Don't Forget the Bubbles

MAY 6, 2024

Outcomes included clinical status when urine culture was available, subsequent antibiotic treatment within seven days and subsequent UTI within 30 days. The primary outcome was the successful intubation on the second attempt. Secondary outcomes included tracheal intubation adverse events (TIAEs) or severe desaturation.

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

Taming the SRU

APRIL 17, 2024

3) Methods This study was a retrospective observational study at a single academic tertiary care facility in their medical intensive care unit (MICU). The primary outcome was defined as agreement of less than 10 % of the mean arterial pressure (MAP) between simultaneously recorded IABP and NIBP measurements. Crit Care Med.

Sepsis 92

Sepsis Research Stroke Outcomes 92

Stop and Think

JUNE 13, 2023

It’s shocking how many have subscribed and supported this newsletter. One of my colleagues, a former academic, who is now in industry, tells me I shouldn’t have this chapter. If the much larger trial could not show a statistically significant benefit in outcomes, how could a trial 1/10th the size tell us much?

Outcomes 98

Outcomes Academics Hospitals Shock 98

RebelEM

JUNE 8, 2023

Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose. PMID: 36108346 Clinical Question: What is the efficacy and safety of peripherally administered push dose pressors for the treatment of acute hypotension?

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

The Skeptics' Guide to EM

DECEMBER 11, 2021

. * Fujii et al ( VITAMINS RCT) JAMA 2020: n=216 patients with septic shock. No statistical difference in their primary outcome for duration of time alive and free of vasopressor administration up to day 7 or the secondary outcome of 90-day mortality. Moskowits et al ( ACTS RCT) JAMA 2020: n=205 patients with septic shock.

Sepsis 40

Sepsis Shock Outcomes Research 40

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Outcomes 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

He heads curriculum and conference for the academic year and is passionate about resident […] The post SGEM#344: We Will…We Will Cath You – But should We After An OHCA Without ST Elevations? She arrives in the emergency department (ED) with decreased level of consciousness and shock.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

PulmCCM

DECEMBER 3, 2023

academic centers received an additional sigh breath every 6 minutes. The short answer is, ventilator-free days combine two outcomes (extubation and mortality); all the patients who survived together generated thousands of ventilator-free days, which in this study, were roughly equal between groups.

Poisoning 64

Poisoning Outcomes Hospitals Academics 64

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. 4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. This is a critical error that leads to poorer outcomes for patients in need of critical care.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

The Skeptics' Guide to EM

DECEMBER 7, 2018

He is unsuccessfully shocked. There was also no increase in survivors with good neurological outcomes with ACLS. We reviewed the Cournoyer et al cohort study as part of the #SGEMHOP series with Academic Emergency Medicine ( AEM ). A cardiac defibrillator is hooked up and the patient is in ventricular fibrillation.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

The notes now refer to the patient being in cardiogenic shock, on pressors. hours from presentation, where he was found to have an acute thrombotic LAD occlusion which was stented with resulting TIMI 3 flow, but still the patient was in severe cardiogenic shock. Academic Emergency Medicine 27(S1): S220; May 2020.

EKG/ECG 83

EKG/ECG Shock Documentation/Coding Academics 83

Dr. No

DECEMBER 6, 2021

In the limp language of academic writing, the authors suggest their findings ‘urge caution’ (sic) in interpretation of small differences, and that ‘bias-susceptible endpoints…should be used with care’ Translating into plain English, the masks don’t work, and the mandates should go.

Academics 52

Academics Outcomes Shock Wellness 52

PHEM Cast

APRIL 10, 2016

This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. Arriving by Emergency Medical Services Improves Time to Treatment Endpoints for Patients With Severe Sepsis or Septic Shock. Academic Emergency Medicine.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

ALiEM

JULY 17, 2023

Match Data The unprecedented numbers of unfilled PGY-1 EM residency training positions in the NRMP Match results shocked the specialty these last two years. Our deep dive into the factors contributing to these outcomes shed light on several program characteristics associated with unfilled positions.

EMS 52

EMS Burns Emergency Department Shock 52

Dr. Smith's ECG Blog

OCTOBER 6, 2023

This is one case where it made a difference: Right Ventricular MI seen on ECG helps Angiographer to find Culprit Lesion Nevertheless, it is sometimes a fun academic exercise to try to predict the infarct artery: An elderly patient had onset of chest pain one hour prior. Thus, this ECG predicts poor myocardial perfusion and poor outcome.

EKG/ECG 66

EKG/ECG Academics Shock Outcomes 66

Taming the SRU

MAY 3, 2023

Ultimately, on the cusp of deterioration, the patient was deemed most appropriate for transfer to a medical intensive care unit (MICU) at a large academic hospital via helicopter emergency medical services (HEMS). A follow-up chest x-ray at that time revealed pneumomediastinum, and she was started on broad-spectrum antibiotics.

Wellness 52

Wellness Hospitals Shock Outcomes 52

Taming the SRU

AUGUST 30, 2023

A 2011 meta-analysis in the journal of Academic Emergency Medicine found ESR, CRP, and PCT were not acutely useful in the diagnosis of septic arthritis due to wildly varying sensitivities and specificities between studies. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

The axiom of "type 1 (ACS, plaque rupture) STEMIs are not tachycardic unless they are in cardiogenic shock" is not applicable outside of sinus rhythm. Again, not an expected outcome with diltiazem). I limit my comments to a number of academic and semantic concepts relating to the arrhythmia in this case: What is an “SVT”?

EKG/ECG 52

EKG/ECG Wellness Administration Academics 52

RebelEM

DECEMBER 19, 2022

This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. Background Information: Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF).

EMS 52

EMS CPR Shock Resuscitation 52

Don't Forget the Bubbles

DECEMBER 11, 2023

This is shocking, but they discovered a staggering dose-response model when they compared these results with medical histories. However, the ACE score was never intended to be used individually but to highlight the links between childhood adversity and lifelong healthcare outcomes and thus provide a measure of risk.

Wellness 104

Wellness Research Outcomes Shock 104

EB Medicine

JULY 8, 2019

Jeff: And while it’s not exactly core EM, we’re going to briefly discuss indications for bariatric surgery, as this is something we don’t often review even in academic training programs. Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

EMDocs

NOVEMBER 13, 2023

2 Outcomes of patients presenting with ischemic stroke who received MRI as initial imaging modality have demonstrated similar outcomes to those with initial CTA, with Kim et al. demonstrating that functional outcome at 3 months did not differ between the CTA and MRI groups (38.5% vs. 38.1%) with a good functional outcome.

Stroke 86

Stroke Radiology Radiology Emergency Department 86