Emergency Medicine Journal

SEPTEMBER 27, 2023

A Silver Trauma Review Clinic (STRC) was developed in conjunction with the geriatric ED and multidisciplinary services to improve the post-discharge care of patients with non-operative traumatic injuries. We aimed to assess the STRC by reviewing the journey and outcomes of patients who attended the clinic.

Operations 75

Operations Fractures Outcomes 75

The Trauma Pro

OCTOBER 3, 2023

Many vertebral fractures can be treated non-operatively. There was no difference in pain, return to work, functional outcome, or instrumentation failure. Post-operative bracing after pedicle screw fixation for thoracolumbar burst fractures: A cost-effectiveness study. A total of 76 studies were included.

Fractures 203

Fractures Dislocations Operations Burns 203

Emergency Live

DECEMBER 12, 2023

The aim of the […] The post The Importance Of Blsd Courses For Improving The Quality Of Cardiopulmonary Resuscitation appeared first on Emergency Live.

Resuscitation 105

Resuscitation CPR Operations Outcomes 105

American Medical Compliance

FEBRUARY 26, 2023

The Orientation to the Operating Room for Sales Professionals course is designed to educate sales professionals on proper operating room practices. There are several benefits and risks of healthcare industry representatives (HCIRs) being in the operating room. Reach out for other courses by visiting the AMC Course Library.

Operations 52

Operations Best Practices Administration Hospitals 52

The Skeptics' Guide to EM

DECEMBER 10, 2022

One-year outcome of surgery compared with immobilization in a cast for adults with an undisplaced or minimally displaced scaphoid fracture: A meta-analysis of randomized controlled trials. The question is does the scaphoid fracture need to be treated operatively or non-operatively. There is not a diagnostic dilemma in this case.

Operations 52

Operations Fractures Military Emergency Department 52

Taming the SRU

SEPTEMBER 22, 2023

million adults undergo tracheal intubation outside of the operating room each year in the United States. Several single-center and moderately-sized studies have compared the outcomes of these two methods with varying results. The operator reported a subjective assessment of the anticipated difficulty. Background More than 1.5

Operations 105

Operations Outcomes Emergency Department Academics 105

EMDocs

JANUARY 11, 2025

Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. 2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation. Mathis, K.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). That sounds reasonable, so what has changed? 0.41), p < 0.001.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

RebelEM

OCTOBER 2, 2023

The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 A more optimal, and promising, solution may be the use of SQ insulin in mild to moderate DKA.

Operations 103

Operations Academics Fluid Resuscitation Outcomes 103

The Trauma Pro

MAY 9, 2023

The Pennsylvania Trauma Outcomes Study database contains a huge amount of data. A good rule of thumb is that ANY hypotensive patient should make you justify why you are NOT ALREADY IN THE OPERATING ROOM! Reference: Defining the optimal time to the operating room may salvage early trauma deaths, J Trauma 76(5):1251-1258, 2014.

Head Injuries 130

Head Injuries Operations Documentation/Coding Outcomes 130

EMDocs

SEPTEMBER 4, 2024

Disparities are measured differences in outcomes for people of different backgrounds. Literature shows disparity across the different outcomes, including wait times, triage levels and delivery of pain medications. Dr. Migita noted differences in admission rates for asthma and bronchiolitis based on race. Discuss as often as possible.

Pediatrics 98

Pediatrics Outcomes Operations Hospitals 98

PulmCCM

OCTOBER 16, 2024

Animal studies have suggested that the body could be prepped or trained to better withstand ischemic-reperfusion injury, by inducing mild ischemia in another tissue bed before the operation. This is a remarkable example of the differences between societies, which might influence the processes of clinical trials and their outcomes.

Outcomes 52

Outcomes Operations Research Hospitals 52

EMDocs

DECEMBER 6, 2024

7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. 5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Antiemetics as needed. 2 L/hr in adults.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

American Medical Compliance

OCTOBER 14, 2024

This reduces their overall stress levels, making aggressive behaviors less frequent. Improved Mental Health Residents who feel understood are more likely to experience improved mental health outcomes. Ready to elevate your caregiving team’s skills? Click here.

Wellness 105

Wellness Operations Outcomes 105

RebelEM

MAY 27, 2024

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. Employing P-values to compare demographics between groups could mislead interpretations of the data’s relevance to the primary outcomes.

Outcomes 137

Outcomes Research Operations Hospitals 137

Emergency Medicine Journal

NOVEMBER 28, 2023

Background The regional emergency medical service (EMS) in Lombardy (Italy) developed clinical algorithms based on operator-based interviews to detect patients with COVID-19 and refer them to the most appropriate hospitals. Results The training set includes 264 976 patients, median age 74 (IQR 55–84). to 0.14) and 98.2% (95% CI 0.98

Operations 52

Operations EMS Hospitals Outcomes 52

PulmCCM

SEPTEMBER 17, 2023

The Centers for Disease Control and Prevention formally called on hospitals to develop robust sepsis care programs to systematically identify and treat sepsis, track outcomes, and improve care delivery.

CDC 98

CDC Sepsis Hospitals Documentation/Coding 98

The Skeptics' Guide to EM

DECEMBER 14, 2024

Comparison: International Pediatric Sepsis Consensus Conference (IPSCC) criteria Outcome: Primary Outcome: In-hospital mortality Secondary Outcomes: Composite of early death (within 72 hours of presentation) and requirement for extracorporeal membrane oxygenation (ECMO).

Sepsis 103

Sepsis Pediatrics Shock Hospitals 103

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 129

Ultrasounds Outcomes COPD Hospitals 129

RebelEM

JUNE 19, 2023

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? 1.00 (0.9 – 1.12) Secondary Outcome Mortality 24h 9.7% Prehospital Tranexamic Acid for Severe Trauma.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

Emergency Medicine Cases

FEBRUARY 13, 2024

How can we integrate systems thinking into the daily operations of EDs to improve patient flow and outcomes? How can we improve our EMS systems? How can we change the system to prevent emergency provider burnout? and many more.

EMS 89

EMS Operations Outcomes Wellness 89

RebelEM

NOVEMBER 20, 2023

Comparator: The control group received standard care provided at a major trauma center, including intubation, blood product transfusion, interventions like tourniquet application, and early operative or endovascular hemorrhage control. Outcome: Primary Outcome: All-cause mortality at 90 days.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

The Trauma Pro

OCTOBER 4, 2024

Clinical outcomes assessed at 60 days included an unplanned return to the emergency department (ED), re-admission, complications, and development of new bleeding confirmed by surgery, ultrasound, or computed tomography (CT) at 60 days post-injury. Adherence to guidelines was assessed by a follow-up phone call two months after injury.

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

Don't Forget the Bubbles

JUNE 26, 2023

Whilst waiting for an operation, they need to be managed medically. The underlying heart defect determines the precise operation performed – you might have heard of the Norwood procedure , an example used for HLHS specifically. Six hours post-operatively, they become more mottled, with weak pulses – signs of poor systemic perfusion.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

Taming the SRU

MARCH 12, 2024

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. The study’s primary outcomes were the operational impacts of the SQuID protocol on EDLOS and ICU admission rates. Secondary outcomes included fidelity to and safety of the intervention. Acad Emerg Med 2023;30(8):800–8.

Operations 97

Operations Hospitals Best Practices Wellness 97

The Trauma Pro

OCTOBER 25, 2024

This is probably because there is no need to perform repeated operations to insert and remove the preperitoneal packs when angiography is used. The primary outcome was the development of VTE during the hospitalization. But what about venous thromboembolism risk? Patients with pelvic fractures are already at high risk for it.

Fractures 113

Fractures Head Injuries Operations Ultrasounds 113

EMDocs

AUGUST 10, 2023

1.40) No statistically significant difference in secondary outcomes No significant difference in safety outcomes Death 18% vs. 19%, RR 0.94 (0.68-1.30) However at the bedside based on current guidelines, I will continue to offer tPA when indicated or requested by endovascular operators. 1.14) Symptomatic 4% vs. 6%, RR 0.70 (0.36-1.37)

Stroke 93

Stroke Outcomes Operations Hospitals 93

Taming the SRU

SEPTEMBER 25, 2023

Specifically, EM physicians should be able to recognize fractures that will likely require operative management and facilitate close follow up, such as a Maisonneuve fracture. Disruption of these structures yields an unstable ankle fracture, thus making close follow up for operative management imperative. screws for medial malleolus.

Fractures 101

Fractures Operations Emergency Department EMS 101

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. They stratified patients according to the ratio of FFP: PRBC received (1:1, 1:2, 1:3 and 1:3+) and performed logistic regression analyses for various outcomes. These procedures require an experienced operator.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Taming the SRU

JULY 25, 2024

Femoral nerve block case review - morbidity & mortality - community practice - r2 Clinical pathologic case - visual diagnosis - when time matters - operational aspects of stroke care Femoral nerve Block Case Review WITH dr. stolz Why do we care about regional anesthesia, specifically femoral nerve blocks?

Stroke 98

Stroke Fractures Operations Outcomes 98

American Medical Compliance

AUGUST 15, 2024

Understanding Medical Standards Medical standards play a crucial role in defining both the processes and outcomes of care. Institutions that previously operated with limited cybersecurity funding are now faced with the urgent need to strengthen their defenses to combat these increasing threats.

Leadership 104

Leadership Best Practices Operations Outcomes 104

RebelEM

APRIL 17, 2023

While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage. Additionally, potential increases in resource utilization, healthcare expense, and ED length of stay are also essential considerations. Ultrasound has become an extended part of our physical exam.

Ultrasounds 130

Ultrasounds Radiology Radiology Operations 130

The Skeptics' Guide to EM

MARCH 2, 2024

Type A AoDs generally require an emergent trip to the operating room as soon as they are identified to reduce the likelihood of a terrible outcome. Symptoms may include more severe chest pain radiating to the back, loss of consciousness, or symptoms of stroke if the blood supply to the brain is affected.

Emergency Department 131

Emergency Department Stroke Operations Hospitals 131

ACEP Now

JUNE 21, 2023

The lack of differences in the observed outcomes do not suggest one EM training length is superior. The additional year may improve career trajectory or longevity, entrance into fellowship or academic practice, or other longer-term outcomes including successful development of a niche in the specialty. 11 What should we take away?

EMS 114

EMS Academics Telemedicine Operations 114

ACEP Now

JANUARY 5, 2025

1 The primary outcome was the frequency of observed hypoxemia, defined as any pulse oximetry reading below 85 percent. Serious patient-oriented outcomes such as cardiac arrest were rare, but almost all occurred in the oxygen mask cohort. The obvious winner was NIPPV, whose 9.1 3 The machine learning model trailed just behind.

Sepsis 40

Sepsis Research Airway Management Stroke 40

PulmCCM

NOVEMBER 6, 2023

TEG or ROTEM) is becoming a more widely used tool to help guide the administration of blood products in hemorrhage from trauma, although its effects on meaningful clinical outcomes remain uncertain. Thromboelastometry (e.g., The balloon generally required 30 minutes to insert.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

American Medical Compliance

MARCH 11, 2024

Amidst the busy dental appointments, treatments, and patient care, there are crucial aspects that often operate in the background but hold importance. Understanding the Significance Dental recordkeeping includes the systematic documentation of a patient’s oral health history, examinations, diagnoses, treatments, and outcomes.

Documentation/Coding 105

Documentation/Coding Best Practices Operations Outcomes 105