EMDocs

JANUARY 11, 2025

A 75-year-old woman who is bedridden after a stroke presents to the ED from a nursing facility with abdominal pain and constipation. Stercoral Colitis in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes. Fecal Impaction and Nonperforated Stercoral Colitis: Red Flags for Poor Outcomes.

EMS 96

EMS Sepsis Shock Fluid Resuscitation 96

The Skeptics' Guide to EM

JUNE 17, 2023

Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. She is a Professor of Pediatrics and Interim Chief of the Section of Pediatric Emergency Medicine at the Medical College of Wisconsin.

Emergency Department 74

Emergency Department Pediatrics Head Injuries Administration 74

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Get up-to-date in the understanding and management of pediatric status epilepticus. Pediatric status epilepticus is analogous to the multi-organ dysfunction syndrome in severe sepsis. Case 3: Headache and Arteriovenous Malformation Unlike in adults, stroke in children is divided evenly between hemorrhagic and ischemic etiologies.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Don't Forget the Bubbles

NOVEMBER 27, 2023

The amount of blood that comes from the heart with each contraction is the stroke volume (SV). The stroke volume is the difference between how full it is at the start and how full it is after a contraction. The next element of stroke volume is the emptying. Pediatr Crit Care Med. Pediatr Crit Care Med.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

Taming the SRU

FEBRUARY 24, 2024

non-invasive positive pressure ventilation and IV nitroglycerin infusion have been shown to reduce morbidity (intubation rates, ICU admission) & mortality.

Leadership 94

Leadership EMS Pediatrics Stroke 94

ACEP Now

OCTOBER 3, 2023

These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations. This document is an update of guidelines first published in 2000, and then updated in 2007.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Taming the SRU

SEPTEMBER 27, 2023

pediatric airways - Landmark studies in em - ebm in the prehospital setting - cpc - r1 diagnostics: pneumothorax - r4 capstone pediatric airways WITH dr. dean Intubation attempts should follow distinct, slow, and deliberate steps. This study did stop early using these rules.

Stroke 52

Stroke EMS Pediatrics Outcomes 52

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. What’s New in Stroke Care?

Research 52

Research Airway Management Stroke Outcomes 52

Pediatric Emergency Playbook

OCTOBER 1, 2017

Also used for severe MS, stroke, TBI, chronic pain. J Neurosurg Pediatrics. Complications of Intrathecal Baclofen Pump Therapy in Pediatric Patients. J Pediatr Orthop. Pediatr Neurosurg. for the Pediatric Heart Transplant Study Investigators. Prospective Trial of a Pediatric Ventricular Assist Device.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

PulmCCM

MAY 8, 2023

Read in JAMA Endovascular thrombectomy for large ischemic stroke came to prominence based on limited data showing its efficacy in patients with smaller strokes; large strokes were excluded. This was a noninferiority trial; remifentanil fell below the prespecified threshold for inferiority, though with a wide confidence interval.

Stroke 52

Stroke Blood Transfusions Hospice Anaphylaxis 52

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

The Effect of Vitamin C on Clinical Outcome in Critically Ill Patients: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. The Effect of Vitamin C on Clinical Outcome in Critically Ill Patients: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. Critical Care Medicine. Critical Care Medicine.

Sepsis 52

Sepsis Shock Outcomes Stroke 52

EM Literature of Note

JANUARY 9, 2022

The Annals of Emergency Medicine Podcast continues apace, with free monthly updates from the original research published in the journal: iTunes Link SoundCloud Link Likewise, the Annals of Emergency Medicine Journal Club has published several monthly installments: Predicting Outcomes in Pediatric Pneumonia: Are We Omnipotent or Incompetent?

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

Pediatric Emergency Playbook

APRIL 1, 2016

Read on to go from bread-and-butter pediatric blood work to answer the question – what’s up with troponin, lactate, d-dimer, and BNP in kids? This is especially true in children – the majority of pediatric ambulatory visits do not require blood work to make a decision about acute care. The punchline is, use a pediatric reference.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

EMDocs

MAY 15, 2024

There are a variety of triggers, including infection (most common in pediatric patients), fat embolism, vaso-occlusive pain crisis, pulmonary embolism, and others. Causes and outcomes of the acute chest syndrome in sickle cell disease. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Am J Emerg Med. 2022 Aug;58:235-244.

Blood Transfusions 100

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 100

Don't Forget the Bubbles

FEBRUARY 5, 2025

There is significant evidence in adults and developing in the paediatric population that TXA results in better outcomes if given early in patients with mild to moderate traumatic brain injury (TBI) and does not cause harm. Disability – Altered mentation, seizure, stroke symptoms, severe headache, neurological deficit, visual symptoms.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

JournalFeed

MARCH 26, 2022

High-dose IN Fentanyl Spoon Feed: Higher doses of intranasal (IN) fentanyl for pain ranging from 2-5 μg/kg (with a maximum of 200 μg) were given in a pediatric emergency department, with no documented episodes of apnea, hypotension, or respiratory failure.

Stroke 40

Stroke Documentation/Coding Emergency Department Resuscitation 40

Pediatric Education

JULY 23, 2023

In adults, cryptogenic stroke is a current indication for treatment of an identified PFO. Adults with a cryotogenic stroke are more likely to have a PFO (up to 40-50%), and a 2017 New England Journal of Medicine study found that interventional closure of adult PFO decreased recurrent ischemic strokes. with timing 37-5137 days).

Stroke 40

Stroke Pediatrics Outcomes Hospitals 40

EMDocs

OCTOBER 30, 2023

Background and Context Contrast-enhanced computed tomography (CECT) is of paramount importance in the emergency department (ED) due to its indispensable role in facilitating precise diagnostic outcomes. 3 A study of CT use trends in the ED has shown increasing use of CTs by almost 60% from 2005 to 2013.

Radiology 94

Radiology Radiology Emergency Department Hospitals 94

EMDocs

MAY 28, 2024

There are a variety of triggers, including infection (most common in pediatric patients), fat embolism, vaso-occlusive pain crisis, pulmonary embolism, and others. Causes and outcomes of the acute chest syndrome in sickle cell disease. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Underestimates alveolar hypoxemia.

Blood Transfusions 95

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 95

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? However, with ultrasonography becoming more prevalent in EDs, it may be possible that initial imaging may avoid this radiation risk and still have similar outcomes for patients. He endorses nausea without vomiting and denies fever.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Pediatric Education

SEPTEMBER 3, 2023

High-quality studies in the SCT population are needed to clarify the health-outcomes as many studies are necessarily smaller or not able to be performed as rigorously. There is no positive association for deep venous thrombosis, cardiomyopathy, heart failure, stroke and no abnormalities of growth parameters in the pediatric population.

Dehydration 40

Dehydration Hyperthermia / Hypothermia Pediatrics Military 40

Mind The Bleep

OCTOBER 25, 2024

Adults: While strabismus is more common in children, it can also occur in adults due to trauma, stroke , or neurological conditions. For medical professionals, a multidisciplinary approach involving ophthalmologists, neurologists, and paediatricians may be necessary to ensure optimal outcomes. Pediatrics. 2016;137(5) S.E.

Stroke 52

Stroke Pediatrics Outcomes Wellness 52

RebelEM

MARCH 22, 2023

Pediatric patients should be considered for admission and further cardiology evaluation. Serum troponin testing in patients with paroxysmal supraventricular tachycardia: outcome after ED care. mg/kg (most studies gave 5 mg over 2-5 minutes). Patients with frequent recurrences should be sent to a electrophysiologist for follow up.

EKG/ECG 52

EKG/ECG EMS Pediatrics Stroke 52

ACEP Now

JULY 7, 2024

Although they may not appear as physically injurious as convulsive seizures, nonconvulsive seizures can significantly impact the neurological outcomes and overall prognosis of patients in critical care settings. Utility of electroencephalogram in the pediatric emergency department. Ann Emerg Med. 2014;63(4):437-447. Am J Emerg Med.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

Taming the SRU

MAY 1, 2023

Exertional Hyperthermia Patients with heat stroke will present with Temp > 104, AMS, or seizures.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Emergency Department Seizures 52

Pediatric Education

MARCH 3, 2024

Long term, infants have higher risks of hypertension, stroke and increased body mass index. Preeclampsia and neonatal outcomes in adolescent and adult patients. D’Alessandro, MD Professor of Pediatrics, University of Iowa Pregnancy Hypertens. 2018;12:11-15. doi:10.1016/j.preghy.2018.02.003 J Med Life. Pre-eclampsia.

Pediatrics 40

Pediatrics Seizures Wellness Stroke 40

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Emergency Medicine Cases

JANUARY 18, 2022

The post EM Quick Hits 35 – 10 Best Papers of 2021, Peripartum Cardiomyopathy, Crashing Asthmatic, Febrile Neutropenia, Anaphylaxis update appeared first on Emergency Medicine Cases.

Anaphylaxis 52

Anaphylaxis EMS Outcomes Hyperthermia / Hypothermia 52

EB Medicine

AUGUST 6, 2019

Nachi: Specifically, we’ll be focusing on the use of DOACs for the indications of stroke prevention in atrial fibrillation and the treatment and prevention of recurrent venous thromboembolisms. Jeff: Rivaroxaban, trade name Xarelto, the second FDA approved DOAC, is used for stroke prevention in those with nonvalvular afib and VTE treatment.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

ACEP Now

MARCH 14, 2024

First reported in 1879 in the case of diphtheria in a pediatric patient, TIF is fatal without surgical treatment due to hemorrhage and failure of airway security. Fatal outcomes postoperatively may be due to re-bleeding after attempts to preserve flow in the innominate artery or using sutures or prosthetic material in an infected area.22,23

Operations 52

Operations Pediatrics Radiology Radiology 52

Taming the SRU

AUGUST 30, 2023

Significantly elevated CRP (>122mg/L) and PCT (>0.5ng/mL) levels are predictors of bad outcomes, and are useful for tracking therapy progress, but are not specific enough to rule-in infectious endocarditis [38-39]. The diagnostic accuracy of fecal calprotectin during the investigation of suspected pediatric inflammatory bowel disease.

Infectious Diseases 89

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

EB Medicine

SEPTEMBER 1, 2018

Nachi: Not only are they out, they actually worsen outcomes, so definitely don’t pursue any of them. Instead, since no treatment has been shown to improve outcome, you should prioritize prompt transport. Fasciotomies have not been shown to improve outcomes and are reserved only for those failing anti-venom treatment.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

Don't Forget the Bubbles

FEBRUARY 7, 2024

This week, NCEPOD (National Confidential Enquiry into Patient Outcomes and Death) produced a much-anticipated report on how we manage acute testicular torsion in young people. “Time is brain” urges us to think about thrombolysis or clot retrieval in acute strokes. Pediatric radiology , 48 , pp.735-744. Coelho, A.Q.,

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

Don't Forget the Bubbles

AUGUST 21, 2023

Stimulation of baroreceptors results in a catecholamine-mediated increase in heart rate , stroke volume, contractility, and systemic vascular resistance (SVR). What are the long-term outcomes for children with dilated cardiomyopathy? Outcomes at 1 year seem to be influenced by the severity of illness at presentation.

Pediatrics 98

Pediatrics Outcomes Research Sepsis 98

ACEP Now

AUGUST 25, 2023

The Pediatric Pain Management Standard 1 for children was published this year to provide guidance to health organizations on how to deliver equitable and quality pain management across hospital settings. IN fentanyl has been safely used to treat pain in pediatric patients. It offers a way to deliver analgesia without IV access.3,

Administration 97

Administration Pediatrics Emergency Department Outcomes 97

EB Medicine

AUGUST 1, 2018

Jeff: For more on synthetic intoxications in the ED, be sure to take a look at the recent May 2018 issue of Pediatric Emergency Medicine Practice on Synthetic Drug Intoxication in Children if you haven’t already read it. First up is the link between cannabis use and stroke or TIA. times higher risk of stroke or TIA.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Taming the SRU

SEPTEMBER 1, 2023

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% 2015) reported a sensitivity of 98.9%

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95