Stop and Think

MARCH 31, 2024

When Ahmed Sayed and Andrew Foy asked me to participate in a research project looking at industry payments to doctors I was happy to help. We excluded research payments, royalty fees, debt forgiveness and loans for supplies and devices. His list of device approvals despite dodgy evidence is shocking. Subscribe now So.

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Research Shock Hospitals 138

Sensible Medicine

AUGUST 26, 2024

It was a shocking result. The SHAM-PVI trial Next weekend at the European Society of Cardiology meeting in London, a UK team of researchers will present results of the SHAM-PVI trial. Patients with severe partial blockages were randomized to a stent or a placebo procedure. They have published their rationale and protocol paper.

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Stroke Outcomes Shock Research 100

Taming the SRU

JULY 24, 2024

National campaigns to improve sepsis care, namely the Centers for Medicare and Medicaid Services’ introduction of “Severe Sepsis and Septic Shock Early Management Bundle”, have faced many challenges in physician and provider adherence. Sepsis as a disease process has been difficult to both clearly define and quickly recognize.

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Sepsis Resuscitation Emergency Department Wellness 89

Medagadget

JUNE 26, 2023

. “This paper uses imaging, behavioral and histological techniques to show how these tissue-integrated electrodes improve the efficacy of stimulation,” said Lan Luan, a researcher involved in the study. “Conventional electrodes are very invasive,” said Chong Xie, another researcher involved in the study.

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Research Shock 77

Don't Forget the Bubbles

JUNE 26, 2023

But, they may present postnatally with cyanosis/hypoxaemia due to insufficient pulmonary blood flow, cardiogenic shock due to insufficient systemic blood flow, or both. Researchers also looked at neurodevelopmental status three years after the operation. Eur J cardio-thoracic Surg Off J Eur Assoc Cardio-thoracic Surg. 2017;51(1):50-57.

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Operations Research Hyperthermia / Hypothermia Hospitals 128

Taming the SRU

APRIL 17, 2024

Ultimately, the presented data is likely no sufficient to suggest that IABP measurements are not needed; rather, it suggests that further research into specific protocols in which invasive blood pressure measurements are not needed is required. Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.

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Sepsis Research Stroke Academics 94

Don't Forget the Bubbles

MARCH 4, 2024

Article 1: Infections in Foreign Travellers Bird C, Hayward GN, Turner PJ, Wasala D, Merrick V, Lyttle MD, Mullen N, Fanshawe TR; for Paediatric Emergency Research in the UK and Ireland (PERUKI). International Consensus Criteria for Pediatric Sepsis and Septic Shock. Paediatr Int Child Health. 2024 Jan 11:1-7. doi:10.1001/jama.2024.0179

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Hospitals Sepsis Fractures Emergency Department 78

JournalFeed

MARCH 23, 2024

Tuesday Spoon Feed: This Bayesian network meta-analysis of RCTs indirectly compares hydrocortisone + fludrocortisone to hydrocortisone alone or placebo in septic shock and finds superiority with the combination regimen.

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Sepsis Shock Research 52

University of Maryland CC Project

AUGUST 18, 2024

His research focuses on monitoring cerebral perfusion and pathophysiology in patients with […] Dr. Imad Khan is an assistant professor in the Division of NeuroCritical Care at the University of Rochester. Imad Khan is an assistant professor in the Division of NeuroCritical Care at the University of Rochester.

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Shock Research 40

PulmCCM

DECEMBER 11, 2024

An excellent review article titled “Sepsis and Septic Shock” was published 4 December 2024 in the New England Journal of Medicine. As for the body of research literature, clinical researchers usually do not have access to superior diagnostic techniques. But it feels like something important was missed, or misplaced.

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Sepsis Shock Research Wellness 45

Sensible Medicine

AUGUST 20, 2023

His most recent Circulation paper: Bringing the Credibility Revolution to Observational Research in Cardiology. Here is the profile for Harvard Professor Robert (Bobby) Yeh. To receive new posts and support our work, consider becoming a free or paid subscriber. I learned a lot from this conversation.

Shock 52

Shock Research Wellness 52

AED Leader

APRIL 21, 2024

An AED is a portable device that delivers an electric shock to the heart to restore its normal rhythm. Research AED Brands : Visit our website, AED Leader, to explore the wide range of AED brands and models available. Q: What should I do if the AED does not deliver a shock? This is where an AED comes into play.

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Shock CPR Research Wellness 52

AED Leader

JULY 5, 2024

The HeartStart OnSite AED boasts a quick start-up time and delivers a shock within eight seconds if it detects a shockable rhythm. The HeartStart OnSite AED has a long-life lithium battery that can deliver up to 200 shocks or provide approximately four hours of continuous monitoring.

CPR 52

CPR Resuscitation Shock Pediatrics 52

Northwestern EM Blog

FEBRUARY 14, 2022

The ATHOS-3 trial in 2017 explored the efficacy of angiotensin II as a vasopressor for severe vasodilatory shock. 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.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

Taming the SRU

FEBRUARY 19, 2024

This has been the central question of many research projects with variable outcomes. A recent observational study was performed to pragmatically assess clinically meaningful differences in BP in a diverse critically ill cohort with shock. Damping Damping is essentially the shock absorbers in the pressurized system. Keville, M.

Shock 59

Shock Resuscitation Ultrasounds Research 59

AED Leader

SEPTEMBER 28, 2024

Key takeaways AEDs, like the Philips HeartStart OnSite and ZOLL AED Plus, help save lives during sudden cardiac arrest by checking the heart’s rhythm and delivering a shock if needed. Models designed for home or public spaces have different features like durability and automatic shocks. They are easy for anyone to use.

CPR 52

CPR Shock Pediatrics Operations 52

Don't Forget the Bubbles

OCTOBER 10, 2024

The others, such as respiratory rate, heart rate, and decompensated shock, were excluded due to the presumed difficulty for non-healthcare professionals to assess them accurately. In the project’s second phase, research leads were asked to submit the written discharge material routinely provided on discharge in their institution.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. [display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Probably not.

Sepsis 52

Sepsis Emergency Department Seizures Pediatrics 52

RebelEM

JANUARY 9, 2024

Except for patients with poor gut absorption or those with critical infectious processes such as septic shock or necrotizing fasciitis, this belief appears to be unfounded. BMJ (Clinical research ed.). This feels intuitive as the IV route seems like it would be stronger, faster, and fix the patient better than the oral route.

Infectious Diseases 98

Infectious Diseases Pediatrics EMS Administration 98

ACEP Now

JUNE 6, 2023

Example: “ I can imagine this comes as a shock” or “ I can hear how upset you are.” Emily has an interest in the intersection of emergency medicine and palliative care and leads research and implementation efforts aimed at improving the quality of palliative care in the ED. References Phillips KA, Ospina NS. 2017;318(1):93–94.

Emergency Department 98

Emergency Department Hospitals Best Practices Shock 98

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. These tables are used when assessing the usefulness of a test (or it’s sensitivity and specificity), and, when researching how useful tests are we need the majority of patients to fall into the green boxes.

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Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

EMDocs

JULY 1, 2023

Upon further research in the 1970’s, retrospective data from autopsies of those patients showed coronary aneurysms 5 Pathophysiology: Kawasaki Disease is a vasculitis of medium sized arteries.

EMS 91

EMS Infectious Diseases Pediatrics Research 91

University of Maryland CC Project

SEPTEMBER 20, 2022

His research interests span the fields of cardiogenic shock and mechanical circulatory assistance, for severe acute respiratory distress syndrome, including ECMO, and mechanical ventilation. His lecture is entitled “ECMO for Severe Acute Respiratory Distress Syndrome Associated with COVID-19”

Shock 40

Shock Research Hospitals 40

RebelEM

DECEMBER 19, 2022

This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. I am hopeful this trial encourages future research on the subject matter so we can answer additional questions it has left us (ie.

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EMS CPR Shock Resuscitation 52

The Skeptics' Guide to EM

AUGUST 5, 2017

He is internationally recognized for his research in emergency medicine with a focus on the development of clinical decision rules. He is internationally recognized for his research in emergency medicine with a focus on the development of clinical decision rules. ” Other Legends of Emergency Medicine:

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Head Injuries Research Shock Hospitals 40

Don't Forget the Bubbles

NOVEMBER 15, 2023

She had septic shock on presentation and was resuscitated with 60ml/kg of balanced crystalloid solution and escalating vasoactive medications. Principles of fluid management and stewardship in septic shock: it is time to consider the four D’s and the four phases of fluid therapy. Ann Intensive Care. PMID: 29589054; PMCID: PMC5924672.

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Resuscitation Dehydration Administration Shock 80

RebelEM

JANUARY 25, 2024

POCUS in dyspnea, nontraumatic hypotension, and shock; a systematic review of existing evidence. Lancet Respir Med. 2014 Aug;2(8):638-46. Epub 2014 Jul 3. PMID: 24998674. Kok B, Wolthuis D, Bosch F, van der Hoeven H, Blans M. Eur J Intern Med. 2022 Dec;106:9-38. Epub 2022 Aug 1. PMID: 35927185.

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Ultrasounds Outcomes COPD Hospitals 128

American Medical Compliance

NOVEMBER 13, 2023

Likewise, to find treatments and eventually prevent Alzheimer’s disease, the National Institute on Aging spearheads clinical, behavioral, and social research initiatives within the National Institutes of Health. Unfortunately, the consequences of these illnesses can be devastating for both the person with AD/ADRD and their families.

Administration 52

Administration Shock Research 52

The Skeptics' Guide to EM

NOVEMBER 12, 2022

Salim is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that try to cut down knowledge translation gaps of research to bedside clinical practice. Case: A 38-year-old male presents to the emergency department (ED) with acute mid epigastric abdominal pain with nausea and vomiting.

Fluid Resuscitation 52

Fluid Resuscitation Resuscitation Emergency Department Shock 52

Pediatric Emergency Playbook

APRIL 1, 2016

There are two main reasons for an elevated lactate: the stress state and the shock state. The shock state is due to tissue hypoxia, seen in septic shock. We should use lactate to detect occult shock. Children compensate so well for shock, that subtle tissue hypoxia may not be detected until later. 2013; 29:715-719.

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Pediatrics Sepsis Shock Outcomes 52

The Skeptics' Guide to EM

JANUARY 7, 2023

We just said there is so much research being published every day. As Professor Altman said in the BMJ back in 1994; “we need less research, better research and research done for the right reasons.” As Professor Feynman said…It’s ok to say: “I don’t know”.

Emergency Department 40

Emergency Department Research Shock EKG/ECG 40

Mind The Bleep

FEBRUARY 27, 2024

2] Since this data was published the APLS guidelines have altered to reflect these results and the need for more research in this area and now recommend the 10ml/kg boluses as above compared to the previous recommendation of 20ml/kg. saline), however more research is needed in this area. [4] Which type of fluid to use?

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Fluid Resuscitation Dehydration Hospitals Research 96

Dr. Smith's ECG Blog

MAY 19, 2020

In this case, profound shock for 1 hour would result in the same degree of infarction. The Type 2 MI would then have been a result of the prolonged severe shock while in arrest. If the arrest had another etiology (such as old scar), and the ST elevation is due to severe shock, then it is a type II STEMI. Troponin I rose to 44.1

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CPR EKG/ECG Shock Ultrasounds 52

The Skeptics' Guide to EM

SEPTEMBER 6, 2020

Date: August 27th, 2020 Guest Skeptic: Dr. Malthaner is the Chair/Chief of the Division of Thoracic Surgery, Director of Thoracic Surgery Research and Simulation, and Professor in the Departments of Surgery, Oncology, and Epidemiology and Biostatistics at the Schulich School of Medicine and Dentistry and Western University.

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Research Emergency Department Shock Hospitals 40

PHEM Cast

JULY 14, 2016

Value of a rigid collar: in need of more research and better devices. Journal of Emergencies, Trauma, and Shock. Should suspected cervical spinal cord injury be immobilised?: A systematic review. Elsevier Ltd; 2015 Apr 1;46(4):528–35. Smyth M, Cooke MW. Emergency Medicine Journal. 2013 May 13;30(6):516–6. 2014 Feb 11;7(4):251–5.

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Fractures Hospitals Shock Research 52

The Skeptics' Guide to EM

FEBRUARY 10, 2018

Exclusions: Oxygen saturations <92% on room air; silent chest; shock or sepsis; previous PICU admission with wheeze; prematurity; other cardiac or respiratory disease; likely alternative diagnosis for the wheeze; or steroid treatment within the preceding 14 days. Intervention: Three-day course of oral prednisolone (1mg/kg once daily).

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

ACEP Now

FEBRUARY 6, 2024

Yes, there are real issues with urine analysis, however in our case it was shocking how fluorescent the patient’s urine was when exposed to ultraviolet (UV) light. Although they may have missed the point of the column, they have written a concise review on urinary fluorescence and discussion of lactic acid gap measurements in EG ingestions.

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Poisoning Pediatrics Shock Research 52