Mind The Bleep

FEBRUARY 2, 2025

This is a tricky area to cover as it can be challenging to us both personally and professionally when things dont go well with a colleague, particularly when we know that this might impact patient care and/or our own mental health. A simple sentence like This interaction hasnt gone well. Can I just check if everything is ok with you?

Documentation/Coding 98

Documentation/Coding Outcomes Burns Wellness 98

The Skeptics' Guide to EM

MARCH 8, 2025

She was born full-term and seemed to be doing very well after the family returned home. Outcome: Primary Outcome(s): Successful lumbar puncture on the first attempt, with < 500 red blood cells/mm3. She is also a new podcast host for Emergency Medicine Residents Association (EMRA) Cast Series.

Outcomes 71

Outcomes Emergency Department Wellness 71

Emergency Medicine Cases

FEBRUARY 18, 2025

The earlier an eating disorder is identified and the earlier that appropriate treatment is initiated the better the long term outcomes. Missing the diagnosis has important consequences.

Psychiatric 87

Psychiatric Emergency Department EMS Outcomes 87

Don't Forget the Bubbles

DECEMBER 31, 2024

The skills needed to deliver the best possible outcomes for children and young people are multifaceted and constantly evolving. Reading Body language in tense meetings, phraseology when making referrals, and quick corridor conversations when hospital capacity is at a premium may all result in improved outcomes but are rarely intentional.

Leadership 140

Leadership Emergency Department Outcomes Operations 140

ACEP Now

NOVEMBER 7, 2024

Wound management in the ED is only a starting point, and appropriate referral and follow-up are key to an improved outcome. Conclusion Poorly healing wounds pose a significant burden on health care systems and personal well-being, and their presence as a harbinger of severe morbidity and mortality must be appreciated.

Burns 97

Burns Documentation/Coding Outcomes Emergency Department 97

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 105

Wellness Operations Outcomes 105

The Skeptics' Guide to EM

MARCH 1, 2025

The Wells Score and Revised Geneva Score (RGS) and YEARS are widely used clinical prediction rules to stratify risk and guide appropriate use of D-dimer testing. AEM Feb 2025 Population: Patients with a high clinical probability of PE (Wells >6 or Revised Geneva Score >10) and underwent D-dimer testing in the ED.

Allergic Reactions 75

Allergic Reactions Research Emergency Department Ultrasounds 75

ACEP Now

MARCH 10, 2025

A sense of purpose is an integral part of well-being. Ikigai and subsequent health and wellbeing among Japanese older adults: longitudinal outcome-wide analysis. A systematic review and meta-analysis on basic psychological need satisfaction, motivation, and well-being in later life: contributions of self-determination theory.

Academics 85

Academics Wellness CPR Hospitals 85

Mind The Bleep

FEBRUARY 2, 2025

” Yes, I have seen clerking look like this and I can confirm, it does not go down well. Examples of examination findings you might find helpful to keep in mind (list not exhaustive): GCS 15/15- alert, orientated, looks comfortable, warm and well perfused, in obvious pain, looks pale and clammy etc.

Documentation/Coding 95

Documentation/Coding COPD EKG/ECG Wellness 95

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

Emergency Medicine Journal

MARCH 25, 2025

The 1-BED.

Sepsis 52

Sepsis Emergency Department Administration Outcomes 52

Dr. Smith's ECG Blog

NOVEMBER 27, 2024

Much more subtle ( but still definitely present ) in this 2009 case — is the lack of even slight ST elevation that we normally see in leads V2 and V3 ( as well as some very subtle ST segment straightening in V2 ). The more abnormal leads and lead areas you can identify in a given ECG — the more solid the evidence of acute OMI becomes.

EKG/ECG 133

EKG/ECG Research Outcomes Wellness 133

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 145

Outcomes Resuscitation Hospitals CPR 145

Sensible Medicine

MAY 28, 2024

The adoption of depression screening is, of course, well-intentioned. A 2008 Cochrane review found adult depression screening does not improve outcomes. The last two trials convincingly demonstrate that when patients with postpartum depression have better access to mental health services, outcomes improve.

Military 144

Military Outcomes Psychiatric Wellness 144

Dr. Smith's ECG Blog

JULY 11, 2024

In support of this ECG representing acute proximal LAD OMI — is the clearly abnormal complex in lead aVL ( within the BLUE rectangle ) — which shows a surprisingly wide and deep Q wave ( given tiny size of the QRS in this lead ) — as well as slight-but-real ST elevation of coved morphology with terminal T wave inversion.

EKG/ECG 113

EKG/ECG Outcomes Hospitals Wellness 113

RebelEM

JUNE 29, 2023

Diagnostic yield, safety, and outcomes of Head-to-pelvis sudden death CT imaging in post arrest care: The CT FIRST cohort study. The CT FIRST Trial: Should We Pan-CT After ROSC?, REBEL EM Blog, June 1, 2023. Available at: HERE Branch KHR et al. Resus 2023.

CPR 145

CPR EMS Documentation/Coding Outcomes 145

RebelEM

FEBRUARY 15, 2024

Additionally, intubation can risk hemodynamic instability as well as hypoxemia from the procedure itself. 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 141

Poisoning Airway Management Seizures Shock 141

EMDocs

DECEMBER 18, 2024

Alcohol withdrawal syndrome: improving outcomes through early identification and aggressive treatment strategies. fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

Seizures 105

Seizures Hyperthermia / Hypothermia Emergency Department EMS 105

EM Literature of Note

SEPTEMBER 11, 2023

Well, PRISMS demonstrated unfavorable results. MARISS tried to ascertain predictors of poor outcome in mild stroke, and intravenous thrombolysis was not associated with an effect on the primary outcome. Now, again, we examine thrombolysis in “mild” stroke, in this case, NIHSS ≤3 – and fail.

Stroke 114

Stroke Outcomes Wellness 114

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 132

Sepsis Hospitals Administration Outcomes 132

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. Your partner asks if you want to administer naloxone as well. Naloxone is a well-established medication used primarily for reversing opioid overdoses. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in Cali.

Hospitals 104

Hospitals CPR EMS Outcomes 104

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. 4F-PCC contains factors II, VII, IX, X as well as Proteins S and C. Severe acute traumatic coagulopathy = PT >1.5

Administration 143

Administration Outcomes Resuscitation Radiology 143

ACEP Now

OCTOBER 29, 2024

4 However, emergency physicians rely on gestalt to predict outcomes well. The externally validated Canadian Syncope Risk Score (CSRS) demonstrated no better prediction of 30-day adverse outcomes for “very low” and “low” risk patients than clinical judgment alone of emergency physicians. Ann Emerg Med. 2024;84(3):246-258.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

Sensible Medicine

NOVEMBER 20, 2023

The primary outcome was stroke or systemic embolism. Lessons and Questions: This surprise illustrates exactly why we need properly powered Phase 3 trials, which measure hard clinical outcomes. But, ultimately, a new medical intervention has to improve an important outcome as well as or better than standard care.

Stroke 124

Stroke Outcomes Wellness 124

EMDocs

JANUARY 25, 2025

Well keep it short, while you keep that EM brain sharp. 0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. 10^9/L) Moderate (0.50.9 10^9/L) Severe (< 0.5 10^9/L) Generalized leukopenia (i.e. Most common causes of leukopenia Infections: 36.4% Medications: 25.6%

EMS 94

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 94

Pediatric EM Morsels

SEPTEMBER 22, 2023

” Children compensate for blood and volume loss very well… until they don’t. Orenstein JB, Klein BL, Gotschall CS, Ochsenschlager DW, Klatzko MD, Eichelberger MR. Age and outcome in pediatric cervical spine injury: 11-year experience. Physical exam findings of occult shock in children can be subtle. J Pediatr Surg.

Shock 304

Shock Pediatrics Dislocations Hyperthermia / Hypothermia 304

Sensible Medicine

AUGUST 12, 2024

Surely you do as well. You can improve your chances by eating well, exercising, avoiding smoking and too much alcohol. What patients, doctors, hospitals and payers want to know is that does the $43 billion spent on screening lead to better outcomes in the average patient. My thinking aligns well with his.

Outcomes 133

Outcomes Research Wellness Hospitals 133

American Medical Compliance

MARCH 21, 2025

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve patient care outcomes. They explore core ethics in this course as well as corollary principles. This helps ensure care remains respectful, patient-centered, and ethically sound.

Outcomes 52

Outcomes Patient Safety Hospitals Wellness 52

EMDocs

JANUARY 11, 2025

Well keep it short, while you keep that EM brain sharp. Admission allows for close monitoring, given the risks of perforation, ischemic bowel, and ulceration, as well as appropriate management of the condition and patient symptoms. Fecal Impaction and Nonperforated Stercoral Colitis: Red Flags for Poor Outcomes. Mathis, K.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

The Skeptics' Guide to EM

JULY 2, 2023

His Glasgow Coma Scale (GCS) score is 13 with obvious head trauma as well. Most of the times the RCTs we critically appraised did not demonstrate superiority for their primary outcome. Background: We have looked at the use of TXA many times on the SGEM. Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group.

EMS 145

EMS Outcomes Hospitals Research 145

The Trauma Pro

JULY 5, 2024

But under-prescribing can create problems as well. Uncontrolled pain is a huge patient dissatisfier, and can lead to unwelcome complications as well (think pneumonia after rib fractures). Make sure all is documented well on the consent or in the EHR.

Documentation/Coding 113

Documentation/Coding Fractures Emergency Department Wellness 113

Sensible Medicine

NOVEMBER 13, 2023

of patients experienced a first primary outcome event in the semaglutide arm vs 8.0% The Kaplan-Meier curves for outcomes began separating early and continued over 3-4 years. There were other positive results as well. Each component of the primary outcome was lower. Patients in the trial were in their low sixties.

Outcomes 116

Outcomes Stroke Wellness Research 116

RebelEM

JULY 1, 2024

AVAPS may be useful, but we still need a well conducted RCT to find out if it is (i.e 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 132

COPD Emergency Department Outcomes EMS 132

EMDocs

DECEMBER 23, 2024

The most recent and well-known trial is the PROCAMIO trial (1). Well, the trial was a multicenter prospective open label trial. Well, lets look at some other trials. Gorgels et al (5) looked at procainamide vs lidocaine and again and primary outcome was VTach termination. Ok, so what did the PROCAMIO trial find?

EKG/ECG 75

EKG/ECG Shock Wellness EMS 75

Stop and Think

AUGUST 28, 2024

Trial after trial after trial finds that fixing stable coronary artery disease does not improve outcomes over basic medications and lifestyle changes. The trial found no difference in outcomes. of patients had a primary outcome (death or heart attack). of the patients had a primary outcome (death or heart attack).

Outcomes 120

Outcomes Shock Hospitals Wellness 120

The Trauma Pro

JANUARY 5, 2024

The group at the Medical College of Wisconsin performed a trial of thoracic cavity irrigation and compared the outcomes with patients who did not undergo irrigation. Bottom line: Well, this was a new one for me. Several protocols have been developed to try to prevent a retained hemothorax.

Hospitals 133

Hospitals Wellness Outcomes 133

The Trauma Pro

SEPTEMBER 20, 2023

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. These low numbers and the nature of this particular registry could inject significant bias as well. AAST 2023 Plenary paper #29.

Military 113

Military Blood Transfusions Administration Outcomes 113