The Skeptics' Guide to EM

AUGUST 24, 2024

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.

Fractures 53

Fractures Emergency Department Ultrasounds Radiology 53

Don't Forget the Bubbles

DECEMBER 25, 2023

Interpreting Research Outcomes 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?

Research 83

Research Outcomes Fractures Pediatrics 83

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

Don't Forget the Bubbles

NOVEMBER 13, 2023

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.

Fractures 64

Fractures Ultrasounds Emergency Department Pediatrics 64

Emergency Medicine Journal

NOVEMBER 28, 2023

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.

Fractures 40

Fractures Ultrasounds Outcomes Research 40

Taming the SRU

JULY 25, 2024

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.

Stroke 98

Stroke Fractures Operations Outcomes 98

The Skeptics' Guide to EM

MARCH 27, 2021

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.

Fractures 40

Fractures Outcomes Hospitals Emergency Department 40

Don't Forget the Bubbles

NOVEMBER 29, 2023

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.,

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

Don't Forget the Bubbles

OCTOBER 10, 2024

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.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

Taming the SRU

OCTOBER 16, 2024

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.

Airway Management 74

Airway Management Fractures CDC Pediatrics 74

PulmCCM

JANUARY 16, 2024

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.

Research 87

Research Documentation/Coding Outcomes Fractures 87

Taming the SRU

OCTOBER 1, 2023

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].

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Don't Forget the Bubbles

MAY 17, 2023

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.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Taming the SRU

APRIL 22, 2023

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.

Outcomes 52

Outcomes Stroke Fractures Documentation/Coding 52

The Skeptics' Guide to EM

JULY 17, 2018

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.

Pediatrics 52

Pediatrics Head Injuries Academics Emergency Department 52

RebelEM

JANUARY 30, 2023

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.

Dislocations 58

Dislocations Emergency Department Outcomes Research 58

Don't Forget the Bubbles

OCTOBER 2, 2024

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.

Administration 49

Administration Pediatrics Outcomes Research 49

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 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.

Stroke 56

Stroke Emergency Department COPD Academics 56

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

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.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

Sensible Medicine

MARCH 14, 2024

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.

Hospitals 92

Hospitals Wellness Academics Fractures 92

PulmCCM

FEBRUARY 8, 2024

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.

Research 52

Research Documentation/Coding Fractures Outcomes 52

The Skeptics' Guide to EM

JULY 2, 2017

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.

Fractures 40

Fractures Emergency Department Outcomes Ultrasounds 40

Don't Forget the Bubbles

SEPTEMBER 5, 2024

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?

Ultrasounds 52

Ultrasounds Research Emergency Department Outcomes 52

Cook County EM Blog

MARCH 20, 2023

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?

Documentation/Coding 52

Documentation/Coding Fractures Operations Research 52

Taming the SRU

MARCH 14, 2023

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.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

EMDocs

NOVEMBER 16, 2024

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.

EMS 96

EMS Dislocations Fractures Operations 96

Taming the SRU

FEBRUARY 22, 2023

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.

Hospice 40

Hospice EKG/ECG Resuscitation Wellness 40

Don't Forget the Bubbles

MARCH 4, 2024

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.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

Don't Forget the Bubbles

JULY 22, 2024

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).

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

Don't Forget the Bubbles

DECEMBER 2, 2024

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.

Documentation/Coding 98

Documentation/Coding Pediatrics Emergency Department Fractures 98

Don't Forget the Bubbles

MAY 8, 2024

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.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

RebelEM

MAY 22, 2023

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)

Administration 82

Administration Emergency Department Dislocations Hospitals 82

Don't Forget the Bubbles

JULY 17, 2023

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.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

EMDocs

NOVEMBER 4, 2024

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.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

Taming the SRU

MAY 22, 2023

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.

Fractures 77

Fractures Dislocations Operations Radiology 77

Don't Forget the Bubbles

OCTOBER 4, 2023

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.

Pediatrics 111

Pediatrics Fractures Outcomes Research 111

Don't Forget the Bubbles

NOVEMBER 6, 2024

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.

Pediatrics 52

Pediatrics Sepsis Fractures Hospitals 52