ACEP Now

MARCH 11, 2025

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) no increase in vasopressor use, mechanical ventilation, admission to an intensive care unit, in-hospital mortality). percent to 56.3

Hospitals 52

Hospitals Administration Outcomes Stroke 52

ACEP Now

AUGUST 25, 2023

The Pediatric Pain Management Standard 1 for children was published this year to provide guidance to health organizations on how to deliver equitable and quality pain management across hospital settings. Primary Outcome: Discharged home from the ED Secondary Outcomes: There were several secondary outcomes. Am J Hematol.

Administration 97

Administration Pediatrics Emergency Department Outcomes 97

EMDocs

JANUARY 11, 2025

A) Administration of IV morphine for pain control B) Admission to general surgery for IV antibiotics C) Discharge home on lactulose D) Emergent surgical consultation for exploratory laparotomy E) Manual disimpaction Correct answer: E Although uncommon, stercoral colitis is a potentially life-threatening complication of chronic constipation.

EMS 97

EMS Sepsis Shock Fluid Resuscitation 97

RebelEM

JULY 3, 2023

What They Did: Researchers conducted a multicenter, retrospective cohort study in three community hospitals and two freestanding emergency departments. Secondary outcome All secondary outcomes were found to be similar (Not statistically significant) between groups (See table above). received CaCl 89.3%

Administration 96

Administration Outcomes Documentation/Coding Emergency Department 96

PulmCCM

JANUARY 6, 2025

With financial penalties coming for noncompliance with the new rule, hospital administrators rapidly deployed the alerts to fire on all eligible inpatients. A cluster randomized trial using all-cause mortality as an outcome was always needed to determine whether EMR alerts improve outcomes for suspected severe infection.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

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. In other words these were pre-made syringes and not mixed at the bedside.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

RebelEM

FEBRUARY 1, 2024

Tenecteplase, a modified version of alteplase, is being increasingly utilized for AIS due to its favorable pharmacological profile, ease of administration, and cost effectiveness. Earlier studies looking at tenecteplase dosing began in 2005 and have largely settled on a dose of 0.25 mg/kg at this time for the potential treatment of AIS.

Stroke 134

Stroke Blood Transfusions Outcomes EMS 134

RebelEM

SEPTEMBER 29, 2022

Outcomes: Primary: Progression to moderately severe or severe acute pancreatitis (according to the Revised Atlanta Classification). Secondary outcomes were pre-specified which helps in terms of minimizing bias (i.e. non-statistically significant difference in the primary outcome. to 9.8L) Moderate: 5.5L (Range 4.0

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

Sensible Medicine

AUGUST 21, 2023

Administrative data sets are often collected for the purpose of billing, or costing, or administrative organization, and thus are extremely vulnerable to up coding or intentional or accidental omissions. ” For example, mortality is a patient outcome—provided it can be reliably ascertained.

Administration 98

Administration Outcomes Research COPD 98

The Skeptics' Guide to EM

OCTOBER 5, 2019

Guest Skeptic: Clay Odell is a Paramedic/RN for New London Hospital EMS in New Hampshire, USA which provides 9-1-1 coverage and Mobile Integrated Healthcare […] The post SGEM#269: Pre-Hospital Nitroglycerin for Acute Stroke Patients? Hypertension is common in acute stroke and is a predictor of poor outcome [ 1 ].

Stroke 52

Stroke Hospitals EMS Administration 52

Don't Forget the Bubbles

JANUARY 31, 2024

As a Trauma Unit within the Thames Valley Trauma Network, Wexham Park Hospital hosts trainees from across the spectrum of acute specialties. Two really important patient groups were excluded – those who were admitted to hospital and families who were not fluent in English. the pre-hospital setting. Why does it matter?

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

RebelEM

SEPTEMBER 7, 2023

ClinicalTrials.gov: NCT02631759 Clinical Question : In adult patients aged 18 years or older presenting within 24 hours of a spontaneous ICH, does the administration of levetiracetam, compared to placebo, reduce the occurrence of clinical seizures? The primary outcome was patient-oriented. Lancet Neurology 2022; 21:781-91.

Seizures 130

Seizures Stroke Outcomes Research 130

RebelEM

AUGUST 22, 2024

Administration of intravenous tissue plasminogen activator (IV tPA) within 4.5 hours of symptom onset appears to be the most promising approach for improving visual outcomes, supported by multiple studies and meta-analyses. Administration of intravenous tissue plasminogen activator (IV tPA) within 4.5 1 week after treatment.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

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. Range 5 to 9) Etomidate: 7.0

Outcomes 97

Outcomes Emergency Department Resuscitation Administration 97

EMDocs

SEPTEMBER 30, 2024

Primary outcome: Prescription of ICS on ED discharge from the index visit Secondary outcomes: ICS prescription rates in high-risk subgroups Rates of outpatient follow-up within 30 days of an ED visit for asthma Variation in ICS prescription rates among attending ED physicians. The primary outcome was hospital admission rates.

Outcomes 105

Outcomes Academics Documentation/Coding Emergency Department 105

RebelEM

OCTOBER 2, 2023

Mild to moderate DKA represents a subgroup of patients that often require admission to the ICU due to hospital policies not allowing insulin infusions outside of this clinical setting. No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 tests/hr (0.8 Traditional: 1.0

Operations 102

Operations Academics Fluid Resuscitation Outcomes 102

EM Literature of Note

APRIL 11, 2024

The most notable feature of this trial is the simple, negative topline result – rollout of this intervention had no reliably measurable effect on patient-oriented outcomes relating to disease progression or acute clinical deterioration. “Pragmatic Trial of Hospitalization Rate in Chronic Kidney Disease” [link] Tweet

Outcomes 92

Outcomes Administration Hospitals Wellness 92

RebelEM

APRIL 29, 2024

Many clinicians don’t consider IO placement while others consider it a last resort or only a pre-hospital procedure. In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Impact of intraosseous versus intravenous resuscitation during in-hospital cardiac arrest: A retrospective study.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Critical Care Now

AUGUST 18, 2024

The primary outcome showed a 28-day mortality of 6.2% Secondary outcomes included reduced mortality at 90 days, lower rates of intubation and vasopressor use, and fewer serious adverse events in the hydrocortisone group. A total of 800 patients were enrolled, with 401 receiving hydrocortisone and 399 receiving a placebo.

Outcomes 93

Outcomes Sepsis Administration EMS 93

The Skeptics' Guide to EM

OCTOBER 19, 2024

Guest Skeptic: Dr. Brendan Freeman is an emergency medicine physician, assistant professor of emergency medicine, and medical education fellow at Staten Island University Hospital. Ketamine’s administration is flexible, with several routes available including IV, intranasal (IN), and more recently, nebulized forms. Annals of EM 2024.

Emergency Department 100

Emergency Department EMS Research Administration 100

The Skeptics' Guide to EM

FEBRUARY 25, 2023

2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Case: A 6-month-old boy presents to […] The post SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

ACEP Now

NOVEMBER 8, 2024

Historically, the endotracheal tube (ETT) has been considered the definitive airway of choice in both the prehospital and in-hospital setting. 1 Prehospital endotracheal intubation and EGAs are typically placed without paralytics and are reserved for unconscious, apneic, and out-of-hospital cardiac arrest patients. DOT HS 813 151).

Airway Management 40

Airway Management EMS Hospitals Administration 40

Don't Forget the Bubbles

DECEMBER 25, 2023

Interpreting Research Outcomes with a Little Bathroom Humour You have learned a method for how to read a research paper , and now you are faced with a bunch of outcomes. There are primary, secondary, composite , and safety outcomes. What are these outcomes? We know there is a bias towards reporting positive outcomes.

Research 83

Research Outcomes Fractures Pediatrics 83

University of Maryland CC Project

JANUARY 31, 2024

The topic of their lecture today is their recently published article in CHEST: “Use and Outcomes of Peripheral Vasopressors in Early Sepsis-Induced Hypotension Across Michigan Hospitals: A Retrospective Cohort Study”. Their article can be found here: [link]

Administration 40

Administration Sepsis Research Outcomes 40

RebelEM

NOVEMBER 6, 2023

ug/kg/min of norepinephrine equivalent at time of hydroxocobalamin or methylene blue administration Exclusion Criteria: Administration of hydroxocobalamin or methylene blue for non-VS indications Hydroxocobalamin or methylene blue given > 48 hours after CPB Pre-intervention cardiac index < 2.0

Shock 71

Shock Administration Academics Hospitals 71

ACEP Now

OCTOBER 10, 2024

McCormick earned his Master of Business Administration from National University and medical degree from Morehouse School of Medicine in Atlanta. He completed residency in emergency medicine through Emory while training at Grady Hospital in Atlanta. Most recently, Dr. McCormick served as an emergency physician at Northside Hospital.

Telemedicine 105

Telemedicine Critical Access Hospitals Emergency Department 105

EMDocs

AUGUST 13, 2024

If the patient has asymptomatic elevated BP, the optimal management strategy is not clear, and there are no data that treating asymptomatic elevated BP (marked versus not) in the acute care setting improves clinical outcomes. Administration of IV antihypertensives in the absence of HTN emergency is not recommended.

Stroke 98

Stroke Administration Outcomes Hospitals 98

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 92

Sepsis Shock Resuscitation Fluid Resuscitation 92

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. and at Naples Community Hospital in Naples, Fla.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

Sensible Medicine

NOVEMBER 30, 2023

Typically, we place the burden on manufacturers to show that their products improve health outcomes prior to sale. Yet, our administration is paying for GRAIL, and doctors on Twitter who know more about virtue signaling than cancer have pressured the insurer to cover this procedure. Manufacturers have to show benefits exceed harms.

Research 145

Research Radiology Radiology Administration 145

The Skeptics' Guide to EM

FEBRUARY 17, 2018

Case: EMS is dispatched to a retirement […] The post SGEM#207: Ahh (Don’t) Push It – Pre-Hospital IV Antibiotics for Sepsis. Clearly something infectious is going on and you wonder if starting antibiotics on route to the hospital would help? Jenn Doyle is a paramedic educator at Middlesex-London Paramedic Service.

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

RebelEM

AUGUST 7, 2023

Traditional RSI entails preoxygenation followed by near-simultaneous administration of an induction agent followed by a neuromuscular blocker. Rapid sequence intubation can be modified for patients who are agitated or combative and not tolerating standard preoxygenation. Re-oxygenation with BMV can increase airway-related adverse events (i.e.

Head Injuries 98

Head Injuries Airway Management Outcomes Burns 98

Emergency Medicine Journal

NOVEMBER 28, 2023

Meaningful measurement for older people living with frailty would include additional person-centred outcomes of healthcare knowledge, shared decision-making, and situational security. Method and Design Older people living with frailty and receiving acute healthcare were recruited at three UK hospitals.

Outcomes 40

Outcomes Administration Research Hospitals 40

EMDocs

NOVEMBER 20, 2023

Key Concept: For patients with LGIB on cardiac aspirin for secondary prevention, aspirin should be continued during hospitalization if possible. Role of antifibrinolytic agents Recommendation: We recommend against the administration of antifibrinolytic agents such as tranexamic acid in LGIB.

Resuscitation 103

Resuscitation Fluid Resuscitation Hospitals Research 103

Mind The Bleep

APRIL 10, 2025

Examples of LLMs used in healthcare are: The main aims of using AI in healthcare would be to reduce costs, improve patient outcomes and medical education. AI can book appointments and perform other administrative tasks, for instance, retrieving medical information and billing.

Documentation/Coding 52

Documentation/Coding Research Outcomes Administration 52

JournalFeed

SEPTEMBER 7, 2024

Friday Spoon Feed : In non-traumatic out of hospital cardiac arrest (OHCA), administration of an initial dose of IM epinephrine by EMS prior to an established IV or IO was associated with improved survival outcomes.

Administration 52

Administration EMS Outcomes Hospitals 52

Emergency Medicine Journal

AUGUST 21, 2024

1 The CFS has become widely adopted in research and clinical settings and has been recommended in the UK for routine administration with adults aged 65+ years with unscheduled hospital attendances. The Clinical Frailty Scale (CFS) uses clinician judgement to quantify the functional impacts of multidimensional health deficits.

Geriatric Emergencies 52

Geriatric Emergencies Administration Research Outcomes 52