Sensible Medicine

JUNE 6, 2023

Two nearly identical trials of the monoclonal drug aducanumab, ENGAGE and EMERGE, had disparate outcomes: ENGAGE showed no benefit and EMERGE showed that the drug slowed decline. This seemed important to consider, and so we looked at whether outcomes in trials of monoclonal antibodies for AD correlated with rates of ARIA.

Outcomes 96

Outcomes Infectious Diseases Research Academics 96

Pediatric EM Morsels

AUGUST 11, 2023

Having authored 575 ( well, now 576 ) of them, I am often quite convinced that there are no new topics to discuss. Infections there become complicated very quickly and the outcomes can be very poor. This is the 601st Ped EM Morsel ! Recently, Dr. Teresa Crow encountered an important topic in children that deserves its own Morsel.

Burns 130

Burns Pediatrics EMS Outcomes 130

RCEM Learning

APRIL 9, 2024

Maintain a Positive Mindset and Well-being: Exam preparation can be demanding, so it’s important to take care of your mental and physical well-being. A positive mindset and well-being contribute to better focus and performance during the exam. The post FRCEM SBA appeared first on RCEMLearning.

Infectious Diseases 52

Infectious Diseases Airway Management Resuscitation Poisoning 52

Pediatric Education

MAY 26, 2024

The pediatrician said that the child was overall healthy and thriving, with the usual minor infectious disease episodes. “I reassured the mother that he was doing well and he should have fewer infections as he grew. The long-term health outcomes for children in childcare are difficult to assess. 2013;17(3):448-455.

Infectious Diseases 40

Infectious Diseases Pediatrics Outcomes Wellness 40

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. A 2015 meta-analysis of 9 studies consisting of 725 patients published in the International Journal of Infectious Diseases found PCT far superior to CRP, with PCT having a sensitivity of 90 and specificity of 98% [36].

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Don't Forget the Bubbles

JANUARY 10, 2024

Some wonder if giving blood to children with a haemoglobin <6g/dl will improve outcomes. Outcomes Primary outcome Mortality at 28 days after randomisation. The authors chose a patient-centred, primary outcome in keeping with their pragmatic design. Groups were well matched at baseline. Was blinding achieved?

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

ACEP Now

MARCH 6, 2024

The PATCH-Trauma trial took a critical look at TXA in major trauma in the advanced trauma systems of Australia and found a mixed result: a slightly greater number of patients were still alive six months following TXA administration, but there was no difference in survival with a good functional outcome. percent to 38.3

Research 52

Research Airway Management Stroke Outcomes 52

Don't Forget the Bubbles

FEBRUARY 28, 2024

Outcomes were: (1) crusting of the lesions; then (2) complete healing of lesions -the end goal of treatment. Was the exposure and outcome accurately measured to minimise bias? There were no objective tests to confirm disease clearance. It was not clear if there was any vested interest in ensuring a certain outcome.

Pediatrics 59

Pediatrics Infectious Diseases Outcomes Research 59

Dr. No

DECEMBER 19, 2021

It’s not often that Dr No’s flabber gets well and truly ghasted. The first is the meaning of a model: is it a prediction, or a scenario, and so the follow-up, more important, question, is it possible to get the two mixed up: that an outcome written as a scenario gets read as a prediction?

Infectious Diseases 52

Infectious Diseases Outcomes Dehydration Operations 52

Pediatric Education

AUGUST 20, 2023

Patient Presentation An 8-year-old male came to clinic for his well-child care after moving to the area. Patients needed prolonged treatment and followup (up to 88 days) but did well without recurrences. ” In the Belgium study, the most common underlying risk factor was hepatobiliary disease (e.g. 2020;71(1):106-111.

Pediatrics 40

Pediatrics Infectious Diseases Wellness Sepsis 40

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

EMDocs

JANUARY 11, 2024

Systems included neurological, cardiac, pulmonary, hematology, infectious disease, gastrointestinal, endocrine, fluids management, and general critical care. Individualize MAP targets based on the patient, as well as treatments (inotropes, vasopressors, and fluids) for hypotensive patients. There are no hard MAP recommendations.

Seizures 94

Seizures Shock Infectious Diseases CPR 94

ALiEM

AUGUST 21, 2023

Risk factors for poor outcomes include immunocompromise (HIV, diabetes, immunosuppression), intravenous drug use, peripheral vascular disease, and polymicrobial infection. Treatment includes emergent consultation with orthopedics or hand surgery as well as early initiation of IV antibiotics. References Ritter K, Fitch R.

Academics 52

Academics Outcomes Hospitals Wellness 52

EMDocs

OCTOBER 5, 2024

ESBL are found exclusively in Gram-negative organisms, including: Klebsiella pneumoniae Klebsiella oxytoca Escherichia coli Proteus mirabilis Pseudomonas aeruginosa The first reported beta-lactamase enzyme was reported in 1963, and today there are well over 350 ESBL enzyme variants. The Lancet Infectious Diseases.

EMS 93

EMS Infectious Diseases Sepsis Hospitals 93

Pediatric EM Morsels

SEPTEMBER 20, 2024

Though most children recover well after STEC is cultured from their stool, some will go on to display the findings that make up HUS. It is critical to detect HUS early in its disease course to ensure the best outcomes. Predicting Adverse Outcomes for Shiga Toxin-Producing Escherichia coli Infections in Emergency Departments.

Pediatrics 164

Pediatrics Ultrasounds Dehydration Emergency Department 164

RebelEM

MAY 15, 2024

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 90

Infectious Diseases Administration Sepsis Anaphylaxis 90

EMDocs

DECEMBER 18, 2023

8 Based on multiple randomized controlled trials (RCTs), SSC 2021 guidelines suggest against using procalcitonin as a screening method to guide initiation of antibiotic therapy, as no difference in clinical outcomes was appreciated. 36 However, the literature has failed to prove that the double coverage has any effect on clinical outcomes.

Sepsis 83

Sepsis Fluid Resuscitation Shock Resuscitation 83

RebelEM

AUGUST 3, 2023

Authors determined they would need to enroll 380 patients (190/group) to achieve a statistical power of 80%, assuming an event rate in the control group of 4% of which neither was achieved however if the control group had a lower prevalence of the outcome (i.e. randomization) as per protocol (i.e.

Anaphylaxis 52

Anaphylaxis Allergic Reactions Infectious Diseases Outcomes 52

The Skeptics' Guide to EM

NOVEMBER 28, 2020

He is the President of the national charity Canadian Association of Physicians for the Environment (CAPE), as well as the co-founder and co-chair of the local non-profit the Calgary Climate Hub, and […] The post SGEM#309: That’s All Joe Asks of You – Wear a Mask first appeared on The Skeptics Guide to Emergency Medicine.

Infectious Diseases 52

Infectious Diseases Operations Outcomes Wellness 52

EMDocs

JANUARY 6, 2024

12 This is a variant of coronary artery disease in the allograft vessels, characterized by concentric intimal hyperplasia, as opposed to the eccentric pattern seen in atherosclerosis among non-transplant coronary arteries. 15 The exact incidence or acute coronary syndrome in heart transplant patients is not well characterized.

EMS 80

EMS Infectious Diseases Shock Emergency Department 80

Pediatric Education

JUNE 25, 2023

Borates can cause skin irritation and there can be some reproductive changes as well. ” They also reviewed other topical antiseptics such as acetic acid, povidone-iodine and aluminum acetate (Burow’s solution) but it was “…not possible to know whether there is a difference between the groups for any other outcome.”

Infectious Diseases 40

Infectious Diseases Pediatrics Seizures Outcomes 40

EB Medicine

JANUARY 2, 2019

With opportunities to improve outcomes for both the fetus and the mother, I’m confident that this episode will be worth your time. Nachi: For patient who have a threatened miscarriage in the first trimester, there is a 2-fold increased risk of subsequent maternal and fetal adverse outcomes.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

PEMBlog

JANUARY 17, 2024

Camargo, Clinical Trial: Comparative Effectiveness of Cephalexin Plus Trimethoprim-Sulfamethoxazole Versus Cephalexin Alone for Treatment of Uncomplicated Cellulitis: A Randomized Controlled Trial, Clinical Infectious Diseases, Volume 56, Issue 12, 15 June 2013, Pages 1754–1762, [link] Liu C, Bayer A, Cosgrove SE, et al. What is it?

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

American Medical Compliance

MARCH 12, 2025

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve patient care outcomes. Get Certified American Medical Compliance (AMC) is a leader in the industry for compliance, Billing, and HR solutions.

Infectious Diseases 52

Infectious Diseases PPE CDC Documentation/Coding 52

Don't Forget the Bubbles

FEBRUARY 24, 2025

They were a well-grown, term infant born in good condition. However, our true success is measured by how effectively we share knowledge, foster understanding, and improve patient outcomes. This reduction is consistently associated with improved outcomes in infants with severe pertussis. Sounding familiar? Namachivayam et al.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

Taming the SRU

JUNE 12, 2023

However, there have been no studies statistically powered well enough regarding dog bite lacerations to confirm or dispute this claim. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clinical Infectious Diseases.

Infectious Diseases 103

Infectious Diseases Emergency Department Administration Academics 103

American Medical Compliance

FEBRUARY 21, 2025

Understanding SDOH is critical, as social and environmental conditions, such as economic stability, education, healthcare access, and community support, play a significant role in health outcomes. This training equips providers with practical strategies to identify and address SDOH, ultimately improving health equity and patient outcomes.

Outcomes 52

Outcomes Infectious Diseases Wellness Academics 52

Mind The Bleep

JANUARY 24, 2025

Fracture reduction and immobilisation : Fracture and/or dislocation reduction can restore alignment and vascular supply as well as reduce pain. Mastering the basics of immediate management and recognising when to seek senior help is key to optimising patient outcomes. References: Murphy, R. de Schoulepnikoff, C., Columb, M. Bedford, J.,

Dislocations 52

Dislocations Fractures Soft Tissue Injuries Infectious Diseases 52

ALiEM

DECEMBER 9, 2024

Physical Exam Vitals : BP 128/84; HR 88; Temp 98F; RR 18; SpO2 (on RA) 100% General : Well appearing HEENT : No conjunctival injection Cardiovascular : S1, S2; no murmurs, rubs, or gallops Skin : Erythematous patch with central clearing in left popliteal fossa Laboratory Data WBC : 5.1 Lyme Disease. Clin Infect Dis. PMID: 20070237.

Emergency Department 60

Emergency Department CDC EMS Academics 60

Don't Forget the Bubbles

SEPTEMBER 23, 2024

This is particularly crucial in younger children who have received a large adult kidney and typically have relatively low creatinine levels when stable and well. Additionally, any child with a kidney transplant might have some degree of chronic kidney disease (CKD). Induction treatment may significantly reduce immunoglobulin titers.

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Pediatric Education

OCTOBER 1, 2023

Despite this tremendously positive outcome, there still are continued threats against polio eradication. Non-polio enteroviruses have emerged which cause acute flaccid paralysis as well. It is estimated that this global vaccination and surveillance program is preventing ~600,000 polio cases/year.

Infectious Diseases 40

Infectious Diseases Pediatrics Outcomes Wellness 40

Mind The Bleep

NOVEMBER 20, 2024

Infectious disease (ID) is much more than simply collecting blood cultures; it’s a dynamic and exciting specialty that offers the opportunity to work with patients of all ages, varying acuities, and diverse clinical presentations. Contents What makes ID a great career choice? What makes ID a great career choice?

Infectious Diseases 52

Infectious Diseases Research Sepsis Patient Safety 52

EMDocs

NOVEMBER 25, 2024

volvulus as well as improvements in the diagnosis and treatment of this morbid disease. Vision loss carries a high degree of morbidity and is associated with higher all-cause mortality, 4 and it is our role as emergency providers to recognize potentially reversible causes of such adverse outcomes. 7 Approximately 14.6

Infectious Diseases 69

Infectious Diseases Emergency Department EMS Administration 69