Taming the SRU

MAY 11, 2024

3% HTS appears to be safe for peripheral IV administration and does not require a central line. The available data does not support any benefit of administration of hyperosmolar therapy in the setting of a TBI. When administered IM, midazolam administration appears superior in terms of time to sedation (Nobay et al.).

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

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. Thromboelastometry (e.g., The balloon generally required 30 minutes to insert. Read in JAMA

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

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

Don't Forget the Bubbles

NOVEMBER 29, 2023

Even though sedation after endotracheal intubation (ETI) reduces the risk of self-extubation, uncontrolled pain, and awakening awareness, several small single-centre studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED). When there is an immediate threat to life (e.g., DOI: 10.1097/ANA.0000000000000275

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

American Medical Compliance

MARCH 11, 2024

Amidst the busy dental appointments, treatments, and patient care, there are crucial aspects that often operate in the background but hold importance. Understanding the Significance Dental recordkeeping includes the systematic documentation of a patient’s oral health history, examinations, diagnoses, treatments, and outcomes.

Documentation/Coding 105

Documentation/Coding Best Practices Operations Outcomes 105

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. Resuscitation. 9 Zhang W et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

American Medical Compliance

AUGUST 7, 2024

Moreover, compliance with HIPAA helps healthcare providers avoid substantial fines and legal penalties associated with data breaches, thereby maintaining compliance with federal standards and ensuring the smooth operation of their practices. It ensures healthcare providers operate ethically.

Hazardous Materials 105

Hazardous Materials Documentation/Coding Legal Issues Patient Safety 105

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 96

Head Injuries Airway Management Outcomes Burns 96

RebelEM

AUGUST 12, 2024

PMID: 36038001 Clinical Question: In patients undergoing cardiac surgery with cardiopulmonary bypass, does the administration of intravenous amino acid therapy lead to lower occurrence of postoperative AKI when compared to placebo? The PROTECTION trial. Contemp Clin Trials. Epub 2022 Aug 28.

Outcomes 81

Outcomes Hospitals Operations Shock 81

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 J Cardiothorac Vasc Anesth.

Shock 71

Shock Administration Academics Hospitals 71

EMDocs

SEPTEMBER 7, 2024

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 93

EMS Fluid Resuscitation Resuscitation Radiology 93

ACEP Now

JULY 7, 2024

2,3 In this case, aortic dissection was visualized neither on initial bedside nor on repeat inpatient TTE, despite operator knowledge of a known lesion and extensive operator training. 1,3 Temporizing measures are not always possible for critically ill Grade IV patients, and outcomes are usually much worse. Click to enlarge.)

Operations 59

Operations Hospitals Administration Outcomes 59

SheMD

MAY 4, 2023

What were their outcomes: The median number of years to first appointment to a chair position was 7 years after graduation. Women were more likely to be first appointed to educational rather than operational roles (52.6% Categorical analyses were conducted to compare demographics, qualifications, and achievements by gender.

Leadership 52

Leadership Academics Operations Emergency Department 52

Ziqitza HealthCare Ltd

JUNE 18, 2023

Ziqitza Healthcare ltd embraces precision medicine by leveraging AI to analyze genomic data, enabling the delivery of tailored therapies to patients for improved treatment outcomes. By automating these processes, healthcare providers can improve efficiency, reduce errors, and lower operational costs.

Documentation/Coding 52

Documentation/Coding Administration Ambulance Services Outcomes 52

PulmCCM

FEBRUARY 5, 2024

Also, many patients with infection won’t have fevers, and those that don’t may be at the highest risk for poor outcomes. to enforce compliance with an administrative policy). For patients >65 years old living in long-term care facilities, IDSA feels lower thresholds should be used (e.g., >37.2°C

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

ACEP Now

SEPTEMBER 3, 2024

These stakeholders are similarly shielded in court when adverse patient outcomes, such as negligent deaths, occur under their management or when the bought-out companies are challenged for anticompetitive business practices overseen by the PE firm. 7-9 The PE model then aims to sell acquired businesses for a profit within three to six years.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

EMDocs

SEPTEMBER 25, 2023

First described in 1970, RSI with the near-simultaneous administration of a sedative agent and NMBA has been shown to have increased first-pass success compared with intubation facilitated by a sedative alone (6,7). Introduction: Since the late 1990s, RSI has been the gold standard of emergency intubations (5).

Emergency Department 84

Emergency Department Soft Tissue Injuries Airway Management Operations 84

RebelEM

JANUARY 25, 2023

Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5

Operations 52

Operations Sepsis Resuscitation Ultrasounds 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

Don't Forget the Bubbles

MAY 17, 2023

Post-operative pain in children: Comparison of pain scores between parents and children. Early Antibiotic Use and Neonatal Outcomes Among Preterm Infants Without Infections. Video laryngoscopy-assisted less-invasive surfactant administration quality improvement initiative. J Pediatr Gastroenterol Nutr. 2023 Apr 24. 2023 Apr 12.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? However, with ultrasonography becoming more prevalent in EDs, it may be possible that initial imaging may avoid this radiation risk and still have similar outcomes for patients. Would you be satisfied with only US and no follow-up CT?

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Sensible Medicine

MAY 26, 2023

By way of introduction, I’ll save myself time and energy by quoting from a JGIM article (minus references), A National Survey of Internal Medicine Primary Care Residency Program Directors : Primary care has been associated with better health outcomes, higher patient satisfaction, and decreased health care cost. The respect.

COPD 62

COPD Wellness Outcomes Operations 62

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. Under standard operating protocols, residual contrast materials are usually wasted, according to current CDC and JC standards.

Radiology 92

Radiology Radiology Emergency Department Hospitals 92

Ziqitza HealthCare Ltd

JULY 26, 2024

Telemedicine facilitates collaboration among doctors, nurses, other medical administrators, staff, and patients. This ongoing communication and accessibility foster stronger patient-doctor relationships, which eventually improve health outcomes. Make sure the internet and gadgets are operational.

Telemedicine 52

Telemedicine Ambulance Services Operations Administration 52

PHEM Cast

APRIL 18, 2016

Following the lecture I found this on Minh’s PHARM website: a review of prehospital ketamine administrations. Hauwald, 2002 A co-operative patient does not require immobilization unless their conscious level deteriorates. Remember this when you get on scene – 98% of patients will not have a spinal injury.

Fractures 40

Fractures Operations Administration Shock 40

AED Leader

DECEMBER 2, 2024

By ensuring quick access to AEDs in public settings, we can significantly increase survival rates for cardiac arrest victims, leading to improved outcomes and better survival to hospital discharge. Rapid treatment is vital to improve survival outcomes. AEDs must meet Food and Drug Administration (FDA) regulations. In the U.S.,

CPR 52

CPR Basic Life Support Resuscitation Hospitals 52

PulmCCM

JANUARY 4, 2022

” -Fran Lebowitz Background Quite recently, the BaSICS investigators evaluated the infusion rate of a fluid bolus on patient outcome. The primary outcome was identification of the optimal volume for assessing fluid responsiveness. If I get to the dry cleaners without having a huge fight, that’s challenging enough.”

Wellness 40

Wellness Outcomes Sepsis Stroke 40

Don't Forget the Bubbles

JANUARY 31, 2024

This was compared to a mixed reference standard that included the results of ultrasound by radiologists, intra-operative findings, and clinical follow-up. Effective pre-hospital analgesia contributes to timely ED analgesia, and not having adequate analgesia can contribute to anxiety and poorer outcomes.

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

ACEP Now

JULY 7, 2023

This is a discussion of a potentially disastrous airway outcome. She was kept upright until immediately before paralytic administration. An additional operator should be present at the airway for any intubation deemed to be difficult, notably when using the SALAD technique.

Airway Management 45

Airway Management EMS Burns Operations 45

EMDocs

NOVEMBER 16, 2024

4 Pain is the most common reason for presentation in the early post operative period. 5 Highest risk of dislocation early in the post operative course due to laxity of the soft tissue after surgery. 6 Hip flexion or adduction in the early post-operative period can cause atraumatic dislocations (typically avoided for 6 weeks post-op).

EMS 94

EMS Dislocations Fractures Operations 94

RebelEM

JULY 31, 2023

Outcomes: Primary Outcome: Successful intubation on the first attempt. Secondary Outcomes: Severe complications of tracheal intubation. Operators had performed a median of 50 previous tracheal intubations (Range 25 to 92) The median proportion of previous intubation operators performed with VL was 0.69. VL vs 8.7%

Operations 96

Operations Outcomes Emergency Department Airway Management 96

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. Limitations : Open label study design Outcome assessments were done via telephone interview. mg/kg at this time for the potential treatment of AIS.

Stroke 132

Stroke Blood Transfusions Outcomes EMS 132

EMDocs

DECEMBER 18, 2023

8 Based on multiple randomized controlled trials (RCTs), SSC 2021 guidelines suggest against using procalcitonin as a screening method to guide initiation of antibiotic therapy, as no difference in clinical outcomes was appreciated. Current SSC guidelines recommend the time from presentation to antibiotic administration as one hour.

Sepsis 83

Sepsis Fluid Resuscitation Resuscitation Shock 83

EMDocs

JULY 17, 2023

7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. 3,14 There are currently no good studies of enteric or rectal contrast administration in the evaluation of LBO and there are no society recommendations for its use. This also serves as a tool for surgical planning.

Operations 95

Operations EMS Fluid Resuscitation Resuscitation 95

ACEP Now

AUGUST 28, 2024

With plenty of warning from the union, TeamHealth and the hospital implemented contingency staffing plans to keep the ED fully operational. Physicians are turning to unionization as one of the few remaining pathways they see available to them to effect change and improve patient outcomes. Only time will tell,” he says.

Emergency Department 98

Emergency Department Hospitals Patient Safety Leadership 98

RebelEM

DECEMBER 19, 2022

trying harder and longer knowing they are enrolled in this study) Use of two different models of defibrillators may negatively impact the internal validity of this pilot study Certain baseline characteristics were not balanced, such as: prehospital intubation and Epinephrine administration.

EMS 52

EMS CPR Shock Resuscitation 52

EMDocs

JUNE 3, 2023

4 This is the framework the ED resuscitationist should be operating under, as hemodynamically unstable pelvic trauma patients require a different approach compared to stable patients who will undergo CT, routine pelvic fixation, and definitive surgical repair. 12 An AP x-ray of the pelvis should be obtained in the ED for unstable patients.

Fractures 60

Fractures Resuscitation Operations EMS 60