St. Emlyn

JANUARY 6, 2025

This retrospective study explores time efficiency, injury severity, and patient outcomes, highlighting the role of HEMS in delivering critical care to severely injured patients in remote locations.

Emergency Department 87

Emergency Department Outcomes Hospitals 87

St. Emlyn

JUNE 23, 2024

Patients presenting […] The post JC: The impact of double sequential shock timing on outcomes during refractory out-of-hospital cardiac arrest appeared first on St.Emlyn's.

Shock 103

Shock Outcomes Hospitals EMS 103

Emergency Medicine Journal

DECEMBER 30, 2024

We aimed to develop a UT measure and assess associations with doctor-related factors (eg, experience), patient outcomes (eg, reattendance) and resource use (eg, episode costs). Multilevel regression explored associations between doctor-level factors, resource use and patient outcomes. Results 39 doctors were matched with 384 patients.

Outcomes 98

Outcomes Wellness Research 98

Pediatric EM Morsels

JULY 26, 2024

Higher titers in both CSF and serum were associated with poor outcomes. Earlier diagnosis leads to better outcomes. Younger Age at Onset Is Associated With Worse Long-term Behavioral Outcomes in Anti-NMDA Receptor Encephalitis. HSV serum and CSF PCR HSV is one of the most common etiologies of encephalitis and is devastating.

Seizures 269

Seizures Psychiatric Outcomes Pediatrics 269

The Trauma Pro

DECEMBER 17, 2024

Here are the factoids from their study: Motor vehicle crash was the most common etiology for this lesion, which makes sense due to the energy needed to shear the tissues The most common locations were thigh, hip, and flank The incidence of pre-existing conditions that might influence outcome (diabetes, obesity, smoking history, use of anticoagulants) (..)

Outcomes 258

Outcomes 258

Pediatric EM Morsels

APRIL 19, 2024

No formal follow up was scheduled Outcomes were: effectiveness, parental satisfaction, and economic benefits The majority of children wore their braces as directed (94%)There was no re-fractureAll parents were happy with the treatment (100%) and felt comfortable removing the brace (100%). West, 2005. Plint, 2006.

Fractures 286

Fractures Pediatrics Best Practices Outcomes 286

The Trauma Pro

JUNE 21, 2024

This situation was first documented in a paper published in the 1960s, which noted that VIP patients have worse outcomes. The VIP syndrome occurs in healthcare when a celebrity or other well-connected “important” person receives a level of care that the average person does not. Who is a VIP? It may be a celebrity. A family member.

Documentation/Coding 290

Documentation/Coding Outcomes Hospitals Wellness 290

St. Emlyn

JANUARY 6, 2025

The post Prehospital Emergency Anaesthesia (PHEA) vs. Emergency Department RSI: A Comparative Study on Trauma Care Timelines and Outcomes appeared first on St.Emlyn's.

Emergency Department 66

Emergency Department Outcomes Hospitals 66

The Trauma Pro

JANUARY 2, 2024

EAST sponsored a prospective, multicenter study to identify factors influencing neurologic outcomes after spinal cord injury. It would be interesting to see if patients who had very consistent MAP therapy, say greater than 90% or 95% of the time, had any difference in outcomes. Could a single low MAP cause damage?

Outcomes 264

Outcomes Hospitals 264

Pediatric EM Morsels

JULY 21, 2023

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. A practical scale. PMID: 4136544.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

The Trauma Pro

AUGUST 19, 2024

I’ve seen the clinical problems and poor outcomes that can arise from ignoring it many times over the years. Here’s another one. You’ve ordered a CT or a conventional x-ray image. The result comes back in your EMR. You take a quick glance at the summary at the bottom of the report. No abnormal findings are listed.

Outcomes 200

Outcomes 200

RebelEM

JUNE 1, 2023

Post-ROSC management is nuanced and challenging but helps to ensure good outcomes. In theory, rapid identification of the underlying cause should improve outcomes by allowing clinicians to tailor management. Diagnostic yield, safety, and outcomes of Head-to-pelvis sudden death CT imaging in post arrest care: The CT FIRST cohort study.

Outcomes 144

Outcomes Resuscitation Hospitals CPR 144

Dr. Smith's ECG Blog

JULY 11, 2024

In general, family medicine physicians may not have the same amount of exposure to EKGs as an emergency medicine specialist or a cardiologist, but they shouldn’t have to rely on the traditional diagnostic computer algorithm.

EKG/ECG 92

EKG/ECG Outcomes Hospitals Wellness 92

Mount Sinai EM

AUGUST 7, 2024

Initially, data suggested that the use of ultrasound during arrest increased pauses between compressions which worsens outcomes. Ultrasound during cardiac arrest has quickly become standard. To decrease time between compressions, many protocols were proposed (see here ).

Ultrasounds 235

Ultrasounds CPR Documentation/Coding COPD 235

Don't Forget the Bubbles

NOVEMBER 11, 2024

One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. The aim of TTM is to control the body and brain’s temperature, thus reducing secondary brain injury and improving the neurological outcome.

Hyperthermia / Hypothermia 116

Hyperthermia / Hypothermia Outcomes Pediatrics Resuscitation 116

RebelEM

DECEMBER 23, 2024

There has been ongoing study about the clinical significance of these effects, as well as whether and for whom LR might provide meaningfully better clinical outcomes ( Myburgh 2013 , Self 2018 , Semler 2018 , Self 2020 ). The enrollment was multicenter, large, and adequately powered for clinically meaningful changes in outcome.

Fluid Resuscitation 124

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 124

Mount Sinai EM

AUGUST 20, 2023

Activate ECMO team early, cardiac arrest due to LAST might be prolonged (especially with bupivacaine) and there’s several case reports with good outcomes after ECMO. Start intralipid emulsion 20% bolus 1.5 mg/kg and infusion, repeat bolus until ROSC (max total dose of Intralipid solution 12 ml/kg).

Seizures 238

Seizures Shock Outcomes 238

Intensive Blog

MARCH 13, 2024

This showed a similar rate of survival to discharge (27%), of whom approximately 50% had a favourable neurological outcome on discharge (CPC 1 or 2). Multiple meta-analyses 9,10 found that ECPR, when compared to conventional CPR (CCPR), was associated with improved 30-day mortality and neurological outcomes. More recently ….

CPR 130

CPR Resuscitation Outcomes Hospitals 130

The Bottom Line

JUNE 19, 2023

In adult patients with major trauma, who are at risk for trauma-induced coagulopathy does early administration of 1g of tranexamic acid (TXA) followed by an infusion of 1g over 8 hours, compared with placebo, increase survival with a favourable functional outcome at 6 months?

Administration 145

Administration Outcomes Shock 145

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 127

Ultrasounds Outcomes COPD Hospitals 127

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 135

Outcomes Research Hospitals Operations 135

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below). to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 134

Stroke Outcomes Hospitals Administration 134

RebelEM

JUNE 26, 2023

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy. Severe acute traumatic coagulopathy = PT >1.5

Administration 140

Administration Outcomes Resuscitation Radiology 140

Emergency Medicine Cases

MAY 28, 2024

Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. What is the evidence for oral nimodipine in improving outcomes in patients with subarachnoid hemorrhage and how does it work? Mortality in SAH patients can be up to 30% even without neurological deficit.

Outcomes 125

Outcomes EMS 125

RebelEM

JANUARY 18, 2024

It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Three outcomes were evaluated, with none being deemed the primary outcome. Background: Sepsis remains one of the leading causes of morbidity and mortality. to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

Sepsis 131

Sepsis Hospitals Administration Outcomes 131

St. Emlyn

JULY 11, 2024

These guidelines advocate a trauma-informed, multidisciplinary approach to improve outcomes for patients who have experienced NFS. St.Emlyn's - Emergency Medicine #FOAMed The Faculty of Forensic & Legal Medicine's guidelines for managing non-fatal strangulation (NFS).

Forensics 126

Forensics Outcomes 126

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 183

Pediatrics Emergency Department Outcomes Sepsis 183

St. Emlyn

FEBRUARY 27, 2024

How we can improve patient outcomes. St.Emlyn's - Emergency Medicine #FOAMed A review of Acute on Chronic Liver Disease (ACLD / decompensated liver disease) in the ED. FOAMed @stemlyns The post Decompensated. Liver disease in the ED. St Emlyn’s appeared first on St.Emlyn's.

Outcomes 122

Outcomes Resuscitation 122

RebelEM

SEPTEMBER 14, 2023

to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% Control: 53.4% D ECLS: 18.2% Control 8.7% Control 38.0% Control: 49.0% RR 0.98; 95% CI 0.80 to 1.19; p = 0.81 vs 13.9% (RR 0.58; 95% CI 0.33 Control: 9.6% Control 3.8%

Shock 134

Shock Outcomes Resuscitation Stroke 134

The Trauma Pro

DECEMBER 22, 2023

The reality is that no one will ever be able to design a study that definitively evaluates the very soft outcomes that result from using this technique. It can help direct the surgical exploration if imaging was unnecessary or contraindicated. So yes, this is dogma.

Operations 264

Operations Outcomes 264

RebelEM

MAY 29, 2023

Without larger studies and a patient centered outcome, the addition of methylene blue within 24 hours of septic shock should still not be part of a general approach but rather an adjunct in specific circumstances (i.e. NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9% 95% CI 15.4 NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9%

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

St. Emlyn

NOVEMBER 19, 2024

This review explores outcomes in drainage efficacy, complication rates, and patient comfort, showing that small-bore thoracostomy may be a reliable alternative for non-emergent cases. However, for severe trauma or urgent settings, large-bore remains the go-to option.

Outcomes 102

Outcomes 102

RebelEM

FEBRUARY 15, 2024

not a patient oriented outcome) Single country study which may limit generalizability Excluded pregnancy where risk of emesis is increased due to gravid uterus Alcohol was the implicated in the overwhelming majority of patients.

Poisoning 140

Poisoning Airway Management Seizures Shock 140

EMCrit

APRIL 27, 2023

Unfortunately, there is little high-level evidence investigating whether these interventions affect patient outcomes (for example, there is precious little evidence to support most of the target values that we're chasing after). The precise utilization of ABG, VBG, and pulse oximetry remains controversial.

Outcomes 133

Outcomes 133

RebelEM

JUNE 22, 2023

Outcomes: Primary: The development of long-COVID up to 300 days after enrollment. This secondary outcome became the primary outcome (see discussion for more detail). As a secondary outcome, the authors wanted to investigate the development of long COVID. Prior vaccination was not an exclusion criteria.

Outcomes 140

Outcomes Research Documentation/Coding Wellness 140

RebelEM

SEPTEMBER 7, 2023

OUTCOMES Primary: Occurrence of at least one clinical or electrographic seizure recorded on continuous EEG within 72 hours after inclusion. 0.38, p=0.0021) No statistically significant results were reported in the other clinical outcomes studied. The primary outcome was patient-oriented. OR 0.07, 95% CI 0.01-0.38,

Seizures 126

Seizures Stroke Outcomes Research 126

RebelEM

JULY 1, 2024

AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20 AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20 AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20

COPD 131

COPD Emergency Department Outcomes EMS 131