EMDocs

JUNE 29, 2024

Spoon Feed This secondary analysis of the DOSE VF trial found that DSED (dual sequence external defibrillation) was the superior strategy for obtaining ROSC and functional neurologic outcome regardless of whether the patient was in recurrent VF or shock-refractory VF after three standard defibrillation shocks.

Shock 95

Shock Emergency Department Administration Resuscitation 95

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. However, rapid initiation of treatment is actually patient-centered care that can both lead to better outcomes and limit ED boarding.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

RebelEM

JULY 3, 2023

Impact of intravenous calcium with diltiazem for atrial fibrillation/flutter in the emergency department. Am J Emerg Med. What They Did: Researchers conducted a multicenter, retrospective cohort study in three community hospitals and two freestanding emergency departments. Article: Rossi N et al. received CaCl 89.3%

Administration 96

Administration Outcomes Documentation/Coding Emergency Department 96

ACEP Now

MARCH 11, 2025

Many patients with PE can be discharged directly from the emergency department (ED). 1 Further, a Cochrane review found that LMWH is associated with improved outcomes compared with UFH including reduced incidence of major hemorrhage (odds ratio [OR]=0.69; 95 percent CI, 0.50-0.95) Ann Emerg Med. 2024;84(5):518-529.

Hospitals 52

Hospitals Administration Outcomes Stroke 52

EMDocs

AUGUST 24, 2023

Study design Multicenter prospective observational cohort study across seven urban emergency departments. Blood cultures were collected from patients before the admiration of antibiotics (gold standard), and then again 30 – 120 min following administration of antibiotics. Difference of 12% (95% CI 5.4 Ann Intern Med.

Administration 94

Administration Sepsis Shock Emergency Department 94

RebelEM

SEPTEMBER 29, 2022

Background: Standard emergency department management of acute pancreatitis has focused on aggressive hydration, analgesia and investigation for an underlying reversible cause (eg gallstones). Outcomes: Primary: Progression to moderately severe or severe acute pancreatitis (according to the Revised Atlanta Classification).

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

RebelEM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

The Skeptics' Guide to EM

JUNE 17, 2023

Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Date: June 15, 2023 Reference: Rees CA et al. Date: June 15, 2023 Reference: Rees CA et al. Reference: Rees CA et al.

Emergency Department 74

Emergency Department Pediatrics Head Injuries Administration 74

RebelEM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. RSI inherently carries with it risks of complications such as post-intubation hypotension and cardiac arrest in the most extreme cases.

Outcomes 97

Outcomes Emergency Department Administration Resuscitation 97

EMDocs

SEPTEMBER 30, 2024

Inhaled Corticosteroids Rarely Prescribed at Emergency Department Discharge Despite Low Rates of Follow-Up Care. J Emerg Med. The primary outcome was hospital admission rates. The primary comparison was between administration of ICS in addition to systemic corticosteroids (SCS) and to SCS alone.

Outcomes 105

Outcomes Academics Documentation/Coding Emergency Department 105

RebelEM

APRIL 29, 2024

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. World J Emerg Surg 2023 PMID: 36918947 3. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med 2009 PMID: 20157465 4. Ngo AS, Oh JJ, Chen Y, Yong D, Ong MEH.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

ACEP Now

DECEMBER 6, 2024

Repeat ECG following return of spontaneous circulation after administration of intravenous nitroglycerin. The decision was made to communicate directly with the on-call interventional cardiologist with specific and direct intent to discuss the administration of intravenous (IV) NTG. Click to enlarge.) What Would You Do Next?

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

The Skeptics' Guide to EM

AUGUST 24, 2024

Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle. Reference: Partyka et al.

Fractures 54

Fractures Emergency Department Ultrasounds Radiology 54

ACEP Now

OCTOBER 10, 2024

RICH MCCORMICK, MD, is a veteran and emergency physician who serves Georgia’s 6th Congressional District in the United States House of Representatives. Between deployments, Dr. McCormick earned his Master of Business Administration from National University and medical degree from Morehouse School of Medicine in Atlanta.

Telemedicine 105

Telemedicine Critical Access Hospitals Emergency Department 105

ACEP Now

AUGUST 22, 2023

Intravenous insulin shifts potassium into cells, thereby lowering serum potassium within an hour of administration. A Common Case Hypoglycemia following insulin administration for hyperkalemia is common, occurring in approximately one in six patients (about 17 percent). Am J Emerg Med. Eur J Emerg Med. 2019;37(2):209-213.

Emergency Department 52

Emergency Department Administration Outcomes Research 52

The Skeptics' Guide to EM

FEBRUARY 27, 2021

Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Rapid Administration of Methoxyflurane to Patients in the Emergency Department (RAMPED): A Randomised controlled trial of Methoxyflurane vs Standard care. Reference: Brichko et al. Reference: Brichko et al. AEM Feb 2021.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Administration Research 52

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. Increased Computed Tomography Utilization in the Emergency Department and Its Association with Hospital Admission.

Radiology 99

Radiology Radiology Emergency Department Hospitals 99

The Skeptics' Guide to EM

JUNE 6, 2020

Max Hockstein trained as an Emergency Medicine physician at University of Texas Southwestern and is finishing his Intensive Care fellowship at Emory. Case: It’s another day in your emergency department (ED). However, it has become evident that patients are often over-resuscitated with IV fluids which adversely impacts outcome.

Sepsis 52

Sepsis Shock Resuscitation Administration 52

The Skeptics' Guide to EM

JUNE 24, 2018

Safety and Efficacy of Intravenous Lidocaine for Pain Management in the Emergency Department: A Systematic Review. Ann Emerg Med. 2018 Guest Skeptics: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. Ann Emerg Med.

Emergency Department 52

Emergency Department Administration Outcomes Research 52

ACEP Now

AUGUST 1, 2023

How does that apply to the role of the board certified emergency physician? Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. When those same fundamentals done right achieve great success, they aren’t little at all.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. hypertensive emergency, need for thrombolytic administration) [1]. Lowering the MAP may mitigate these risks and possibly improve outcomes.

Stroke 99

Stroke Outcomes EMS Seizures 99

The Skeptics' Guide to EM

AUGUST 22, 2020

He is also the CME editor for Academic Emergency Medicine. Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Exam, Labs, Imaging Accuracy and Biases. He is also the CME editor for Academic Emergency Medicine. Reference: Carpenter et al. Reference: Carpenter et al. Reference: Carpenter et al.

Emergency Department 52

Emergency Department Academics Research Administration 52

The Skeptics' Guide to EM

SEPTEMBER 26, 2020

Case: A 34-year-old male presents to the emergency department with burning epigastric pain after eating two hours ago. Background: Patients presenting to emergency departments (EDs) with epigastric pain are typically treated with an antacid, either alone or combined with other medications. AEM Sept 2020. AEM Sept 2020.

Emergency Department 52

Emergency Department Burns Outcomes Administration 52

RebelEM

MARCH 23, 2023

The primary outcome, hospital length of stay, was significantly shorter both before and after propensity score adjustment for the phenobarbital group. The 30-day emergency department readmission rate and all-cause 30-day readmission were significantly lower only when adjusted for propensity scores.

Emergency Department 52

Emergency Department Outcomes Burns Hospitals 52

Emergency Medicine Journal

JUNE 22, 2023

The main outcome measures were ambulance transport, lumbar imaging, opioid administration and hospital admission. We included adult patients diagnosed with non-serious low back pain at ED discharge. CALD status was defined by country of birth, preferred language and use of interpreter service.

Emergency Department 40

Emergency Department Administration Hospitals Outcomes 40

The Skeptics' Guide to EM

DECEMBER 25, 2021

The patient is transported to the emergency department with vital signs absent (VSA). Clinical Question: Does administration of calcium during out-of-hospital cardiac arrest improve sustained return of spontaneous circulation? Intraosseous access is quickly obtained, and a dose of epinephrine is provided.

CPR 52

CPR Administration Outcomes Hospitals 52

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Case: You’re working a shift in a rural emergency department when a 68-year-old man presents with a two-day course of worsening cough, shortness of breath, and fever. In acutely ill adults, this same concept is not yet as widespread and liberal administration is still common place. This is Bob’s ninth visit to the SGEM.

Poisoning 52

Poisoning Administration Hospitals Sepsis 52

The Skeptics' Guide to EM

DECEMBER 15, 2018

He specialises in Paediatric Emergency Medicine and is a passionate believer that education exists to be shared (#foamed). The primary outcome was the FART (Found and Retrieved Time) score. The seizure lasted no more than a minute and now having been in the department for a couple of hours the infant is back to their normal selves.

Seizures 52

Seizures Pediatrics Emergency Department Administration 52

Don't Forget the Bubbles

OCTOBER 2, 2024

A previously well 6-year-old boy is brought into the emergency department at a major trauma centre via HEMS following a road traffic accident, in which he was hit by a car while crossing the road. No studies involving mannitol administration met the foundation’s inclusion criteria. A full primary survey is carried out.

Administration 49

Administration Pediatrics Outcomes Research 49

The Skeptics' Guide to EM

APRIL 25, 2020

Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke. He has been practicing in Emergency Medicine for over 40 years and involved in EMS services for over 30 years.

Stroke 40

Stroke Emergency Department Outcomes Administration 40

EB Medicine

AUGUST 6, 2019

In the end, they reported similar rates of recurrence and bleeding outcomes for acute treatment. Make sure to get the name, dose, and time of last administration of any DOAC. Nachi: Though you can, in theory, test for plasma DOAC concentrations, such tests are not routinely indicated as levels don’t correspond to bleeding outcomes.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

The Skeptics' Guide to EM

JANUARY 20, 2018

Background: Patients present commonly to their primary care providers (PCPs) and to the emergency department (ED) with complaints of a sore throat. However, previous systematic review and meta-analyses have been confounded by co-administration of antibiotics and analgesics, as well as variability in measures of efficacy among studies.

Academics 52

Academics Emergency Department EMS Administration 52

EMDocs

OCTOBER 21, 2023

The NIHSS cutoff that predicts outcomes is 4 points higher in AC compared with PC infarctions. Basilar artery occlusion remains a challenging diagnosis to make, and the delays in reaching the diagnosis can have considerable impact on health outcomes. NIHSS does have limitations when applied to posterior circulation (PC) strokes.

EMS 97

EMS Stroke Outcomes Hospitals 97

The Skeptics' Guide to EM

JUNE 5, 2021

Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis on Functional Outcome Among Patients With Acute Ischemic Stroke: The SKIP Randomized Clinical Trial. JAMA 2021 Case: A 74-year-old woman presents to your emergency department with 1.5 References: * Suzuki et al. JAMA 2021 * Zi et al.

Stroke 52

Stroke Urgent Care Critical Access Outcomes 52

RebelEM

JANUARY 23, 2023

Health care professional involved in patient management and outcome assessment was completely blinded. Multicenter study of emergency department visits for insect sting allergies. Multicenter study of emergency department visits for food allergies. Patients were randomized in a 1:1 ratio. J Allergy Clin Immunol.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

The Skeptics' Guide to EM

SEPTEMBER 16, 2017

Your resident tells you that they recently read an article in the NEJM that argued for the administration of icatibant to usher along resolution of symptoms in ACE-I induced angioedema and asks whether you should consider this treatment. Background: ACE-I are prescribed to millions of patients in the US. Reference: Sinert et al.

Anaphylaxis 52

Anaphylaxis Administration EMS Emergency Department 52

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Case: A 6-month-old boy presents to the emergency department (ED) with three days of worsening cough, cold symptoms, and fever. Sodium bicarbonate administration will increase the pH. * Pediatric Crit Care Med. Parents note that he has been progressively more tired and difficult to arouse. But it’s not that straightforward.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52