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.

Hospitals 98

Hospitals Resuscitation Outcomes CPR 98

Dr. Smith's ECG Blog

DECEMBER 13, 2023

And she learned it well: She is not highly confident, but she does diagnose OMI. Outcome: 100% LAD Occlusion Here the Queen explains why: The dark blue tells us that she is looking especially at the QRS in V3 and the T-wave in V2 and V3. Not OMI, and we (Pendell and I) always take proportionality into account.

EKG/ECG 123

EKG/ECG COPD Wellness Outcomes 123

ACEP Now

DECEMBER 6, 2024

A 45-year-old male with a history of chronic obstructive pulmonary disease (COPD), asthma, amphetamine and tetrahydrocannabinol (THC) use, and coronary vasospasm presented to triage with chest pain. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

Sensible Medicine

MARCH 11, 2024

In the assessment of a clinical trial, we want to know if differences in baseline characteristics may have played a role in the observed outcome. The question to consider is…are the actual differences seen between the groups with regards to baseline characteristics large enough to have influenced the outcome?

Outcomes 117

Outcomes Research Stroke COPD 117

Dr. Smith's ECG Blog

SEPTEMBER 17, 2023

There is some upwards concave ST segment elevation in the inferior leads with what seems to be well formed J-waves. maybe not seen well on these echo-loops) The CW doppler at the tricuspid valve showed a maximum TR velocity of 2,55m/s with a TRP gradient of 26mmHg. Not much difference from 1st ECG. A bedside echo was performed.

EKG/ECG 116

EKG/ECG COPD Shock Wellness 116

Sensible Medicine

JUNE 30, 2023

1] Would the outcomes be different? On the other hand, KW was a middle-aged American man with chest pain and significant risk factors for coronary artery disease – hypertension and diabetes – neither of which had ever been terribly well-controlled. She was well hydrated and her vital signs were normal.

Hospitals 97

Hospitals Hospice Resuscitation COPD 97

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. Persistent air-leak in spontaneous pneumothorax--clinical course and outcome. 2023;78(Suppl 3):s1-s42. Respir Med. 1998;92(5):757-761.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Dr. Smith's ECG Blog

NOVEMBER 25, 2017

Written by Pendell Meyers, edits by Smith: Case A 72 year old female with hypertension and COPD presented with sudden shortness of breath and chest pain. More important, there is right bundle branch block with hyperacute concordant T-waves in V3-V6, as well as hyperacute T-waves in leads III and aVF with reciprocal ST depression in aVL.

COPD 52

COPD EKG/ECG Wellness Outcomes 52

PulmCCM

MARCH 25, 2024

In a well-randomized trial, equal numbers of clinically important differences in outcomes in opposite directions could average out to a null result, hiding the variability between patients. Neither PILOT nor ICU-ROX found a difference in outcomes with higher vs lower oxygenation targets in mechanical ventilated patients.

COPD 52

COPD Outcomes Research Wellness 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 medicine is amazing.

COPD 58

COPD Wellness Outcomes Operations 58

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

Mind The Bleep

NOVEMBER 21, 2023

” Yes, I have seen clerking look like this and I can confirm, it does not go down well. Examples of examination findings you might find helpful to keep in mind (list not exhaustive): GCS 15/15- alert, orientated, looks comfortable, warm and well perfused, in obvious pain, looks pale and clammy etc.

Documentation/Coding 52

Documentation/Coding COPD EKG/ECG Wellness 52

EB Medicine

OCTOBER 1, 2018

Jeff : So as well all know Sepsis is bread and butter emergency medicine, but, what is sepsis? Sepsis is coming in at a higher readmission rate and cost per admission than acute MI, CHF, COPD, and PNA. If it’s possible to establish an IV and initiate fluids without delaying transport, EMS should do that as well.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

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. The enrolled patients were not well. What we have not really known is how much oxygen is enough.

COPD 112

COPD Outcomes Shock Hospitals 112

EMDocs

FEBRUARY 12, 2024

Louis); Marina Boushra, MD (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case Emergency Medical Services brings in a 62-year-old male with COPD in acute on chronic hypoxemic respiratory failure (usually on 3 L nasal cannula, now on non-rebreather at 15 L/min). proning patients, ECMO) (12).

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 Click to enlarge.

COPD 52

COPD Hospitals Emergency Department Outcomes 52

RebelEM

MAY 15, 2024

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

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

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? About two thirds of patients in each arm were vaccinated.

COPD 95

COPD Stroke Academics Urgent Care 95

The Skeptics' Guide to EM

JANUARY 22, 2022

Her vitals signs are all normal and she feels well enough to isolate at home. There is strong evidence that systemic steroids improve outcomes in patients with severe COVID-19 ( First10EM: Steroids for COVID ). She is fully vaccinated against COVID-19. She thinks her friend might have been prescribed a puffer of some sort.

Urgent Care 40

Urgent Care COPD Outcomes Emergency Department 40

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

Written by Magnus Nossen, edits by Smith The patient in today's case is an 85-year-old male with a history of COPD and dementia. Premature, gradual reversal of inverted T waves to positive (upright) deflections by 48 to 72 hours after MI onset in the presence of well formed Q-waves. How will you manage this patient in each scenario?

EKG/ECG 89

EKG/ECG Shock COPD Wellness 89