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 69

Administration Sepsis Shock Outcomes 69

EMDocs

MAY 25, 2023

mg/kg or 10 mg Seizures must persist for at least 5 minutes after administration of the prespecified benzodiazepines. In light of these data, I will give levetiracetam due to its less severe side effects and ease of administration. mg/kg or 10 mg Intravenous lorazepam 0.1 mg/kg or 4 mg Intravenous midazolam 0.2

Seizures 64

Seizures Administration Outcomes Anaphylaxis 64

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

JULY 20, 2024

Case: A 70-year-old man presents to the emergency department (ED) with an exacerbation of COPD. This process involves the administration of supplemental oxygen before the induction of anesthesia to increase the oxygen reserves in the lungs, thereby reducing the risk of hypoxemia.

COPD 93

COPD Patient Safety Administration Emergency Department 93

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

Cook County EM Blog

APRIL 27, 2022

Effectiveness and safety of droperidol in a United States emergency department. Am J Emerg Med. 2019.09.007 What : Retrospective cohort study of all droperidol administrations between January 2012 and April 2018 at an academic and pediatric emergency department in the US with 77,000 annual visits.

Administration 52

Administration EKG/ECG Emergency Department EMS 52

The Skeptics' Guide to EM

APRIL 29, 2023

The effect of telemental versus in-person mental health consults in the emergency department on 30-day utilization and processes of care. AEM April 2023 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Reference: Han et al.

Psychiatric 40

Psychiatric Emergency Department Urgent Care Academics 40

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 102

Resuscitation Administration Emergency Department Hospitals 102

PulmCCM

NOVEMBER 6, 2023

TEG or ROTEM) is becoming a more widely used tool to help guide the administration of blood products in hemorrhage from trauma, although its effects on meaningful clinical outcomes remain uncertain. The intervention took place in the emergency department, with device placement by ED physicians. Thromboelastometry (e.g.,

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

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 Hospitals Burns 52

Don't Forget the Bubbles

OCTOBER 4, 2023

In the same journal , we learned that in fetuses with transposition of great arteries (TGA), a better prenatal diagnosis led to poorer early postoperative outcomes. A Randomized Controlled Trial of a NICU Language Intervention for Parents of Preterm Infants and Two-Year Language Outcomes. As always, more research seems needed.

Pediatrics 111

Pediatrics Fractures Outcomes Research 111

The Skeptics' Guide to EM

MARCH 18, 2023

Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. She is also the […] The post SGEM #397: Give a Little Bit…of Oseltamivir to Pediatric Patients Admitted with Influenza first appeared on The Skeptics Guide to Emergency Medicine. JAMA Pediatr. JAMA Pediatr. JAMA Pediatr.

Pediatrics 40

Pediatrics Infectious Diseases Administration Outcomes 40

Taming the SRU

MAY 5, 2023

doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. Each subsequent one-hour delay in antimicrobial administration increases mortality by 35% in patients with septic shock (Im, Kang et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 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 Administration Emergency Department Research 52

ACEP Now

JULY 7, 2023

CASE A 30-year-old woman presents to the emergency department with left arm pain from a chronic wound. Since 2020 to 2021, the Drug Enforcement Administration has reported a sharp rise in xylazine use across the U.S., Dr. Marco is professor of emergency medicine at Penn State Health Milton S. Click to enlarge.)

Forensics 98

Forensics Airway Management Administration Emergency Department 98

Taming the SRU

JUNE 12, 2023

Although not every person seeks health care for these injuries, the majority of those that do end up in the emergency department. In 2008, this led to greater than 316,000 emergency department (ED) visits and about 9,500 hospitalizations [1]. Annals of Emergency Medicine. Annals of Emergency Medicine.

Infectious Diseases 101

Infectious Diseases Emergency Department Administration Academics 101

PulmCCM

OCTOBER 23, 2023

Answering this research question has been made more difficult by pip-tazo’s possible status as a pseudo-nephrotoxin (elevating creatinine levels in the blood without harming the kidneys) and frequent co-administration with vancomycin, a known nephrotoxin. Read in JAMA Does Paxlovid Improve Covid-19 Outcomes in the Omicron Era?

Hospitals 98

Hospitals Emergency Department COPD CDC 98

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

ACEP Now

MARCH 6, 2024

The PATCH-Trauma trial took a critical look at TXA in major trauma in the advanced trauma systems of Australia and found a mixed result: a slightly greater number of patients were still alive six months following TXA administration, but there was no difference in survival with a good functional outcome. percent to 38.3

Research 52

Research Airway Management Stroke Outcomes 52

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 Outcomes 52

Taming the SRU

JANUARY 26, 2024

Wosiski-Kuhn and Stothers BP cuff sizing: Using a cuff too large results in lower SBP, using too small results in higher BP VTE risk with hormonal contraception and NSAIDS Isolated use + and contraception leads to IRR of 7.2 10 or greater days and high or moderate risk hormonal contraception amplifies risk to IRR of 44.8

Stroke 59

Stroke EKG/ECG Outcomes Seizures 59

EB Medicine

SEPTEMBER 1, 2018

Jeff: Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the September 2018 issue of Emergency Medicine Practice - Emergency Department Management of North American Snake envenomations.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Be careful with excessive medication administration.

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

EMDocs

SEPTEMBER 7, 2023

2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergency department. 2 Administration of an alcohol dehydrogenase (ADH) inhibitor, such as fomepizole, is recommended in suspected or known DEG poisoning. Toxicological Sciences , vol. 1, 2010, pp.

Poisoning 66

Poisoning CDC Administration Emergency Department 66

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

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

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 Hospitals 40

Taming the SRU

SEPTEMBER 1, 2023

for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 93

Sepsis Administration Documentation/Coding Fractures 93

Dr. Smith's ECG Blog

AUGUST 9, 2024

Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. Usefulness of automated serial 12-lead ECG monitoring during the initial emergency department evaluation of patients with chest pain.

EKG/ECG 88

EKG/ECG EMS Emergency Department Outcomes 88

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge. Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. Date: September 20th, 2021 Reference: Litell et al.

Sepsis 40

Sepsis Emergency Department COPD Hospitals 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

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

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 Outcomes Administration Research 52

The Skeptics' Guide to EM

JANUARY 25, 2020

Case: A 60-year-old male is in your emergency department with sepsis from pneumonia. Clinical Question: Is bag-mask ventilation (BMV) performed during the apneic period of RSI (defined as the time between administration of RSI medications and intubation) in critically ill adults safe and effective? Reference: Casey et al.

EMS 40

EMS Airway Management Administration Resuscitation 40

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 73

Stroke Outcomes EMS Seizures 73

Taming the SRU

DECEMBER 6, 2023

ems grand rounds: southwest ohio protocol updates WITH dr. weekley Ideally, medications will be administered IV or IO, therefore endotracheal tube drug administration will be de-emphasized. The INTERACT3 trial showed improved neurological outcomes with these measures as part of a complete bundle of care for sICH in the emergency department.

Leadership 56

Leadership Stroke Airway Management Administration 56