The Skeptics' Guide to EM

FEBRUARY 20, 2021

The presentation is available to listen to on iTunes and GooglePlay and all the slides can be downloaded […] The post SGEM Xtra: Dogmalysis 2021 first appeared on The Skeptics Guide to Emergency Medicine. The title of the talk “Dogmalysis: Five Medical Myths in Emergency Medicine”. Date: February 19th, 2021 This is an SGEM Xtra episode.

Fractures 52

Fractures Outcomes Hospitals 52

Don't Forget the Bubbles

FEBRUARY 5, 2025

There is significant evidence in adults and developing in the paediatric population that TXA results in better outcomes if given early in patients with mild to moderate traumatic brain injury (TBI) and does not cause harm. Immediate Treatment One immediate medication to consider is tranexamic acid (TXA). link] SafeLives.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

EM SIM Cases

AUGUST 8, 2023

She is interested in treating opioid and alcohol use disorders to decrease Emergency Medicine visits and harmful adverse outcomes related to substance use. Case 1 SBIRT Sim Download CASE 2 Buprenorphine – Suboxone Induction Download Case 1 SBIRT Sim Download CASE 2 Buprenorphine – Suboxone Induction Download

Leadership 40

Leadership Emergency Department Outcomes Wellness 40

The Skeptics' Guide to EM

APRIL 2, 2022

. * Intervention: Virtual reality “ Take Pause ” program for 5 minutes * Comparison: Passive distraction technique with hospital-owned iPad with pre-downloaded age-appropriate games for 5 minutes * Outcome: * Primary Outcome: Difference in the change in situational anxiety level between groups 15 minutes after intervention using the Spielberger State (..)

Pediatrics 52

Pediatrics Emergency Department Outcomes Research 52

The Skeptics' Guide to EM

DECEMBER 25, 2021

JAMA 2021 This was an SGEM Journal Club and all the slides from the presentation can be downloaded using this LINK. Effect of Intravenous or Intraosseous Calcium vs Saline on Return of Spontaneous Circulation in Adults With Out-of-Hospital Cardiac Arrest – A Randomized Clinical Trial. As a reminder, here are the five rules for SGEM JC.

CPR 52

CPR Administration Outcomes Hospitals 52

RebelEM

MARCH 13, 2024

REBEL Reflections Episode 5: Thinking in Bets – Making Better Decisions When You Don’t Have All the Facts Click here for Direct Download of the Podcast Think back to the last time someone asked you a difficult question regarding a patient on shift. How sure were you about your decision? How would the hemodynamics respond to RSI?

Documentation/Coding 58

Documentation/Coding Outcomes EMS Stroke 58

RebelEM

MARCH 8, 2023

Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. Rapid diagnosis and emergency referral improves outcomes of ophthalmologic interventions. REBEL Core Cast 97.0 – Acute Vision Loss II Click here for Direct Download. Read more

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

Downeast Emergency Medicine

MAY 16, 2022

The primary outcome was admission or discharge, and bounce-back to the ED within 48 hours. Secondary outcomes were level of care on admission, ED length of stay, first and highest CIWA score, and adverse events. The primary outcome was initial and subsequent level of hospital care on admission (ICU vs telemetry vs floor).

Outcomes 52

Outcomes Emergency Department Hospitals Wellness 52

RebelEM

MARCH 2, 2023

Click here for Direct Download of the Podcast Paper: Stewart, RAH et al. However, this was not the primary outcome of this trial and no definitive conclusions can be drawn. Based on recent studies, current guidelines recommend that O2 should not be given to non-hypoxemic patients with STEMI or NSTEMI [2,3]. Low O2 protocol: 3.1%

Outcomes 52

Outcomes EMS EKG/ECG Hospitals 52

RebelEM

JUNE 5, 2023

This study investigated whether it is feasible to initiate buprenorphine/naloxone in the form of “take home” packages containing low-dose and standard-dose inductions. REBEL Cast Ep117: Low-Dose vs Standard-Dose Take Home Buprenorphine From the ED Click here for Direct Download of the Podcast Paper: Moe et.

Emergency Department 88

Emergency Department Hospitals Outcomes EMS 88

Don't Forget the Bubbles

JULY 26, 2023

Cardiac testing and outcomes in infants after an ALTE, Hoki et al, Archives of Disease in Childhood 2012 showed significant cardiac disease was present in <1% of patients presenting with ALTE (although cardiac abnormalities were found in 4% overall). How might these present in a less catastrophic way to the ED?

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Downeast Emergency Medicine

APRIL 26, 2021

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. JAMA Neurol.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Downeast Emergency Medicine

DECEMBER 1, 2021

The primary outcome was enrollment in and receiving addiction treatment at 30-days post-randomization. Additional outcomes included self-reported days of illicit opioid use, urine testing for illicit opioids, HIV risk, and use of addiction treatment services. Download article summaries D’ONOFRIO ET AL. 2021; 78(3): 434-442.[

Emergency Department 52

Emergency Department Documentation/Coding Leadership Administration 52

RebelEM

MARCH 23, 2023

REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal Click here for Direct Download of the Podcast Clinical question : Is a phenobarbital-based or lorazepam-based alcohol detoxification protocol associated with a lower hospital length of stay compared to Ativan for alcohol withdrawal?

Emergency Department 52

Emergency Department Burns Outcomes Hospitals 52

PulmCCM

MARCH 7, 2022

The primary outcome was 90-day, all-cause mortality in trials deemed to be ‘low-risk-of-bias.’ When using a Bayesian paradigm with vague priors for the primary outcome, the authors calculated an 89.5% Download his free textbook here. What they found The authors retrieved 1779 records plus three unpublished studies.

Resuscitation 40

Resuscitation Outcomes Research 40

PulmCCM

FEBRUARY 28, 2022

Death, from any cause, within 90 days of randomization was the primary outcome. There were multiple secondary outcome measures that related to acute kidney injury, hemodynamic stability and respiratory failure. There was no statistically or clinically-significant difference in any of the primary or secondary outcomes.

Fluid Resuscitation 40

Fluid Resuscitation Resuscitation Outcomes Sepsis 40

PHEM Cast

APRIL 10, 2016

This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. EMS Patients and Walk-In Patients Presenting With Severe Sepsis: Differences in Management and Outcome. Link to the Sepsis-3 guideline. South Med J.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 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. Download his free textbook here. For what are intravenous fluids diagnostic?

Wellness 40

Wellness Outcomes Sepsis Stroke 40

Downeast Emergency Medicine

JULY 17, 2021

The primary endpoint was pain reduction at 30 minutes with secondary outcomes looking at 15, 45, and 60 minute scores as well as need for rescue analgesia and adverse effects. Download article summaries EIDINEJAD ET AL. American Journal of Emergency Medicine 39 (2021) 71-74.[ MOTOV ET AL. Holmes, MD

Emergency Department 52

Emergency Department Wellness Administration EMS 52

PulmCCM

JANUARY 2, 2022

The primary outcome was the number of days alive without life-support – defined as invasive mechanical ventilation, circulatory support or renal replacement therapy – at 28 days post randomization. Download his free textbook here. days [p = 0.07] in absolute terms. no difference] or rejecting it [i.e.,

Outcomes 40

Outcomes Hospitals Shock Wellness 40

RebelEM

MARCH 22, 2023

REBEL Core Cast 98.0 – AVNRT Click here for Direct Download of the Podcast Definition: A regular, narrow-complex rhythm with a ventricular rate that is typically > 160 bpm. Serum troponin testing in patients with paroxysmal supraventricular tachycardia: outcome after ED care. Serum troponins should not routinely be obtained.

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

RebelEM

JANUARY 25, 2023

Small bowel obstruction: Outcome and cost implications of admitting service. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 BET 1: Is Routine Nasogastric Decompression Indicated in Small Bowel Occlusion?

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

PulmCCM

SEPTEMBER 9, 2021

The primary outcome was 90-day survival. Secondary outcomes included: the need for kidney replacement therapy up to 90 days; acute kidney injury defined as the progression KDIGO stage 0 or 1 at enrollment to at least 2 at days 3 and 7; SOFA score; and the number of days not requiring mechanical ventilation within 28 days. more than 2].

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

Sensible Medicine

FEBRUARY 28, 2024

The online MESA Risk Score Calculator is available here and the app can be downloaded for free (search for “MESA Risk Score”) on Apple and Android smartphones.

Stroke 46

Stroke Documentation/Coding Outcomes Wellness 46

Rural Doctors Net

AUGUST 30, 2013

Imagine being able to stream or access a downloaded 60 sec video file on how to perform a critical procedure – not a tool for novices, but a useful aide memoire for rural clinicians who may only do this stuff once in a blue moon. Even EMST-ATLS has (at last) moved away from the old mantra of “two litres of crystalloid, stat”.

Burns 52

Burns Hospitals Ambulance Services Wellness 52

RebelEM

JULY 31, 2023

REBEL Cast Ep121: The Battle of the Blades – VL vs DL Click here for Direct Download of the Podcast Article: Prekker ME, Driver BE, Trent SA, et al. Outcomes: Primary Outcome: Successful intubation on the first attempt. Secondary Outcomes: Severe complications of tracheal intubation. 1420 patients were enrolled.

Operations 96

Operations Outcomes Emergency Department Airway Management 96

RebelEM

JANUARY 24, 2024

REBEL Core Cast 116.0 – Achilles Tendon Rupture Click here for Direct Download of the Podcast Achilles Tendon Rupture Exam (www.lfaclinic.co.uk) Physical Exam May have palpable gap or deformity in region of tendon. Schedule follow up with orthopedics within 1 week for discussion of operative management vs early rehab protocols.

Operations 90

Operations Ultrasounds Fractures Outcomes 90

Mount Sinai EM

OCTOBER 10, 2024

2021 looked at smartphone addiction and associated health outcomes in adults. These included signing out of social media sites, deleting these apps, turning their phone off, turning off social media notifications, disconnecting from wifi, and downloading an app blocker that blocks relevant social media sites, but none of them were compulsory.

Wellness 100

Wellness Research Outcomes 100

RebelEM

MAY 15, 2024

REBEL Core Cast 122.0 – Neutropenic Fever Click here for Direct Download of the Podcast. 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. 2014;14:162.

Infectious Diseases 90

Infectious Diseases Administration Sepsis Anaphylaxis 90

RebelEM

DECEMBER 19, 2022

REBEL Cast Ep113 – Defibrillation Strategies for Refractory Ventricular Fibrillation Click here for Direct Download of the Podcast Paper: Cheskes S, et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. N Engl J Med.

EMS 52

EMS CPR Shock Resuscitation 52

PulmCCM

JANUARY 29, 2022

The primary outcome measure was the proportion of patients with COVID-19-related hospitalization or death from any cause through 28 days. RRR is different from the absolute risk reduction [ARR] which is simply the mathematical difference in outcome between the two arms. For example, if the observed outcome for placebo is 1% and 0.1%

Outcomes 40

Outcomes Hospitals 40

PulmCCM

NOVEMBER 18, 2021

The PRINCIPLE authors note that this may have been driven by vaccine-effects in spring 2021 and also that this, more objective, outcome points towards true pathophysiological amelioration of COVID-19 by ICS. Download his free textbook here.

Urgent Care 40

Urgent Care Hospitals Stroke Wellness 40

The Skeptics' Guide to EM

JANUARY 11, 2025

Scott is best known for talking to himself about Resuscitation and Critical Care on a podcast called EMCrit, which has been downloaded more than 50 million times. Intervention: sRCTs Comparison: mRCTs Outcome: Primary Outcome: Mortality assessed at specified time points such as hospital discharge or predefined follow-up periods.

Evidence-Based Practice 116

Evidence-Based Practice Outcomes Operations Emergency Department 116

PulmCCM

OCTOBER 31, 2021

The primary outcome was a composite end-point consisting of either observation for at least 6 hours for COVID-19 in an emergency setting or referral for hospitalization both within 28 days of randomization. the patient had an outcome after at least 24 hours of therapy] and per-protocol [i.e., Download his free textbook here.

Outcomes 40

Outcomes Hospitals Psychiatric Wellness 40

JournalFeed

MARCH 8, 2025

Download the JournalFeed iPhone app ! Friday Spoon Feed : This pre-planned secondary analysis compared OHCA patients who received a single dose of epinephrine to standard ACLS epinephrine dosing and found mixed results in the outcomes of ROSC and survival to hospital discharge. The JournalFeed podcast for the week of March 3-7, 2025.

Outcomes 52

Outcomes Hospitals 52

RebelEM

DECEMBER 4, 2024

REBEL Core Cast 132.0 – Recent-Onset AFib Click here for Direct Download of the Podcast. Thirty-day Outcomes of Emergency Department Patients Undergoing Electrical Cardioversion for Atrial Fibrillation or Flutter. Electrical cardioversion (> 95%) is more likely to be successful than chemical cardioversion (~ 60%).

Emergency Department 83

Emergency Department Stroke EMS Shock 83

Don't Forget the Bubbles

JULY 5, 2023

Furthermore, educating both patients and their families is important in order to achieve good treatment compliance and better clinical outcomes. Incentive spirometry has also demonstrated to improve outcomes in SCD without respiratory symptoms and with back pain. 2019, 3 rd edition.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126