fractures CDC Pediatrics 74

Don't Forget the Bubbles

FEBRUARY 5, 2024

Their main outcome measure was the proportion of pictures inconsistent with current safety recommendations. 2024 Jan 12:archdischild-2023-326225. 2024 Jan 23:archdischild-2023-325984. Are sucking patterns and early spontaneous movements related to later developmental functioning outcomes? Anagnostou A, et al. 2024 Jan 13.

Pediatrics 52

Pediatrics Research Resuscitation Psychiatric 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Managing pain in these patients is notoriously challenging but essential to prevent complications, facilitate physiotherapy, and improve outcomes. ED Physicians are already well-versed in the use of ultrasound. Abstract 2268 Table 1 Rib-fracture Data Set March 2022 – June 2023

Fractures 40

Fractures Anaphylaxis Emergency Department Ultrasounds 40

Stop and Think

MARCH 1, 2023

Then, in residency, in our outpatient clinics, consensus held that we should use hormone replacement therapy in post-menopausal women to reduce cardiac outcomes. The core problem we have in 2023 is that we have made so many gains that true progress is quite hard. The number needed to kill patients with this practice was 29.

Ultrasounds 52

Ultrasounds Outcomes 52

ACEP Now

NOVEMBER 16, 2023

The lack of differences in the observed outcomes do not suggest one EM training length is superior. The additional year may improve career trajectory or longevity, entrance into fellowship or academic practice, or other longer-term outcomes, including successful development of a niche in the specialty. Accessed October 9, 2023.

Academics 52

Academics EMS Telemedicine Research 52

Taming the SRU

FEBRUARY 19, 2024

This has been the central question of many research projects with variable outcomes. 12) Axillary While axillary arterial line placement has been uncommon, in the age of facile ultrasound operators it may become a more advantageous and accessible site particularly in patients with high BMIs. 2/19/2023 REFERENCES Sharman, J.E.,

Shock 59

Shock Resuscitation Ultrasounds Research 59

ACEP Now

JULY 7, 2024

1,3 Temporizing measures are not always possible for critically ill Grade IV patients, and outcomes are usually much worse. Published 2023 Apr 17. Diltiazem, nicardipine, and nitroprusside should be considered as adjuncts. Endovascular therapy for patients with heritable thoracic aortic disease. Ann Cardiothorac Surg. 2022;11(1):31-36.

Operations 59

Operations Hospitals Administration Outcomes 59

EMDocs

JANUARY 11, 2024

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association (AHA) and Neurocritical Care Society (NCS) released their 2023 Scientific Statement on the critical care management of post ROSC patients. 2023 Dec 1. Neurocrit Care. doi: 10.1007/s12028-023-01871-6. Epub ahead of print.

Seizures 87

Seizures Shock Infectious Diseases CPR 87

PEMBlog

FEBRUARY 22, 2024

Updated 2023 Jun 26]. And I mentioned it before and I’ll say it again, but intracranial bleeding is the worst possible outcome. So get a chest x-ray or an ultrasound, determine if there’s bleeding in the body cavities, you know, the chest or the abdomen. 1997 Jan;99(1). Kher P, Verma RP. In: StatPearls [Internet].

Pediatrics 72

Pediatrics Anaphylaxis Administration Wellness 72

Dr. Smith's ECG Blog

JANUARY 6, 2023

Smith comment: We have shown that use of opiates is associated with worse outcomes in ACS: Bracey, A. Smith comment: Point of Care ultrasound is not adequate to rule out wall motion abnormality; moreover, diffuse subendocardial ischemia often has no wall motion abnormality because the epicardium is still contracting. Abstract 556.

EKG/ECG 52

EKG/ECG Wellness Academics Ultrasounds 52

Dr. Smith's ECG Blog

FEBRUARY 23, 2023

Here is PM Cardio's Queen of Hearts interpretation (AI ECG interpretation trained by Meyers, Smith, and PM Cardio team using thousands of cases and their outcomes): The output number ranges from 0 to 1, with numbers closer to zero meaning likely NOT OMI, and numbers closer to 1 meaning OMI.

EKG/ECG 52

EKG/ECG Ultrasounds Outcomes Hospitals 52

Don't Forget the Bubbles

JUNE 14, 2023

2023 May;182(5):2077-2088. 2023 Jun;59(6):786-793. 2023 May 13. 2023 May 12:fetalneonatal-2022-324935. 2023 May 10. 2023 May;38(5):1411-1425. 2023 May;182(5):1965-1976. 2023 May;38(5):1449-1458. 2023 May;182(5):2027-2039. 2023 May 1;151(5):e2022058846. 2023 May 4;28(2):102-106.

Pediatrics 119

Pediatrics Point-of-Care Testing Outcomes Hospitals 119