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 125

Academics Outcomes Wellness 125

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 96

Stroke Academics Outcomes Administration 96

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 145

Patient Safety Academics Outcomes Wellness 145

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 97

Administration Outcomes Research COPD 97

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 119

EKG/ECG Documentation/Coding Patient Safety Outcomes 119

ALiEM

OCTOBER 30, 2023

Those who take the academic route face unclear promotion expectations, uncertainty about their niche, and a double-whammy of high clinical burden and a tacit expectation that you “prove” your worth as a teacher by taking on more tasks before being rewarded with salary support. But what can Dr. Garcia – or you – do?

Academics 64

Academics Leadership Wellness Research 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 Pediatrics Outcomes 145

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

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 91

Seizures Administration Anaphylaxis Outcomes 91

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 108

Stroke Academics Outcomes Shock 108

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 122

CDC Radiology Radiology Head Injuries 122

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

Sensible Medicine

SEPTEMBER 12, 2024

We find the letter to be well-argued. 3 Another meta-analysis in HF patients indicated that higher doses of ACEIs and ARBs, compared to lower doses, significantly improved outcomes. 4 The study's open-label design increases the risk of differential misclassification of outcomes and performance biases. References 1. Am Heart J.

Academics 64

Academics Outcomes Hospitals Wellness 64

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 94

Sepsis Research Stroke Academics 94

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

Don't Forget the Bubbles

AUGUST 2, 2023

Early management leads to better outcomes. Children and their families should undergo a psychological assessment to understand and properly address possible individual, familial, social or academic issues. Outcomes of children with complex regional pain syndrome after intensive inpatient rehabilitation. Audouin-Pajot C.,

Psychiatric 98

Psychiatric Pediatrics Outcomes Fractures 98

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 94

Leadership EMS Pediatrics Stroke 94

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

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 Emergency Department 52

Sensible Medicine

JUNE 6, 2023

Two nearly identical trials of the monoclonal drug aducanumab, ENGAGE and EMERGE, had disparate outcomes: ENGAGE showed no benefit and EMERGE showed that the drug slowed decline. This seemed important to consider, and so we looked at whether outcomes in trials of monoclonal antibodies for AD correlated with rates of ARIA.

Outcomes 96

Outcomes Infectious Diseases Research Academics 96

EMDocs

OCTOBER 30, 2023

Background and Context Contrast-enhanced computed tomography (CECT) is of paramount importance in the emergency department (ED) due to its indispensable role in facilitating precise diagnostic outcomes. Some institutions developed a tier-based system for outpatient imaging as well which was updated in real-time. West J Emerg Med.

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

Dr. Smith's ECG Blog

AUGUST 2, 2024

The LCx and OM branches are not as well seen. the investigators reviewed outcomes in 118 patients presenting with NSTEMI. This is the right anterior oblique cranial view Here is a representative still. This shot is typically best for viewing the LAD and its diagonal branches. There is non-obstructive disease here.

EKG/ECG 119

EKG/ECG Fluid Resuscitation Academics Resuscitation 119

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 EMS Stroke 52

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

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

Sensible Medicine

AUGUST 4, 2024

Before reading the article closely, I assumed that the results reflected the fact that our treatments for breast cancer have gotten so good that it is less important to prevent a breast cancer as it is to treat it well. ” To argue against this in polite, academic medicine company is to risk censure.

Academics 103

Academics Outcomes Wellness 103

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 Pediatrics Outcomes Documentation/Coding 75

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 76

Operations Wellness Academics Ultrasounds 76

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

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

Sensible Medicine

OCTOBER 4, 2023

The device becomes a screening test or provides information to “promote wellness.” Perhaps the most well-known example happened when the nature of primary hyperparathyroidism changed with the advent of automated multi-channel chemistry tests. Devices used to monitor disease in patients often get marketed to healthy people.

Research 86

Research Outcomes Stroke Academics 86

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

The Skeptics' Guide to EM

JANUARY 20, 2018

She has contributed to the Academic Life in Emergency Medicine and EM PharmD blogs, […] The post SGEM#203: Let Me Clear My Sore Throat with a Corticosteroid first appeared on The Skeptics Guide to Emergency Medicine. She has contributed to the Academic Life in Emergency Medicine and EM PharmD blogs, and is a part of the ALiEM Capsules Team.

Academics 52

Academics Emergency Department EMS Administration 52

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

Dr. Smith's ECG Blog

MAY 31, 2023

It is one of the few OMI patterns that is really well described: de Winter’s T-waves. Here is her astonishing reply: "Well, they still haven’t taken her to the Cath Lab yet!!!! Opiates are associated with worse outcomes in Myocardial Infarction. Academic Emergency Medicine 27(S1): S220; May 2020. Trop at 5000 by now."

EKG/ECG 96

EKG/ECG Outcomes Academics Wellness 96

Sensible Medicine

MARCH 14, 2024

I’ve heard arguments that frame this discussion in terms of trainee wellness, physician burnout, social contract, and patient outcomes. In short, it’s a mistake to picture medical students on their wellness days off just “kicking their feet up.” The result? Burnout rates have never been higher.

Hospitals 97

Hospitals Wellness Fractures Academics 97

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