Sensible Medicine

NOVEMBER 28, 2023

For many doctors in academic medicine, publishing in peer reviewed journal is an important part of their careers. People can rise through the academic ranks as gifted clinicians, creative and effective educators, and talented administrators. [i] Being perfectly honest, not all the articles have aged well.

Stroke 83

Stroke Academics Outcomes Administration 83

Stop and Think

JANUARY 14, 2024

Since Andrew Foy and I wrote our Case Against Coronary Artery Scans in an academic journal, the test has only increased in popularity. The academic proponents of CAC scans strongly recommend CAC scans only to guide decision-making about using primary prevention therapies, such as statin drugs, in medium risk people. Pause there.

Academics 122

Academics Outcomes Wellness 122

SheMD

MAY 4, 2023

80% of department chair roles in academic medicine are held by men. Article Summary What they looked at: This article aimed to look at career trajectory differences between genders in faculty who have attained academic chair roles in emergency medicine. Why do we care about this article? How does this apply to us?

Leadership 52

Leadership Academics Operations Administration 52

Pediatric EM Morsels

JULY 21, 2023

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. A practical scale. PMID: 4136544.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

RebelEM

SEPTEMBER 14, 2023

to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% Control: 53.4% D ECLS: 18.2% Control 8.7% Control 38.0% Control: 49.0% RR 0.98; 95% CI 0.80 to 1.19; p = 0.81

Shock 137

Shock Outcomes Resuscitation Stroke 137

SheMD

AUGUST 24, 2023

Medical specialty society membership can have an impact on the development of an academic physician’s career through networking, speaking opportunities, and awards. Underrepresentation of female faculty members may be an obstacle to career advancement in academic medicine. Why is this article important? Am J Clin Pathol. 2022.40001.

Leadership 52

Leadership Academics Outcomes Wellness 52

ACEP Now

JULY 7, 2024

My current practice is a hybrid of academic and community sites, and I have worked in myriad community hospitals from busy ones to single coverage critical access hospitals. You are well prepared for this. Lead your room well. If the resuscitation does not go as well as you wanted, learn from it and move on.

Resuscitation 98

Resuscitation Risk Management Hospitals Critical Access 98

Dr. Smith's ECG Blog

MARCH 14, 2024

Written by Jesse McLaren Three patients presented with acute chest pain and ECGs that were labeled by the computer as completely normal, and which was confirmed by the final cardiology interpretation (which is blinded to patient outcome) also as completely normal. It is well known that NOMI usually has a normal ECG or nonspecific ECG.

EKG/ECG 108

EKG/ECG Documentation/Coding Patient Safety Outcomes 108

Sensible Medicine

AUGUST 21, 2023

On yesterday’s podcast , I talked with Bobby Yeh, an academic cardiologist who made a compelling case for enhancing credibility of observational research. Another problem, which is possibly surmountable, is the conflation of what one can call “patient outcomes” versus “doctor outcomes.”

Administration 89

Administration Outcomes Research COPD 89

Sensible Medicine

SEPTEMBER 23, 2024

They also found that the largest difference between truncated and nontruncated trials occurred when the truncated trials had fewer than 500 outcome events. The rate of the composite primary outcome of CV death, MI, unstable angina, stroke or transient attack was 4.29% with asa vs 4.48% with placebo. The six-year trial was not stopped.

Stroke 92

Stroke Academics Outcomes Shock 92

The Skeptics' Guide to EM

APRIL 29, 2023

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. Clinical Question: What is the effect of TMH, versus in-person consult, on 30-day outcomes and processes of care during the visit? Yes * Was the outcome accurately measured to minimize bias?

Psychiatric 40

Psychiatric Emergency Department Urgent Care Academics 40

Sensible Medicine

APRIL 14, 2024

Including: The academic speakers— who often consult for the drug companies and receive sizable personal payments. Medicine has become a financial commodity with the rare adverse event of better health outcomes. A few companies will get rich doing this, and many well-intentioned people will be cheering us over the cliff.

Patient Safety 143

Patient Safety Academics Outcomes Wellness 143

The Skeptics' Guide to EM

NOVEMBER 26, 2022

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. Deaf and hard-of-hearing (DHH) experience disparities in social outcomes as well as health inequities (1), likely due to audism, which creates privilege for non-DHH people in our society (2).

Academics 40

Academics Emergency Department Research Outcomes 40

Mind The Bleep

OCTOBER 22, 2024

Whether you enjoy working in the high-stakes setting of a cath lab or improving patient outcomes through prevention and rehabilitation, cardiology offers something that aligns with your interests and career aspirations. Research remains encouraged within cardiology, and there will be an opportunity to develop a range of academic interests.

Evidence-Based Practice 52

Evidence-Based Practice Academics Operations Hospitals 52

ALiEM

NOVEMBER 6, 2023

WPW Syndrome consists of characteristic EKG findings as well as symptomatic arrhythmias. Outcome and use of antiarrhythmic drugs during follow-up. WPW is a pre-excitation syndrome characterized by an accessory pathway caused by a congenital failure of cells to resorb near the AV valves. Crit Care Nurse. 1994 Jun;14(3):30-9; quiz 40-1.

EKG/ECG 78

EKG/ECG Academics Outcomes Wellness 78

SheMD

JULY 27, 2023

What were their outcomes: Physician mothers report having more domestic responsibilities than their partners. Unequal distribution of domestic responsibility has been documented as a factor in the underrepresentation in female physicians in leadership roles in academic medicine as well as contributing to career satisfaction.

Academics 52

Academics Leadership Documentation/Coding Research 52

PulmCCM

DECEMBER 18, 2023

In a large, complicated pragmatic cluster-crossover study at a single academic center, there was no difference in any meaningful outcome (death, ventilator-free days, or severe complications) between patients randomized to an oxygen saturation target of 90%, 94%, or 98%. NICO trial ) Does oxygen target matter?

Outcomes 52

Outcomes Academics Wellness 52

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 4, 8 Paper: Dahyot-Fizelier, C., Included traumatic and nontraumatic brain injuries.

CDC 126

CDC Outcomes Radiology Radiology 126

Taming the SRU

FEBRUARY 24, 2024

Early recognition and prompt treatment is key. non-invasive positive pressure ventilation and IV nitroglycerin infusion have been shown to reduce morbidity (intubation rates, ICU admission) & mortality.

Leadership 92

Leadership EMS Pediatrics Stroke 92

Stop and Think

JUNE 13, 2023

One of my colleagues, a former academic, who is now in industry, tells me I shouldn’t have this chapter. In PARAGON-HF, the new drug reduced a composite primary outcome of heart failure events and death from cardiovascular causes but the reduction failed to meet statistical significance. PARAGON-HF randomized 10x more.)

Outcomes 98

Outcomes Academics Shock Hospitals 98

Northwestern EM Blog

SEPTEMBER 26, 2022

It is well-documented that ED physicians have historically high rates of burnout compared to other specialties as well as a high incidence of post-traumatic stress disorder (PTSD) compared to the general population. PTSD is 2 times more prevalent in physicians (14.8%), with EM resident physicians falling in the range from 11.9%-21.5%.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

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.

Sepsis 92

Sepsis Research Stroke Academics 92

EMDocs

MAY 25, 2023

Outcome: No statistically significant difference in primary outcome, which was absence of clinically apparent seizures without the need for additional anti-convulsant medications AND improving responsiveness at 60 minutes after the start of trial-drug infusion, as determined by the treating physician.

Seizures 63

Seizures Administration Anaphylaxis Outcomes 63

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

The Skeptics' Guide to EM

MAY 30, 2020

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. The evidence for TXA providing a patient-oriented outcome (POO) has been mixed. AEM May 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is hypotensive and tachycardic.

Head Injuries 52

Head Injuries Academics Outcomes EMS 52

ALiEM

DECEMBER 8, 2023

Major risk factors for their development include prior abdominal surgeries that weaken the musculature as well as cardiovascular co-morbidities. Incidence, etiology, management, and outcomes of flank hernia: review of published data. PMID: 32310432. Zhou DJ, Carlson MA. 2018 Apr;22(2):353-361. doi: 10.1007/s10029-018-1740-1.

Academics 60

Academics Emergency Department Outcomes Wellness 60

ALiEM

JANUARY 29, 2024

It requires immediate consultation with ophthalmology as well as neurology as it is considered a stroke equivalent. Case Question: What treatments can you perform in the ED for this diagnosis and do they improve outcomes? This has the potential to expedite consultations with specialty teams and treatment. 39,1 (2020): 197-202.

Stroke 64

Stroke Ultrasounds Academics Outcomes 64

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 Outcomes Pediatrics 145

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

ALiEM

AUGUST 21, 2023

Risk factors for poor outcomes include immunocompromise (HIV, diabetes, immunosuppression), intravenous drug use, peripheral vascular disease, and polymicrobial infection. Treatment includes emergent consultation with orthopedics or hand surgery as well as early initiation of IV antibiotics. References Ritter K, Fitch R. Tenosynovitis.

Academics 52

Academics Outcomes Hospitals Wellness 52

The Skeptics' Guide to EM

AUGUST 22, 2020

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. This review discusses the diagnostic accuracy of rt-PCR for COVID-19, as well as signs, symptoms, imaging, and other laboratory tests. Reference: Carpenter et al. Reference: Carpenter et al.

Emergency Department 52

Emergency Department Academics Research Administration 52

PulmCCM

DECEMBER 12, 2023

academic centers received an additional sigh breath every 6 minutes. Well, that would be ground-breaking and practice-changing, to say the least. Could there be benefit from simulating the natural episodic physiologic sighs we all perform during spontaneous breathing? The SiVent trial, reported in JAMA, tested this hypothesis.

Academics 52

Academics Outcomes Hospitals Wellness 52

Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

It radiated to both shoulders and both upper extremities, and there was shortness of breath and diaphoresis as well. Long term outcome unknown but obviously bleak. Association of intravenous morphine use and outcomes in acute coronary syndromes: Results from the CRUSADE Quality Improvement Initiative. Am Heart J. Abstract 556.

EKG/ECG 78

EKG/ECG Outcomes Academics Documentation/Coding 78

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

The Skeptics' Guide to EM

DECEMBER 12, 2020

She is systemically well and there is no sign of tracking, so you decide to perform incision and drainage in the ED. Secondary Outcomes: Ease of procedure, pain at the time of treatment, ease of care at 36 hours, pain at 36 hours. . Dr. Ladde is in an active academic emergency physician working at Orlando R.

Operations 52

Operations Outcomes Research Academics 52

Sensible Medicine

MAY 31, 2024

This is not to say that I always agree with the process or outcomes of medical decision-making. Second guessing, also called post-call quarterbacking, is alive and well in medicine and, when done thoughtfully, can be a great way to teach and learn. At most academic medical centers, doctors are salaried. The patient did well.

Operations 67

Operations Wellness Academics Ultrasounds 67

PulmCCM

DECEMBER 3, 2023

academic centers received an additional sigh breath every 6 minutes. Well, that would be ground-breaking and practice-changing, to say the least. However, the hard outcomes data (did intubation occur or not, did anyone die, and how long were they in the hospital) are persuasive. vs 17.6%) in the sigh-ventilation group!

Poisoning 64

Poisoning Outcomes Hospitals Academics 64