This site uses cookies to improve your experience. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country, we will assume you are from the United States. Select your Cookie Settings or view our Privacy Policy and Terms of Use.
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Used for the proper function of the website
Used for monitoring website traffic and interactions
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Strictly Necessary: Used for the proper function of the website
Performance/Analytics: Used for monitoring website traffic and interactions
One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. His CT scan showed extensive cranial fractures, traumatic subarachnoid haemorrhage, and intraparenchymal haemorrhage. Should we aim to prevent fever, or should we cool patients?
Ultrasonography or radiography for suspected pediatric distal forearm fractures. Casey currently splits his time […] The post SGEM#415: Buckle Down for some Ultrasound to Diagnosis Distal Forearm Fractures first appeared on The Skeptics Guide to Emergency Medicine. Reference: Snelling et al. He is also a fully-fledged ultrasonographer.
Background Lidocaine patches, applied over rib fractures, may reduce pulmonary complications in older patients. We aimed to establish whether a definitive randomised controlled trial (RCT) evaluating lidocaine patches in older patients with rib fracture(s) was feasible. Feasibility outcomes were recruitment, retention and adherence.
Which clinical features best predict occult scaphoid fractures? He will soon be transitioning out of the US military after […] The post SGEM#420: I get knocked down, but I get up again – do I have a scaphoid fracture? Which clinical features best predict occult scaphoid fractures? Emerg Med J. Emerg Med J. Emerg Med J.
Ultrasound‐Guided Serratus Anterior Plane Block (SAPB) Improves Pain Control in Patients With Rib Fractures. This topic is important because of the high incidence of rib fractures in trauma patients and their association with increased morbidity and mortality. Researchers then performed the serratus anterior plane block.
In the previous post in this series, I described an early review article summarizing several older studies comparing these two hemorrhage control techniques for pelvic fractures. They separated all patients with acetabular and pelvic ring fractures using ICD-10 codes. AE and PPP have equivalent outcomes.
The authors are given very little print space to fully describe their research idea, their methods, and their results’ significance. Even then, it needs to be taken in context with past, similar research before trickling down to patient care. Aspirin or Low-Molecular-Weight Heparin for Thromboprophylaxis after a Fracture.
Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial. Interests include information systems and digital health, research and education. He has three left-sided rib fractures on imaging without underlying complications. We have covered rib fractures twice on the SGEM.
Interpreting ResearchOutcomes with a Little Bathroom Humour You have learned a method for how to read a research paper , and now you are faced with a bunch of outcomes. There are primary, secondary, composite , and safety outcomes. What are these outcomes? What should you focus on?
Should we use ultrasound to diagnose distal forearm fractures in children and adolescents? Distal forearm fractures are common in children and adolescents, but the best method for diagnosing them is still debatable. Ultrasonography or Radiography for Suspected Pediatric Distal Forearm Fractures. N Engl J Med.
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?
Background There is a high rate of surgical fixation of displaced Colles’ type distal radial wrist fractures despite fracture manipulation in the ED. Point-of-care ultrasound has been used to guide ED manipulations but its effect on the quality of fracture reduction or subsequent need for surgical fixation is unknown.
More efficacious than parenteral opioids alone Safer than opioids Decreased delirium Patients have been shown to have improved functional outcomes at 30 days Early pain control matters! Currently EVT for large core is being looked at and so far the outcomes seem to be favorable Staphylococcus spp., and Pasteurella spp.
He has a passion for FOAMed and is the creator of the […] The post SGEM#324: Blow Away, Blow Away, Blow Away – Spirometry for Discharging Older Patients with Rib Fractures first appeared on The Skeptics Guide to Emergency Medicine. Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures.
Ben has a possible skull fracture and has been intubated, but his oxygen requirement is minimal. Intensive Care Research , 1 (3-4), pp.60-64. In studies including patients with trauma or Glasgow Coma Scale less than 8, intubation without sedation led to poorer neurological outcomes. His name is Ben. Burgart, A.M. and Kanaris, C.,
Reviewed by: Isabella Davenport Article 2: Does it improve outcomes if you replace the nail in nail bed repair? Children with nail bed injuries were randomly assigned to nail replacement or discarding , with the primary outcomes being secondary infection in 7 days and cosmetic outcome in four months.
Patients are unable to actively flex their DIP and x-ray imaging often will reveal and avulsion fracture. X-ray imaging should be obtained to evaluate for avulsion fracture. Major contributing factors for poor outcomes in this patient population (Dalton et.
The dueling guidelines conflict in parts, reflecting the fundamental ontological confusion and challenges to effective research on the amorphous syndrome that is ARDS. Progress in ARDS research has been very slow, from a clinical perspective. This looks like the major fracture between the two expert panels.
There are many different types of pneumothorax (PTX), and the management paradigm has shifted in recent years as the research has exploded on this topic. As these patients are typically already at a high risk for poor health outcomes, secondary spontaneous PTX is often more serious in presentation and management more complex [11].
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Early Antibiotic Use and Neonatal Outcomes Among Preterm Infants Without Infections. Distribution and pattern of hand fractures in children and adolescents.
Currently, there is limited data investigating outcome differences between beta blockers and calcium channel blockers for atrial fibrillation with rapid ventricular response in a patient diagnosed with heart failure. There were similar lengths of say overall and no significant difference in safety outcomes.
Bill is a professor in-residence at the UCLA School of Medicine in Los Angeles and among many other things, the director of UCLA Emergency Medicine Research Assistance program.
Data were extracted by one researcher and verified by another. Researchers contacted authors of RCT trials for additional information and access to raw data when required. Heterogeneity (I 2 ) for the primary outcome was 69%, representing a moderate value. A third reviewer adjudicated discrepancies when necessary.
He is diagnosed with a traumatic brain injury and a fracture to his right tibia and fibula. Given the lack of high-quality studies – particularly for mannitol – there is s need for further research in hyperosmolar therapy. Significantly, it should be noted that the study does not cover long-term outcomes, including survival.
John Brown PhD is a Professor of Health Services Research in Ireland who has been studying rural healthcare issues since 2012. The main outcome was the adjusted odds ratio for in-hospital mortality and hazard ratio for 30-day mortality with some pre-specified subgroups. Her main job is working for a think tank.
In an attempt to improve resource utilization, emergency department length of stay, limit cost and improve outcomes, there have been multiple Clinical Decision Rules (CDRs) created to help guide clinicians in their decision-making process. The CCHR is the most researched CDR in mTBI [3] and ha.
A more inquisitive approach would seek to understand why the educational bargain feels more fractured now despite ACGME work hours being more “protective” than ever before. I’ve heard arguments that frame this discussion in terms of trainee wellness, physician burnout, social contract, and patient outcomes.
Impact of Thrombolytic Therapy on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism. Impact of Thrombolytic Therapy on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism. Kirsty did her residency in North West England and has a PhD in Health Services Research from Sheffield.
The dueling guidelines conflict in parts, reflecting the fundamental ontological confusion and challenges to effective research on the amorphous syndrome that is ARDS. Progress in ARDS research has been very slow, from a clinical perspective. This looks like the major fracture between the two expert panels.
This time, Doctors from ‘The Bridge ‘ tell us what is new in the world of paediatric literature… The Bridge: Is a Post Graduate Doctor in Training (PGDiT) -led paediatric research forum in Yorkshire and Humber, UK, with the aim of bridging the gap in research access amongst PGDiT. PMID: 38471744 What’s it about?
Research suggests that injections with these chemicals, even with presentations delayed up to 24 hours after insult, has very good prognosis with no reported amputations9,10 Resolution of our case Our patient presented six days after an injection with a water (latex) based paint. Latex paint-gun injuries of the hand: are the outcomes better?
VP Shunt - Courtesy of Cancer Research UK via wikimedia - CC-4.0 - [link] Case courtesy of Paul Simkin, Radiopaedia.org, rID: 30453 Case courtesy of Dr Ruslan Asadov, Radiopaedia.org, rID: 8401. Obtain shunt imaging (“shunt series,” CTH non-con) Shunt series shows no migration of the shunt catheters or fractures of the tubing.
6 Periprosthetic fracture Occurs at an estimated rate of 3.5-4.1%. 5 CT if concern for occult fracture. Periprosthetic Fractures Pain prior to injury may point toward underlying pathology like infection, implant loosening, etc. Unified classification system used to describe periprosthetic hip fractures. 10% of patients.
doing the little things right, with the understanding that small gains are additive, and that details can be the difference between a good outcome and a poor one. Lesson 11 Find what you love to do and surround yourself with people who make you better at doing it.
Article 1: Infections in Foreign Travellers Bird C, Hayward GN, Turner PJ, Wasala D, Merrick V, Lyttle MD, Mullen N, Fanshawe TR; for Paediatric Emergency Research in the UK and Ireland (PERUKI). Without a clear definition, tailoring research and audit is difficult. Primary outcomes were sedation success and adverse event rates.
Randomised controlled trials addressing the benefit of steroids in preschool wheeze have compared different cohorts, used different trial designs and measured different outcomes. This is a way to overcome different trial outcomes. This paper’s primary outcome was a change in wheeze severity score (WSS).
The majority of them focused on the care process (86.8%), while a smaller percentage focused on care outcomes (9.3%) and structural aspects (3.9%). Most QIs focus on the care process; however, there is a lack of QIs that assess clinical outcomes. However, the low quality of evidence highlights the need for further research.
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. The researchers compared children diagnosed via screening with those diagnosed after clinical symptoms appeared. Dell KM, et al. Koenis MM et al. Eur J Pediatr.
saline Outcomes: Primary: Improvement in pain, measured on a 0 to 10 pain scale from baseline to 60 minutes later Secondary: Use of additional medication for the treatment of pain at any time during the ED course Percentage of patients who failed to achieve clinically important improvement in pain (<1.3)
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Original clinical studies Distribution and pattern of hand fractures in children and adolescents. Strategies for Managing Impairing Emotional Outbursts. JAMA Pediatr.
Costochondritis, rib fractures, and pericarditis are common causes of chest pain that can be treated with multimodal regimens. 7 Rib and Sternal Fractures: Rib fractures are often caused by blunt chest trauma. Up to two-thirds of rib fractures are missed on initial chest radiographs. Most cases abate by one year.
Ankle fractures are the third most common fracture in the ED [2] and more than 20,000 patients are seen in the ED for ankle sprains each day [3]. Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED.
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. In this issue of the Archives , we read a large retrospective study about gastric acid suppression in infancy and the increased risk of fractures. Engl J Med.
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Palpable signs of skull fractures on physical examination and depressed skull fractures or traumatic brain injuries on CT in children. Catassi G, et al.
We organize all of the trending information in your field so you don't have to. Join 5,000+ users and stay up to date on the latest articles your peers are reading.
You know about us, now we want to get to know you!
Let's personalize your content
Let's get even more personalized
We recognize your account from another site in our network, please click 'Send Email' below to continue with verifying your account and setting a password.
Let's personalize your content