Pediatric EM Morsels

JULY 21, 2023

We had just received a young child from EMS who was post-ictal with decreased mentation. Orso 2020] One pediatric study in this systematic review, and the intubated patients had worse outcome than non-intubated Early airway protection = lower rates of complications (in TRAUMA), but this is not always true with medical patients.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

The Skeptics' Guide to EM

JANUARY 6, 2024

Her research focuses on prehospital care of children with anaphylaxis. […] The post SGEM #425: Are You Ready for This? Her research focuses on prehospital care of children with anaphylaxis. She is an executive lead for the EMS for Children Innovation and Improvement Center. JAMA Netw Open. Veterans Affairs and prison hospitals.

Emergency Department 127

Emergency Department Pediatrics Anaphylaxis Leadership 127

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. August 20, 2024 Guest Skeptic: Dr. Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Chris completed his emergency medicine residency and EMS fellowship at UNM.

Hospitals 103

Hospitals CPR EMS Outcomes 103

RebelEM

JANUARY 21, 2025

Outcomes: Primary: Rate of missed PE in high-risk patients with a negative D-dimer at index visit or 3-month follow-up Secondary: Rate of missed PE in high-risk patients using a 500ng/mL D-dimer threshold at index visit or 3-month follow-up Design: Post hoc analysis of three European studies: PROPER, MODIGLIANI, and TRYSPEED.

EMS 45

EMS Research Wellness Outcomes 45

RebelEM

JUNE 1, 2023

Post-ROSC management is nuanced and challenging but helps to ensure good outcomes. In theory, rapid identification of the underlying cause should improve outcomes by allowing clinicians to tailor management. Diagnostic yield, safety, and outcomes of Head-to-pelvis sudden death CT imaging in post arrest care: The CT FIRST cohort study.

Outcomes 144

Outcomes Resuscitation Hospitals CPR 144

The Skeptics' Guide to EM

OCTOBER 19, 2024

Annals of EM 2024. Each method has its advantages, and ongoing research continues to refine the efficacy and safety of these delivery methods in acute pain management in the ED​​. Prior research by this same group has shown ketamine breath-actuated nebulizer (K-BAN) has effective analgesic properties at three different doses 0.75

Emergency Department 94

Emergency Department EMS Research Administration 94

The Skeptics' Guide to EM

JUNE 1, 2024

His research focuses on the pre-hospital care of children by EMS. He is the principal investigator for EMSC State Partnership in Washington, DC and is also involved in various multi-center EMS studies with the Pediatric Emergency Care Applied Research Network (PECARN). The fall was witnessed by his family.

Pediatrics 87

Pediatrics EMS Emergency Department Research 87

RebelEM

MAY 27, 2024

It is the first research paper to explore the synergistic effects of combining MVM and IV Adenosine in treating PSVT. The primary outcomes are patient-centered and objectively measured, potentially ensuring relevance and reliability. The unblinded nature of the study could influence outcomes due to observer bias.

Outcomes 134

Outcomes Research Operations Hospitals 134

RebelEM

OCTOBER 30, 2023

This could dilute any beneficial effects seen Lack of blinding may bias results (Although mortality is a solid objective primary outcome, bias may still creep in terms of management) Discussion: Authors were looking for an absolute mortality difference of 7% from baseline mortality of 26% with a 90% power. Cryoprecipitate Group: 25.3%

Administration 125

Administration Blood Transfusions Outcomes Hospitals 125

RebelEM

MAY 29, 2023

Most of the research on the use of MB has been in patients with vasoplegia following cardiopulmonary bypass. MB decreases nitric oxide levels by inhibiting inducible nitric oxide synthase (iNOS) and soluble guanylate cyclase (sGC). Through these mechanisms it restores vasoregulation. NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9%

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

RebelEM

SEPTEMBER 7, 2023

More research is needed to inform preventive treatment strategies for seizures in patients with spontaneous intracerebral hemorrhage (ICH). OUTCOMES Primary: Occurrence of at least one clinical or electrographic seizure recorded on continuous EEG within 72 hours after inclusion. The primary outcome was patient-oriented.

Seizures 123

Seizures Stroke Outcomes Research 123

RebelEM

NOVEMBER 30, 2023

What They Did: Researchers performed a systematic review and meta-analysis. Outcomes: Primary Outcome: In-hospital mortality. Secondary Outcomes: Delayed hypotension, increased ICU stay, and other relevant outcomes. The study was conducted according to PRISMA guidelines. 2.89, p = 0.01.

Sepsis 118

Sepsis Fluid Resuscitation Resuscitation Administration 118

Critical Care Now

AUGUST 10, 2024

A Cochrane review identified several small, heterogeneous randomized controlled trials comparing simple aspiration with drainage, concluding that more robust research is needed. Secondary outcomes showed similar treatment failure rates at 7 days, with lower pain scores reported in the aspiration group.

Research 98

Research EMS Outcomes Hospitals 98

RebelEM

JUNE 19, 2023

The PATCH-trauma researchers sought to address this critique. PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy? Prehospital Tranexamic Acid for Severe Trauma.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

RebelEM

AUGUST 14, 2023

days 2 most common sites of infection were lung (44.8%) and inta-abdominal (32.1%) Majority of infections were community-acquired (≈84%) Over half the patients were on mechanical ventilation (≈53%) Primary Outcome Results: 28-day mortality rate: Placebo 26.1% (230/882) vs. XBJ 18.8% (165/878); P<0.001 The risk difference was 7.3% (95% CI, 3.4-11.2)

Sepsis 97

Sepsis Outcomes Administration EMS 97

ACEP Now

MARCH 6, 2024

Every year, the volume of published research continues to outpace capacity to consume. Gotta catch ‘em all!” 4 Repeated trials have not shown alteplase to have any signal of better outcomes, nor tenecteplase to have an association with increased adverse events. How Best to Stop the Bleeding in Trauma? percent to 38.3

Research 52

Research Airway Management Stroke Outcomes 52

RebelEM

SEPTEMBER 14, 2023

to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% Control: 53.4% D ECLS: 18.2% Control 8.7% Control 38.0% Control: 49.0% RR 0.98; 95% CI 0.80 to 1.19; p = 0.81

Shock 133

Shock Outcomes Resuscitation Stroke 133

RebelEM

SEPTEMBER 19, 2022

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. Over the years, we as a scientific community have worked extensively to find other interventions that improve outcomes. However, human data is sorely lacking.

CPR 52

CPR Outcomes Resuscitation EMS 52

Taming the SRU

MAY 11, 2024

r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Flood syndrome- start fluids, give antibiotics, consult surgery. Ways to get involved?

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

Broome Docs

OCTOBER 6, 2024

Mols EM, Haak H, Holland M, Schouten B, Ibsen S, Merten H, Christensen EF, Nanayakkara PWB, Nickel CH, Weichert I, Kellett J, Subbe CP, Kremers MNT; Safer@Home Research Consortium. Can acutely ill patients predict their outcomes? Can patients predict the future? A scoping review. Emerg Med J. 2024 May 28;41(6):342-349.

Emergency Department 102

Emergency Department EMS Research Outcomes 102

Pediatric EM Morsels

AUGUST 9, 2024

If not treated early, then increased risk of poor outcomes and death. The post Congenital Syphilis appeared first on Pediatric EM Morsels. Maternal screening early in pregnancy is the best means to prevent congenital syphilis. Penicillin is 98% effective at preventing congenital syphilis. Can identify T. A case of congenital syphilis.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

The Skeptics' Guide to EM

JULY 22, 2023

NEJM 2023 Guest Skeptic: Dr. Jeff Jarvis is the Chief Medical Officer and System Medical Director for the Metropolitan Area EMS Authority in Fort Worth, Texas, also known as MedStar. Jeff Jarvis is the Chief Medical Officer and System Medical Director for the Metropolitan Area EMS Authority in Fort Worth, Texas, also known as MedStar.

EMS 88

EMS CPR Ultrasounds Research 88

Don't Forget the Bubbles

JUNE 19, 2024

In adult trauma cases, there has been significant research to help decide which patients require X-ray or CT imaging for possible cervical spine injuries, leading to the development of the National Emergency X-Ray (NEXUS) prediction rule and the Canadian C-Spine Rule (CCR). Why is this study needed?

CPR 124

CPR Research Documentation/Coding Outcomes 124

The Skeptics' Guide to EM

OCTOBER 17, 2020

Salim is probably better known as the creator and founder of the wonderful knowledge translation project called REBEL EM. It is a free, critical appraisal blog and podcast […] The post SGEM#305: Somebody Get Me A Doctor – But Do I Need TXA by EMS for a TBI? first appeared on The Skeptics Guide to Emergency Medicine.

EMS 52

EMS Head Injuries Outcomes Hospitals 52

Taming the SRU

AUGUST 7, 2023

Demel and kreitzer Expanding indications for Thrombolytics Initial tPA window of 0-3 hours number needed to treat (NNT) to achieve a good outcome was 10. hours increased the NNT for a good outcome to 20. Research Grand rounds WITH Drs. The expanded window of 3-4.5 How do you apply the knowledge of studies you review?

Stroke 93

Stroke Outcomes EKG/ECG Research 93

RebelEM

OCTOBER 5, 2023

Secondary Outcome By day 90, mortality was 9.3% Strengths: The investigators framed a research question centered on patient outcomes, ensuring the study’s relevance and practicality. Control: Normal Saline via continuous infusion according to the same regimen used in the hydrocortisone group. to −0.8).

Research 94

Research Outcomes Administration Shock 94

RebelEM

JANUARY 25, 2024

What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021. Outcomes: Primary Outcome: Reduction of dyspnea measured on a verbal dyspnea scale (VDS) from 0 to 10 recorded at enrollment, then at 2, 4, and 5 hours after arrival.

Ultrasounds 125

Ultrasounds Outcomes COPD Hospitals 125

EMDocs

SEPTEMBER 4, 2024

The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research.

Pediatrics 97

Pediatrics Outcomes Operations Hospitals 97

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 4, 8 Paper: Dahyot-Fizelier, C.,

CDC 111

CDC Radiology Radiology Head Injuries 111

RebelEM

SEPTEMBER 2, 2024

PMID: 36088303 Research Question: How effective is the DuCanto catheter, compared to the Yankauer and standard suction catheters, at suctioning liquids of different viscosities? Device-Oriented Outcomes : While suction rate improvements were significant, the clinical relevance of these findings remains uncertain. BMC Anesthesiol.

Airway Management 114

Airway Management Outcomes EMS Research 114

Taming the SRU

NOVEMBER 3, 2023

Broad strokes In this prospective, non-randomized study published by Kring et al in January 2022 out of Maine Medical Center, researchers compared mean pain scores at rest and during incentive spirometry before, at 15 minutes after, and then 60 minutes after treatment with a serratus anterior plane block. Ultrasound Med. 41, 2695–2701 (2022).

Fractures 98

Fractures Ultrasounds Research Outcomes 98

ACEP Now

OCTOBER 3, 2023

These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations. There are at least 600 TBI-related hospitalizations and 175 TBI-related deaths per day.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation Pediatrics 98

RebelEM

NOVEMBER 20, 2023

Researchers randomly assigned 90 eligible patients over ≈ 4.5 Outcome: Primary Outcome: All-cause mortality at 90 days. The primary outcome focused on patient-centered outcomes. The outcomes were predominantly binary and objective, reducing the potential for subjective interpretation and bias.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

RebelEM

FEBRUARY 5, 2024

They concluded that more research of higher quality is needed to strengthen the evidence in favor of one technique over the other. Outcomes: Primary Outcome: Pulmonary expansion 24 hours after the procedure. Secondary Outcomes: Pulmonary expansion 7 days after the procedure. Recurrence of pneumothorax within 1 year.

Outcomes 98

Outcomes Hospitals Research Emergency Department 98

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St.

Stroke 91

Stroke Outcomes EMS Seizures 91

Emergency Medicine Cases

DECEMBER 20, 2022

The post Ep 177 Bronchiolitis – Diagnostic Challenges and Management Pitfalls appeared first on Emergency Medicine Cases.

Pediatrics 52

Pediatrics EMS Research Outcomes 52

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 91

Administration Outcomes Documentation/Coding Emergency Department 91