Don't Forget the Bubbles

JUNE 26, 2023

Whilst waiting for an operation, they need to be managed medically. Too much pulmonary blood flow and we will see well-oxygenated blood ( SpO2 >85% ) but insufficient systemic blood flow (pallor/mottling, cool peripheries, delayed capillary refill time, weak pulses, hypotension, narrow pulse pressure) and hypoxia (lactic acidosis).

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

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% Demographics were well balanced in the two groups.

Outcomes 105

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 105

RebelEM

APRIL 17, 2023

However, It is unclear how well POCUS performs in ruling in or ruling out the diagnosis of PTA. Question: How well does the US perform in diagnosing PTA compared to CT, needle aspiration, or Incision and Drainage? While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage.

Ultrasounds 130

Ultrasounds Radiology Radiology Operations 130

RebelEM

AUGUST 22, 2024

hours of symptom onset appears to be the most promising approach for improving visual outcomes, supported by multiple studies and meta-analyses. 1,2 Intra-arterial (IA) tPA has also shown benefit but is less well studied. Patients whose last known well (LKW) time was within 24 hours of presentation. 1 week after treatment.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

PulmCCM

NOVEMBER 6, 2023

Intuitively, plasma seemed even less likely to help the very sickest of the sick— those mechanically ventilated with ARDS from Covid-19, whose mortality rate was well over 50% at many centers. Convalescent plasma, it was concluded, didn’t help patients with severe Covid-19 as a general group. Only it turns out, it did help.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Don't Forget the Bubbles

JUNE 19, 2024

Well-designed multicentre large studies in children were warranted; cue Leonard et al. Children in the validation cohort were admitted to the intensive care unit or operating room less frequently than those in the derivation cohort. Were the predictor variables and the outcome evaluated in a blinded fashion?

CPR 124

CPR Research Outcomes Documentation/Coding 124

Taming the SRU

MARCH 11, 2024

Reducing the total ischemic time in patients with vascular injury is the single most important variable in improving outcomes and reducing the risk of amputation; an ischemic time of >8 hours is associated with amputation rates of up to 85%, compared with <20% in those with ischemic time of <8 hours (2).

Dislocations 107

Dislocations Emergency Department Fractures Operations 107

American Medical Compliance

OCTOBER 31, 2024

This strategy improves patient outcomes and increases overall satisfaction. Key Components of Effective Healthcare Personnel Training for Senior and Disabled Care An effective training program should cover several core areas to ensure comprehensive care. Communication training should also emphasize listening skills.

Outcomes 84

Outcomes Best Practices Patient Safety Wellness 84

Medagadget

SEPTEMBER 14, 2023

Called “eAir”, the devices can also be highly miniaturized to just a few millimeters in size, making them well suited for inclusion in laparoscopic devices. Ultimately, these intra-operative benefits have the potential to translate into improved surgical and patient outcomes.”

Research 93

Research Operations Outcomes Wellness 93

ACEP Now

JULY 7, 2023

1 Ventricular tachycardia (VT) and ventricular fibrillation (VF) represent the most common initial rhythms for patients presenting to the ED in out-of-hospital cardiac arrest, as well as for patients who develop cardiac arrest while in the ED. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. Circulation. 2018;137(12).

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Don't Forget the Bubbles

JUNE 30, 2023

You will be running the show today, and you want to use your preparation time well. The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. These procedures require an experienced operator. These procedures require an experienced operator.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

American Medical Compliance

NOVEMBER 29, 2024

Continuous Glucose Monitoring (CGM) technology is transforming the approach to diabetes care for healthcare providers, including endocrinologists, diabetes educators, and nurses, as well as for the patients they support. However, to maximize its benefits, healthcare providers must be well-versed in the technology.

Outcomes 77

Outcomes Wellness Operations Pediatrics 77

Medagadget

AUGUST 4, 2023

This leads to suboptimal outcomes, and the frequent need to repeat the biopsy procedure because the first attempt did not yield an adequate sample. And this blind approach results in flawed outcomes. Again, this blind approach results in flawed outcomes. A suction curette can only sample 4% of the uterus. scissors, graspers).

Operations 92

Operations Urgent Care Outcomes OB/GYN 92

RebelEM

AUGUST 7, 2023

This helps relieve agitation/pain while maintaining spontaneous breathing and airway reflexes allowing for adequate pre-oxygenation as well as facilitates other resuscitation interventions including IV access, vasopressors, fluids, etc. that would not be possible in an agitated/combative patient.

Head Injuries 97

Head Injuries Airway Management Outcomes Burns 97

RebelEM

AUGUST 12, 2024

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

Outcomes 81

Outcomes Hospitals Operations Shock 81

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. While the primary focus in dentistry is patient health and well-being, carefully keeping records is equally needed. These are recordkeeping and documentation.

Documentation/Coding 87

Documentation/Coding Best Practices Operations Outcomes 87

RebelEM

NOVEMBER 25, 2024

Included patients from out-of-hospital, emergency department, intensive care unit, and operating-room intubations. Intubation performed in all settings (out-of-hospital, emergency department, ICU, and operating room). Studies that report the outcome of first-attempt intubation success for both bougie and non-bougie groups.

Outcomes 77

Outcomes Emergency Department Operations Hospitals 77

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

MAY 11, 2024

Of note, HTS is more effective in trauma patients because it is used as a resuscitative fluid as well. Usually presents consistent with failure of that organ. For mid-shaft femur fractures, traction appears to may reduce blood loss and pulmonary complications, but the available data is very scarce.

Administration 91

Administration Resuscitation Fluid Resuscitation Research 91

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) 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) N Engl J Med.

Stroke 67

Stroke Outcomes Operations Hospitals 67

RebelEM

JUNE 8, 2023

Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Taming the SRU

NOVEMBER 3, 2023

The thought with introducing the serratus anterior plane block was that regional anesthesia is well within the purview of EM physicians and can offer a safe alternative to systemic pain medications. The primary outcome in this study was a change in pain score at rest 60 minutes after block. SD 3.28) and 6.5, respectively.

Fractures 97

Fractures Ultrasounds Outcomes Research 97

American Medical Compliance

DECEMBER 13, 2024

For healthcare providers, mastering EKG interpretation goes beyond being a technical necessityit is a critical skill that directly improves patient outcomes, facilitates timely decision-making, and fosters trust between providers, patients, and their families.

EKG/ECG 83

EKG/ECG Outcomes Operations Wellness 83

Don't Forget the Bubbles

JUNE 17, 2024

High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. Loss of psychological safety and mental well-being persist long after the episode and can impact future episodes of care. Exposure to incivility hinders clinical performance in a simulated operative crisis. 2020 Jan 1;35(1):70-6.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

American Medical Compliance

OCTOBER 14, 2024

Moreover, they pose risks to the safety and well-being of residents and staff. Empathy allows caregivers to demonstrate that they are not just there to perform tasks but are genuinely concerned about the resident’s well-being. It also contributes to the overall well-being of residents.

Wellness 88

Wellness Operations Outcomes 88

Ziqitza HealthCare Ltd

MARCH 6, 2024

Let’s delve deeper into the significance of Ziqitza’s operations and how they navigate the complex issues of traffic and population density, ensuring that help arrives when it’s needed the most. Ziqitza Rajasthan uses advanced GPS tracking systems to streamline operations.

Ambulance Services 52

Ambulance Services Telemedicine Operations Wellness 52

PulmCCM

FEBRUARY 5, 2024

Also, many patients with infection won’t have fevers, and those that don’t may be at the highest risk for poor outcomes. As all radiologists are ostensible experts, this reads more like an endorsement of POCUS in the ICU for intensivists well-trained and experienced in the technique. °C oral measured multiple times).

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

Sensible Medicine

MAY 31, 2024

This is not to say that I always agree with the process or outcomes of medical decision-making. Second guessing, also called post-call quarterbacking, is alive and well in medicine and, when done thoughtfully, can be a great way to teach and learn. ” When things run well, the person with the power has it for a reason.

Operations 57

Operations Wellness Academics Ultrasounds 57

Taming the SRU

MAY 22, 2023

Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED. Use your exam to guide your initial management as well as your imaging decisions and differential diagnosis. Injuries discussed are shown in Image 1. 12): e0244291.

Fractures 76

Fractures Dislocations Operations Radiology 76

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane). for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 94

Sepsis Fractures Documentation/Coding Administration 94

The Skeptics' Guide to EM

DECEMBER 12, 2020

She is systemically well and there is no sign of tracking, so you decide to perform incision and drainage in the ED. AEM December 2020 * Population: Patients of any age undergoing ED drainage of skin abscesses * Exclusions: Patient with abscess located on hand, foot, or face or if they required admission and/or operative intervention.

Operations 52

Operations Outcomes Research Academics 52

American Medical Compliance

NOVEMBER 8, 2024

It’s vital for staff well-being, helping to build a transparent, accountable workplace culture where incidents like slips, falls, and exposures are addressed promptly. Non-compliance can result in hefty fines, inspections, and audits that disrupt operations. It creates a safer environment for both patients and staff.

Documentation/Coding 84

Documentation/Coding Legal Issues Operations Incident Reporting 84

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. Studies have compared IO to peripheral intravenous (PIV) and central venous (CVC) access for resuscitation.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Medagadget

AUGUST 25, 2023

During operation, the space to be disinfected must be evacuated since germicidal UV light is harmful, causing damage to nucleic acids, and generates Ozone, which can be a harmful gas by itself. PCO has the capability to oxidize organic matter, VOCs and other organic molecules as well as airborne contaminants / pathogens.

CDC 76

CDC Operations Hospitals Wellness 76

EMDocs

JANUARY 11, 2025

Well keep it short, while you keep that EM brain sharp. Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. Stercoral Colitis in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes.

EMS 72

EMS Sepsis Shock Fluid Resuscitation 72

American Medical Compliance

AUGUST 7, 2024

Moreover, compliance with HIPAA helps healthcare providers avoid substantial fines and legal penalties associated with data breaches, thereby maintaining compliance with federal standards and ensuring the smooth operation of their practices. It protects the health and well-being of staff.

Hazardous Materials 80

Hazardous Materials Documentation/Coding Legal Issues Patient Safety 80

RebelEM

AUGUST 31, 2023

CVC placement under ultrasound guidance has decreased overall complication rates and there is increased awareness of transfusion reactions, alloimmunization, acute lung injury, circulatory overload, as well as infection. Primary Outcome – Bleeding (Grade 2 to 4) Transfusion 4.8% Non-inferiority margin was set at 2.5% g/dl vs 8.5

Ultrasounds 59

Ultrasounds Outcomes Wellness Research 59