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.

COPD 62

COPD Wellness Outcomes Operations 62

Taming the SRU

MARCH 17, 2023

mepivacaine (1-3 h) 1% lidocaine +/- epi (2-3h) 0.25% bupivacaine (2-3 h) 0.25-0.5% mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2 mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2

Seizures 40

Seizures Fractures Burns Pediatrics 40

RebelEM

AUGUST 21, 2023

This trial aimed to assess whether targeted therapeutic mild hypercapnia (TTMH) applied during the initial 24 hours of mechanical ventilation in the ICU can enhance neurological outcomes at the 6-month mark, as compared to standard care, which involves targeted normocapnia (TN). Paper: Eastwood G, et al. N Engl J Med. Epub 2023 Jun 15.

Hospitals 98

Hospitals Resuscitation Outcomes CPR 98

Mind The Bleep

FEBRUARY 2, 2025

Ensure you management plan includes how you plan to rule out any immediate concerns and what the outcome is likely to be if normal. Your trust will have guidelines on the treatment regimen using chlordiazepoxide/lorazepam and pabrinex. Ensure that there is a Treatement Escalation Plan and/or a DNACPR in place if required.

Documentation/Coding 95

Documentation/Coding COPD EKG/ECG Wellness 95

EMDocs

MARCH 18, 2025

Physiologic dead space higher in chronic lung disease (COPD). Poor candidates: underlying pulmonary disease like COPD, lung cancer, bronchiectasis. Hirshberg B, Biran I, Glazer M, Kramer MR. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Anatomic dead space is approximately 150 mL.

COPD 81

COPD Radiology Radiology PPE 81

Taming the SRU

OCTOBER 1, 2023

It can be further divided into two types: primary--those that occur in generally healthy individuals without underlying lung disease, and secondary--those that occur in individuals with underlying lung disease such as COPD [1]. Is additionally helpful to differentiate bullous lung disease from PTX [18].

Fractures 96

Fractures COPD Hospitals Emergency Department 96

The Skeptics' Guide to EM

APRIL 8, 2023

The objective of that study was the following: * To investigate how the’ natural experiment’ of reconfiguring the emergency healthcare system in Denmark affected in-hospital and 30-day mortality on a national level. They found no statistical difference for in-hospital mortality but slightly increased 30-day mortality.

Stroke 57

Stroke Emergency Department COPD Academics 57

The Skeptics' Guide to EM

MARCH 25, 2018

Risk factors for adverse outcomes in older adults with blunt chest trauma: A systematic review. Christina loves serving as […] The post SGEM#212: Holding Back the Years – Risk Factors for Adverse Outcomes in Older Adults with Blunt Chest Trauma first appeared on The Skeptics Guide to Emergency Medicine. Reference: Sawa et al.

Outcomes 40

Outcomes Geriatric Emergencies Emergency Department COPD 40

PulmCCM

JUNE 10, 2024

Background I’m not sure if you’ve noticed this, but patients and families frequently disagree with their physicians about the likely outcomes from critical illness. 3 days for anoxic encephalopathy to regain pupillary responses after cardiac arrest, 4-7 days for a DNR/DNI patient to receive NIPPV for COPD exacerbation, etc.)

COPD 45

COPD Outcomes Hospitals EMS 45

RebelEM

MAY 15, 2024

Follow your hospital’s protocol (if available). High Risk Patients will need hospitalization and IV antibiotics. Changing aetiology, clinical features, antimicrobial resistance, and outcomes of bloodstream infection in neutropenic cancer patients. Time to antibiotics and outcomes in cancer patients with febrile neutropenia.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

Sensible Medicine

JUNE 30, 2023

1] Would the outcomes be different? Patients present with troublesome symptoms that they “just want checked out before the weekend” and I’m left either worrying about them all weekend or admitting them to the hospital where I know little will happen for the next two days. She did not require hospitalization.

Hospitals 98

Hospitals Hospice Resuscitation COPD 98

The Skeptics' Guide to EM

JUNE 29, 2019

Population: Patients over the age of 65 who stayed overnight in the emergency department or were admitted to hospital. The derivation population was from five hospitals in Australia, while the validation population was from a single hospital in Ireland. Intervention:The CriSTAL score, and its various components.

Emergency Department 52

Emergency Department COPD Hospitals Outcomes 52

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. million hospitalized people annually. He’s afebrile.

Sepsis 40

Sepsis Emergency Department COPD Hospitals 40

Mind The Bleep

NOVEMBER 21, 2023

Ensure you management plan includes how you plan to rule out any immediate concerns and what the outcome is likely to be if normal. Your trust will have guidelines on the treatment regimen using chlordiazepoxide/lorazepam and pabrinex. Ensure that there is a Treatement Escalation Plan and/or a DNACPR in place if required.

Documentation/Coding 52

Documentation/Coding COPD EKG/ECG Wellness 52

EB Medicine

OCTOBER 1, 2018

For those listening, my hospital probably looks a little bit like yours. Roughly half of in-hospital mortality is associated with septic in some fashion. clearly this is an important topic if it warrants it’s own chair at a major hospital in NYC. At our hospital in southern Manhattan, patients tend to breathe around 16.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Notably, in the initial analysis of blunt chest trauma (i.e.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

ACEP Now

JUNE 14, 2024

Chronic obstructive pulmonary disease (COPD) is a chronic disease of the lungs caused by inflammatory and structural changes of the small airways and parenchyma of the lungs that result in chronic airflow obstruction and gas trapping. In 2019, the global prevalence of COPD was estimated to be 10.3 8 Bronchodilators Albuterol 2.5-5

COPD 52

COPD Hospitals Emergency Department Outcomes 52

Sensible Medicine

JANUARY 3, 2024

I served the neighborhood of Austin, disproportionately debilitated by opioid overdoses, gun violence, and incarceration, not to mention COPD, diabetes and asthma. The predictable outcome has been mass hysteria. How often will vaccination prevent hospitalization and death? Direct evidence on hard clinical outcomes is needed.

CDC 143

CDC Allergic Reactions Hospitals COPD 143

Sensible Medicine

SEPTEMBER 22, 2024

In studies, and in practice, these people tend to be patients with COPD who have resting O 2 sats of < 88%. The primary outcome was a composite of hospitalization or death from any cause within one year. About 80% had either COPD or pulmonary fibrosis and the mean PaO 2 and O 2 sats were about 50mm Hg and 80%, respectively.

COPD 115

COPD Outcomes Shock Hospitals 115

Dr. Smith's ECG Blog

FEBRUARY 18, 2025

Written by Willy Frick A man in his 50s with COPD presented with dizziness and hypotension. He had worked overnight the night before and presented to the hospital after his shift. The patient's long term outcome is unknown. His first recorded blood pressure was 88/53 mm Hg. Here is his presenting ECG: What do you think?

EKG/ECG 63

EKG/ECG COPD CPR Administration 63

The Skeptics' Guide to EM

JANUARY 22, 2022

There is strong evidence that systemic steroids improve outcomes in patients with severe COVID-19 ( First10EM: Steroids for COVID ). Their primary outcome was a ‘COVID-19 related’ urgent care visit, emergency department assessment, or hospitalization, and was significantly reduced in the budesonide arm (15% vs 3%, p=0.009).

Urgent Care 40

Urgent Care COPD Outcomes Emergency Department 40

PulmCCM

OCTOBER 23, 2023

Read in JAMA Does Paxlovid Improve Covid-19 Outcomes in the Omicron Era? Even people with COPD or asthma under age 50 did not benefit from Paxlovid, in that analysis. absolute risk reduction in the composite outcome among the immunocompromised or those with significant medical conditions. Paxlovid was associated with about a 1.5-2.5%

Hospitals 98

Hospitals COPD Emergency Department CDC 98

PulmCCM

SEPTEMBER 28, 2023

Systemic corticosteroids (such as intravenous dexamethasone) improve outcomes in severe pneumonia due to SARS-CoV-2 infection. It makes sense that inhaled steroids might improve outcomes from less severe infections. Do inhaled steroids improve Covid pneumonia?

COPD 95

COPD Stroke Academics Urgent Care 95