Emergency Medicine Journal

OCTOBER 26, 2023

Despite decades of investment and research, survival remains disappointingly low. Inclusion criteria were non-traumatic cardiac arrests treated with at least one external electric shock with an automated external defibrillator from the basic life support team and resuscitated by a physician-staffed ALS team.

Resuscitation 75

Resuscitation Basic Life Support Hospitals CPR 75

The Skeptics' Guide to EM

NOVEMBER 30, 2024

After starting cardiopulmonary resuscitation (CPR), you note pulseless electrical activity (PEA) on the monitor. With a survival rate to discharge often below 10% globally, rapid, effective interventions are needed to improve patient outcomes. The paramedic is trying to get intravenous (IV) access to give epinephrine per the protocol.

Administration 85

Administration CPR Airway Management Outcomes 85

The Trauma Pro

OCTOBER 6, 2023

At the time, there was a debate about whether the procedure should be done immediately versus waiting until the patient was well-resuscitated. Although many of these injuries were managed within hours, a growing number were delayed by a few days to improve outcomes. However, the same question arises: do it early or wait a while?

Head Injuries 147

Head Injuries Research Hospitals Resuscitation 147

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% 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%

Shock 136

Shock Outcomes Resuscitation Stroke 136

Ultrasound Gel

JUNE 24, 2019

It is great to see more and more research on ultrasound in cardiac arrest. Here is a nice study that looks to see if ultrasound is associated with increased resuscitation efforts or better survival outcomes. link] It is great to see more and more research on ultrasound in cardiac arrest.

Outcomes 52

Outcomes Ultrasounds Resuscitation Research 52

Taming the SRU

MARCH 30, 2023

Diastolic shock index and clinical outcomes in patients with septic shock. Background Early recognition and resuscitation of patients in septic shock are critical skills for an emergency medicine physician. the diastolic shock index) could provide providers a tool to quickly identify patients that are at risk for unfavorable outcomes.

Shock 52

Shock Outcomes Sepsis Resuscitation 52

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12].

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

ACEP Now

MARCH 6, 2024

Every year, the volume of published research continues to outpace capacity to consume. 4 Repeated trials have not shown alteplase to have any signal of better outcomes, nor tenecteplase to have an association with increased adverse events. Gotta catch ‘em all!” How Best to Stop the Bleeding in Trauma? percent to 38.3

Research 52

Research Airway Management Stroke Outcomes 52

RebelEM

JUNE 19, 2023

The PATCH-trauma researchers sought to address this critique. 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? Prehospital Tranexamic Acid for Severe Trauma.

Outcomes 105

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 105

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. On arrival, you find a 35-year-old male, pulseless and apneic with cardio-pulmonary resuscitation (CPR) in progress by a bystander. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in Cali. JAMA Network Open. Reference: Dillon et al.

Hospitals 95

Hospitals CPR EMS Outcomes 95

Taming the SRU

MAY 11, 2024

r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Assessed and provided feedback of pediatric resuscitations based on video review.

Administration 91

Administration Resuscitation Fluid Resuscitation Research 91

RebelEM

SEPTEMBER 19, 2022

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. Over the years, we as a scientific community have worked extensively to find other interventions that improve outcomes. Resuscitation 2022; 179: 9-17.

CPR 52

CPR Outcomes Resuscitation EMS 52

Don't Forget the Bubbles

NOVEMBER 29, 2023

Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. Intensive Care Research , 1 (3-4), pp.60-64. In studies including patients with trauma or Glasgow Coma Scale less than 8, intubation without sedation led to poorer neurological outcomes. Ben was awake but paralysed.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

St. Emlyn

JUNE 4, 2024

Prioritising rapid resuscitation and OR transfer over ED intubation may improve outcomes. Further prospective research is needed The post JC: Risky intubations in the Emergency Department appeared first on St.Emlyn's.

Emergency Department 57

Emergency Department Resuscitation Research Outcomes 57

AED Leader

DECEMBER 6, 2024

This article explores Stryker’s impactful role in revolutionizing cardiac emergency preparedness worldwide, from pioneering technologies and addressing healthcare disparities to aligning with major organizations like the American Heart Association in pursuit of improved outcomes.

Basic Life Support 52

Basic Life Support Resuscitation Outcomes Hospitals 52

ACEP Now

JUNE 21, 2023

The latest research Two new studies have investigated academic and clinical performance between the two EM training lengths. The lack of differences in the observed outcomes do not suggest one EM training length is superior. A study of 92 EM programs from 1999 observed similar counts for most procedures between training lengths.

EMS 114

EMS Academics Telemedicine Operations 114

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. The GCS must be obtained through interaction with the patient (i.e.,

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Taming the SRU

OCTOBER 5, 2023

morbidity and mortality - quality improvement - research grand rounds - r1 clinical knowledge: pres/rcvs - r4 case follow-up: compartment syndrome Morbidity and Mortality WITH dr. finney Takotsubo Cardiomyopathy with COVID-19 Increasing incidence of Takotsubo Cardiomyopathy with the COVID-19 pandemic Morbidity and mortality is similar to that of ACS (..)

Stroke 89

Stroke EKG/ECG Seizures CPR 89

The Trauma Pro

SEPTEMBER 20, 2023

Researchers from the US Army performed a retrospective registry study on a sample of military casualties over four years. The primary outcome was mortality, and secondary outcomes included the need for surgery, fluid and blood infusions, and the use of a massive transfusion protocol.

Military 113

Military Blood Transfusions Administration Outcomes 113

PulmCCM

JANUARY 22, 2024

Background Therapeutic hypothermia, later rebranded as targeted temperature management, became a standard post-cardiac arrest therapy for comatose patients after two 2002 NEJM trials ( n=273 and n=77 ) suggested reducing core temperature to 32°C to 34°C markedly improved neurologic outcomes and survival.

Hyperthermia / Hypothermia 80

Hyperthermia / Hypothermia Outcomes Research Hospitals 80

EMDocs

NOVEMBER 20, 2023

High certainty of evidence: further research is unlikely to change the confidence in the estimate of the effect. Moderate certainty of evidence: further research is likely to have an important impact and may change the estimate. Low certainty of evidence: further research is very likely to change the estimate.

Resuscitation 80

Resuscitation Fluid Resuscitation Hospitals Research 80

Critical Care Now

JULY 7, 2024

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. While REBOA may not be a universal solution, further research is needed to determine specifically which patients or injury patterns would benefit from its deployment.

Resuscitation 52

Resuscitation Military Outcomes Hospitals 52

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Robert’s academic interests include research and evidence-based medicine. Audrey’s academic interests include trauma and resuscitation. Robert’s academic interests include research and evidence-based medicine. Audrey’s academic interests include trauma and resuscitation. Reference: Roberts et al.

Academics 52

Academics Resuscitation EMS Stroke 52

Don't Forget the Bubbles

JUNE 26, 2023

The team start CPR, and this is emergently converted to extra-corporeal cardiopulmonary resuscitation via the open sternotomy wound. These cases illustrate some of the common issues associated with each shunt type, but what does the evidence say about outcomes? What is the best option for repair? 2017;51(1):50-57.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

Don't Forget the Bubbles

NOVEMBER 15, 2023

One-liner… Understanding how to manage maintenance fluids in critically unwell children best is a basic but important way to improve outcomes. In a PICU setting, sodium can come from various sources (resuscitation fluids, IV drugs and infusions, enteral feed), not just the maintenance fluids we prescribe. sodium chloride.

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

RebelEM

MARCH 13, 2023

Nevertheless, mortality of prehospital traumatic cardiac arrest (TCA), and survivability with good neurologic outcome, remain the gold standards of trauma care in and out of the hospital and are effectively the criterion by which we measure outcomes in the trauma literature. Discussion: Dead On Scene: The 96.2% mortality rate and 43.5%

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52

ACEP Now

APRIL 3, 2024

Targeted temperature management (TTM) for patients following cardiac arrest resuscitation has gone through several dosing iterations in the past two decades. Finally, the guidelines support active temperature management’s (though not necessarily hypothermia) role in improving post-arrest outcomes. degrees Celsius for 72 hours.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

SheMD

MAY 11, 2023

Research indicates that the gender of a provider may impact their performance. In medical emergencies, provider qualities which lead to greater performance and patient outcomes include leadership and teamwork. Female physician leadership during cardiopulmonary resuscitation is associated with improved patient outcomes*.

Leadership 52

Leadership Documentation/Coding Teamwork CPR 52

PulmCCM

JUNE 5, 2023

Read in Journal of Critical Care ECMO vs CPR for pre-hospital resuscitation after cardiac arrest. There was no significant difference in survival with a favorable neurologic outcome at 30 days (20% vs 16% nominally favoring the ECMO group, P=0.52) or at 6 months. makes me long for an adequately powered randomized trial. In the U.S.,

Advances Cardiac Life Support (ACLS) 96

Advances Cardiac Life Support (ACLS) Documentation/Coding CPR Shock 96

Don't Forget the Bubbles

MAY 8, 2024

We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. The researchers compared children diagnosed via screening with those diagnosed after clinical symptoms appeared. Dell KM, et al. Koenis MM et al. Eur J Pediatr.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

AED Leader

JULY 5, 2024

It features a clear and intuitive interface that guides users through the resuscitation process with step-by-step voice prompts and visual instructions. Smart CPR Guidance Cardiopulmonary resuscitation (CPR) is a critical component of saving a life during a cardiac arrest.

CPR 52

CPR Resuscitation Shock Pediatrics 52

PHEM Cast

APRIL 10, 2016

And from our buddies at HEFT EM CAST: [link] A bit more detail covering some of the research in an easy to understand way. This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. Scand J Trauma Resusc Emerg Med.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

EMDocs

JANUARY 29, 2024

Finally, anticipating and addressing known complications such as seizures, increased intracranial pressure, or cerebral edema with appropriate measures, including antiepileptic drugs or osmotic agents, is essential for improving patient outcomes. Lowering the MAP may mitigate these risks and possibly improve outcomes. doi: 10.1161/01.str.0000014509.11540.66.

Stroke 74

Stroke Outcomes EMS Seizures 74

RCEM Learning

APRIL 9, 2024

Ensure that you have a solid understanding of the core subjects, including emergency medicine, critical care, resuscitation, trauma management, and relevant guidelines. By following these steps and dedicating sufficient time and effort to your preparation, you can increase your chances of achieving a favourable outcome.

Infectious Diseases 52

Infectious Diseases Airway Management Resuscitation Poisoning 52

AED Leader

SEPTEMBER 21, 2024

Incorporating defibrillation into Cardiopulmonary Resuscitation (CPR) significantly enhances survival rates for victims of sudden cardiac arrest (SCA). The critical factor in improving outcomes lies in time-to-defibrillation. The defibrillator administers a shock measured in joules to the heart at precisely the right moment.

CPR 52

CPR Shock Resuscitation Hospitals 52

Northwestern EM Blog

FEBRUARY 14, 2022

Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation. The primary outcome of the study was the response in MAP three hours after the start of angiotensin II infusion.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52