Taming the SRU

AUGUST 7, 2023

The patient needs a transvaginal ultrasound w/ doppler with gynecology consult and possible laparotomy TVUS is not just for torsion, it can also be used for ectopic pregnancies or pregnancy of unknown location Acute Ischemic Stroke Updates WITH Drs. Research Grand rounds WITH Drs. The expanded window of 3-4.5

Stroke 93

Stroke Outcomes EKG/ECG Research 93

Pediatric EM Morsels

JULY 21, 2023

We had just received a young child from EMS who was post-ictal with decreased mentation. Borgialli DA, Mahajan P, Hoyle JD Jr, Powell EC, Nadel FM, Tunik MG, Foerster A, Dong L, Miskin M, Dayan PS, Holmes JF, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN). Less than 8, intubate! PMID: 1933914. Acad Emerg Med.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

RebelEM

SEPTEMBER 14, 2023

bleeding, stroke, limb ischemia, and hemolysis). PMID: 37634145 Post Peer Reviewed By: Anand Swaminathan, MD (Twitter/X: @EMSwami ) The post The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock appeared first on REBEL EM - Emergency Medicine Blog. The evidence for this practice has been sparse until now. Zeymer HT et al.

Shock 133

Shock Outcomes Resuscitation Stroke 133

RebelEM

JUNE 19, 2023

The PATCH-trauma researchers sought to address this critique. SBP < 75 mm Hg: 39% SBP 76-89 mm Hg: 33% Critical Findings: No statistically significant difference in safety outcomes (DVT, PE, MI, Stroke) TXA Placebo RR (95% CI) Primary Outcome Good Functional Outcome (6 months) 53.7% Prehospital Tranexamic Acid for Severe Trauma.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

RebelEM

FEBRUARY 29, 2024

3, 6 Among patients with stroke or traumatic brain injury (TBI), the risk may be as high as 28%-76% and 23%-60%, respectively. The authors rightfully note future research targets should include how/if the routine use of ceftriaxone increases antibiotic resistance in a population that is already quite vulnerable to devastating infection.

CDC 111

CDC Radiology Radiology Head Injuries 111

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.

Fractures 98

Fractures Ultrasounds Research Outcomes 98

The Skeptics' Guide to EM

OCTOBER 14, 2019

He is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that tries to cut down knowledge translation gaps of research to bedside clinical practice. He arrives at the emergency department via EMS with a Glasgow Coma Scale (GCS) score of 10 and both pupils reactive.

Stroke 52

Stroke EMS Emergency Department Outcomes 52

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. 2019;154(7):e191152.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation Pediatrics 98

The Skeptics' Guide to EM

APRIL 8, 2023

John Brown PhD is a Professor of Health Services Research in Ireland who has been studying rural healthcare issues since 2012. The pre-specified subgroup analyses showed a decrease in in-hospital or 30-day mortality for myocardial infarction, stroke, aortic aneurysm, and major trauma but not for pneumonia, bowel perforation or hip fractures.

Stroke 56

Stroke Emergency Department COPD Academics 56

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Robert’s academic interests include research and evidence-based medicine. Alongside his EM residency, he is doing a PhD in epidemiology. Robert’s academic interests include research and evidence-based medicine. Alongside his EM residency, he is doing a PhD in epidemiology.

Academics 52

Academics Resuscitation EMS Stroke 52

EMDocs

OCTOBER 30, 2023

Pillai, MBBS (@sspillai01, EM Resident Physician, University of Kentucky) and Christopher N. 2 In response to the constrained availability of contrast media, emergency medicine (EM) and radiology departments were compelled to enact modifications in their imaging techniques. Authors: Saran S. 11 Table 1.

Radiology 92

Radiology Radiology Emergency Department Hospitals 92

RebelEM

MARCH 13, 2024

This was not a Code 3 respiratory distress, fentanyl overdose with minimal response to Narcan or even an unconscious stroke patient with the blood pressure of a giraffe. How does thinking on the spectrum of more or less right impact our utilization of new research or of implementing a consultant’s recommendations?

Documentation/Coding 58

Documentation/Coding Outcomes EMS Stroke 58

ACEP Now

SEPTEMBER 13, 2023

Years before, he’d started his EM career as medical director of the ER at Memphis’ public hospital and Memphis Fire EMS. 1 “I remarked that EM was not even a specialty then, and suggested it might be an opportune time for an updated IOM report that examined the achievements and challenges of emergency care in the U.S.,”

EMS 45

EMS Research Academics Military 45

The Skeptics' Guide to EM

DECEMBER 5, 2020

She is the New York ACEP liaison for the Research and Education Committee and is a past ALL NYC EM Resident Education Fellow. You’re about to call in your MRI tech from home, but then you remember reading that the HINTS exam is more sensitive than early MRI for diagnosis of posterior stroke. How hard can it be?”

Stroke 40

Stroke Documentation/Coding Emergency Department Hospitals 40

Taming the SRU

AUGUST 4, 2024

to teach you and your learner something new on shift skin adhesives WITH dr. hill Dermabond is a polymer (octyl cyanoacrylate) that can be used to repair lacerations in the Emergency Department faster than sutures, allowing the ED physician to be more efficient.

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

ACEP Now

JULY 7, 2024

35-year-old man presents by EMS with seizures. He has been seizing for 30 minutes, despite treatment of intravenous lorazepam by EMS. The Neuroscience Research Group (NeuRos). According to family at the scene, he has a history of seizures but has not been taking his medication recently. 2015;31:22-26. Neurol Clin Pract.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

ACEP Now

JULY 6, 2023

Emergency medicine (EM) has evolved over time and has long passed a crossroads where previously unachievable capabilities should be celebrated and shared. Pediatric Emergency Care Applied Research Network head injury clinical prediction rules are reliable in practice. However, such a view overlooks two critical facts. Stiell IG, et al.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

Taming the SRU

OCTOBER 7, 2024

In 2009, a cross-sectional research study of pregnant patients with suspected DVT were evaluated, and used to derive three symptoms that are highly predictive of DVT in pregnancy ( L eft leg symptoms, >2 cm calf circumference difference or E dema, and F irst t rimester onset) called the LEFt clinical decision tool. references Mulhotra, A.

Ultrasounds 64

Ultrasounds CDC Research Stroke 64

Taming the SRU

MAY 1, 2023

EMS was bagging him on arrival Primary notable for Compromised Airway Protection, bilateral Breath sounds, strong pulses,GCS 3 CT images of Head, Chest, Abdomen, Pelvis, and Spine No acute findings pH of 6.75 Exertional Hyperthermia Patients with heat stroke will present with Temp > 104, AMS, or seizures.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

Advanced Emergency Nursing from AENJ

JULY 10, 2016

Joe Lex, MD, just retired from Temple University in Philadelphia after 50 years of working his way up in Emergency Medicine, from a Vietnam Medic, to EMS, Nursing, Medicine, and Emergency Medicine. If you want to know how we will practice medicine in the future – use FOAMed. Dr. May will tell you how to modulate the flow from the hoses.

Military 40

Military Emergency Nursing Stroke Wellness 40

RebelEM

FEBRUARY 1, 2024

Background : Alteplase, a class of medication that converts plasminogen to plasmin leading to fibrin degradation and subsequent clot lysis, has been the standard of care for acute ischemic stroke (AIS) patients that meet eligibility criteria. mg/kg non-inferior to alteplase in the treatment of acute ischemic stroke? vs Alteplase 34.8%

Stroke 132

Stroke Blood Transfusions Outcomes EMS 132

EMDocs

DECEMBER 16, 2023

We’ll keep it short, while you keep that EM brain sharp. A 34-year-old male is brought via EMS after collapsing during an outdoor adventure race. EMS reports the patient was conscious but altered, with slurred speech and confusion. Both can result in heat exhaustion and heat stroke and have many overlapping symptoms.

Hyperthermia / Hypothermia 87

Hyperthermia / Hypothermia EMS Stroke Seizures 87

The Skeptics' Guide to EM

JULY 4, 2020

Date: June 30th, 2020 Guest Skeptic: Professor Daniel Fatovich is an emergency physician and clinical researcher based at Royal Perth Hospital, Western Australia. Date: June 30th, 2020 Guest Skeptic: Professor Daniel Fatovich is an emergency physician and clinical researcher based at Royal Perth Hospital, Western Australia.

Stroke 52

Stroke Research Hospitals Emergency Department 52

EMDocs

OCTOBER 27, 2023

Further review reveals the patient was unable to afford his refill of Eliquis and abruptly stopped taking it, leading to his acute stroke. Research shows that nearly a third of adults report not taking medications as prescribed for cost-related reasons. What happened here, and how can we advocate to prevent this going forward?

Research 90

Research Stroke EMS EKG/ECG 90

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. Jeff: This DEA designation limits the ability to do research and obtain federal funding for such research. First up is the link between cannabis use and stroke or TIA.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EMDocs

NOVEMBER 4, 2024

Bhana, MD (EM Resident Physician, University of Massachusetts/UMass Chan Medical School); Clarence Kong, MD (Pain Fellow, Eastern Virginia Medical School – Virginia Health Sciences at Old Dominion University); Mani Hashemi, MD (EM Attending, HCA Florida Mercy Hospital); S.M. 2017.04.011 Witt CE, Bulger EM. Authors: Nikhil B.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

RebelEM

FEBRUARY 22, 2024

It opens the door for further research to definitively answer the question posed by this study. Rezaie, MD (Twitter/X: @srrezaie ) The post Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia (MINT Trial) appeared first on REBEL EM - Emergency Medicine Blog. years Female sex 44.3 Baseline hemoglobin 8.6

Blood Transfusions 58

Blood Transfusions Outcomes Wellness Research 58

Dr. Smith's ECG Blog

APRIL 8, 2015

in 2010 EM Clinics of North America (full text link) For an Exhaustive Review of Syncope and its full management outside the ED environment, go to the 2009 European Society of Cardiology Guidelines (full text pdf). to 1.45) for fatal or nonfatal stroke. to 1.51) for death from any cause, 1.27 (95 percent confidence interval, 0.99

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EMDocs

NOVEMBER 2, 2024

We’ll keep it short, while you keep that EM brain sharp. A broad workup is initiated for altered mental status, including an STD panel, which shows a reactive Venereal Disease Research Laboratory (VDRL) and a negative CT head. cognitive and behavioral impairment) – 33% Ataxia – 28% Stroke – 23% Ophthalmic symptoms (e.g.,

EMS 111

EMS Infectious Diseases CDC Research 111

ACEP Now

DECEMBER 7, 2024

The use of thrombolytics for acute ischemic stroke may be one of the most controversial topics in emergency medicine during the last several decades. 1 The reason is understandablethrombolytics in stroke is a high-risk, higher-reward treatment. This debate recurs in multiple forums including many previous pieces in ACEP Now.

Stroke 98

Stroke Research Hospitals Outcomes 98