Sensible Medicine

APRIL 29, 2024

You can assess how well (or poorly) a practicing cardiologist did analyzing a paper in the Journal of Clinical Epidemiology. Specification curve analysis is similar to a multiverse analysis, meaning it’s a way of defining and implementing all plausible and valid analytic approaches to a research question. It’s the Methods

Stroke 142

Stroke Documentation/Coding Shock Research 142

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. What we want to know is whether that reduction in AF produces a placebo-resistant effect of improved well being.

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Stroke Outcomes Shock Research 96

Sensible Medicine

DECEMBER 16, 2024

No prior studies have shown that ICDs reduce heart failure hospitalizations—on the contrary, ICDs are often associated with increased hospitalizations due to the progression of heart failure, particularly when frequent shocks are involved ( Goldenberg I et al ). No efficacy claims should be made in underpowered studies.

Shock 96

Shock Hospitals Outcomes Research 96

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. Resistance provided by this pathway will have a marked bearing on how well-balanced the circulation is – it is the primary determinant of PVR.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

Sensible Medicine

SEPTEMBER 3, 2024

It is well-recognized that our commercial drug development process, a process that has led to so many nearly miraculous advancements, serves people with rare diseases poorly. Sensible Medicine readers appreciate a well-designed clinical trial. Here is a sample of what I have heard: “You don’t want to raise research funds?

Pediatrics 75

Pediatrics Poisoning Research Military 75

Taming the SRU

APRIL 17, 2024

IABP MAP measurements tended to have a lower diastolic blood pressure measurement, which caused much of the discrepancy between NIBP and IABP measurement, although the clinical significance of this is not well understood.(4) Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.

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Sepsis Research Stroke Academics 94

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. Jeff : So as well all know Sepsis is bread and butter emergency medicine, but, what is sepsis? Optimal management of septic patients has been a source of intense research, stemming from the landmark study by Rivers in 2001.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

RebelEM

AUGUST 14, 2023

in both groups Mean APACHE II score was 12 in both groups Almost half of the patients had septic shock at enrollment Mean time from sepsis identification to randomization was 1.4 Investigators asked a patient-centered research question. Many of the secondary outcomes were changed well after most of the data was acquired.

Sepsis 98

Sepsis Outcomes Administration EMS 98

Sensible Medicine

AUGUST 20, 2023

His most recent Circulation paper: Bringing the Credibility Revolution to Observational Research in Cardiology. One of the main lessons is that no matter how well the authors avoid causal language, the intent of an observational comparison study is causal. Here is the profile for Harvard Professor Robert (Bobby) Yeh.

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Shock Research Wellness 52

Northwestern EM Blog

JANUARY 24, 2022

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

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. It’s a wonderful contribution to the literature and well worth reading. These are nonfalsifiable claims that illustrate the problem well.

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Sepsis Shock Research Wellness 45

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

Carly Eastin is an Associate Professor, Division of Research and Evidence Based Medicine, Department of Emergency Medicine, University of Arkansas for Medical Sciences. Case: A 45-year-old female in the emergency department is being admitted to the intensive care unit (ICU) for septic shock secondary to urinary tract infection (UTI).

Sepsis 52

Sepsis Shock Outcomes Stroke 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. Remember, investing in an AED is investing in the safety and well-being of those around you.

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Shock CPR Research Wellness 52

Dr. Smith's ECG Blog

AUGUST 9, 2024

The LCx and OM vessels are not as well visualized. below) Other examples of AIVR: Young man with Gunshot wound to right chest with hemorrhagic shock, but bullet path not near heart. Circulation Research , 56 (2), 184–194. In fact, use of antidyrhythimcs (e.g., In other words, it is a safe rhythm. Leave it alone. Bigger et al.

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EKG/ECG EMS Emergency Department Wellness 107

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. Adopting this approach would reduce time in surgery for the child as well as the financial cost of nail bed repair. 61 out of 77 departments responded.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

Stop and Think

JUNE 13, 2023

It’s shocking how many have subscribed and supported this newsletter. He says it is cynical and if I say a study was done for marketing it might insult the researchers. Well, the authors of the smaller trial did not choose clinical outcomes, such as heart failure or death, as the primary endpoint.

Outcomes 98

Outcomes Academics Shock Hospitals 98

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

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 92

EMS Infectious Diseases Pediatrics Research 92

RebelEM

JANUARY 25, 2024

CHF, in particular, lends itself well to diagnosis and treatment with PoCUS, as it readily reveals the presence of B lines. POCUS in dyspnea, nontraumatic hypotension, and shock; a systematic review of existing evidence. Furthermore, the serial US group included more patients with conditions detectable with US. vs. 18.3%).

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

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

JULY 26, 2023

A cardiac family history should of course be sought, but think a little outside the box as well. For anyone approaching a structured ABC would be a priority to establish whether shock was present or not. We now have a patient who is in sustained SVT but with no features of shock. Family history. What if this does not work?

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Greater Sydney Area HEMS

APRIL 26, 2023

Both the stuff of legend and go by multiple names including harness hang syndrome and orthostatic intolerance, as well as bigfoot and the abominable snowman, respectively. Thus, ST management has been heavily based on lay opinion, and until recently, lightly on peer-reviewed research. Health and Safety Executive Research Report 451.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Shock Research Operations 52

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.

EMS 52

EMS CPR Shock Resuscitation 52

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. As well as considering volume, hyponatraemia is a harmful consequence of incorrect administration of fluids. Remember, we can add more if needed, but taking it away is much harder.

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

AED Leader

SEPTEMBER 24, 2024

Key takeaways Automated External Defibrillators (AEDs) increase survival rates by detecting irregular heart rhythms and delivering shocks during cardiac arrest. They analyze heart rhythms and provide shocks if needed to restore a normal heartbeat. It features a pediatric mode, enabling safe treatment for children as well.

Pediatrics 52

Pediatrics Shock Operations Wellness 52

Mind The Bleep

FEBRUARY 27, 2024

1] It is worth mentioning this formula was designed for well, euvolaemic children, which does not represent the popluation of children who require IV fluids. saline), however more research is needed in this area. [4] Our population and their demographics has also changed significantly since this study in 1957.

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Hospitals Research 96

The Skeptics' Guide to EM

DECEMBER 11, 2021

Date: December 10th, 2021 Guest Skeptic: Dr. Carly Eastin is an Associate Professor, Division of Research and Evidence Based Medicine, Department of Emergency Medicine, University of Arkansas for Medical Sciences. Fujii et al ( VITAMINS RCT) JAMA 2020: n=216 patients with septic shock. You can listen to his introduction at this LINK.

Sepsis 40

Sepsis Shock Outcomes Research 40

AED Leader

SEPTEMBER 21, 2024

Why is defibrillation important Defibrillation is the process of delivering an electrical shock to a person experiencing life-threatening heart rhythms, like ventricular fibrillation (VF) or pulseless ventricular tachycardia. The defibrillator administers a shock measured in joules to the heart at precisely the right moment.

CPR 52

CPR Shock Resuscitation Hospitals 52

Don't Forget the Bubbles

JANUARY 10, 2024

The factorial design chosen by Dr Maitland and her research group means that several comparisons in transfusion practice could be carried out at the same time. What were the research questions? Does the study address a clearly focused research question? Groups were well matched at baseline. N Engl J Med.

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Blood Transfusions Research Outcomes Hospitals 78

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

ACEP Now

SEPTEMBER 13, 2023

Emergency Medicine research was and still is tremendously underfunded,” says John E. We wanted to reach emergency physicians, nurses and others working in trauma as well as those at Health and Human Services and the Centers for Disease Control. Prescott, MD, another member of the committee. “We

EMS 45

EMS Research Academics Military 45

Pediatric Emergency Playbook

APRIL 1, 2016

Brain natriuretic peptide (BNP) In adults, we typically think of a BNP Luckily, we have data in children with congenital heart disease as well. This has been studied in children as well, and an elevated lactate in children – typically above 4 – was a predictor of prolonged ICU course and mortality in septic patients.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

PHEM Cast

JULY 14, 2016

Value of a rigid collar: in need of more research and better devices. Crane T, Cooke MW, Wellings R, Wayte S, Higgins J. Journal of Emergencies, Trauma, and Shock. : 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. The University of Warwick.

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Fractures Hospitals Shock Research 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Perhaps, not insignificantly, they were accustomed to receiving systematized government-supplied medical and trauma care, with "shock rooms" receiving an influx of victims, as contrasted to those later who opposed "socialized medicine." 1950s & 1960s Resuscitation Research. Committee on Shock. Farrington, J.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

PEMBlog

JUNE 5, 2024

It was inspired by a hot-off-the-presses publication from the Pediatric Emergency Care Applied Research Network (PECARN) focused on clinical decision rules for cervical spine imaging in children. Leonard JR, Jaffe DM, Kuppermann N, Olsen CS, Leonard JC; Pediatric Emergency Care Applied Research Network (PECARN) Cervical Spine Study Group.

Fractures 52

Fractures Pediatrics Radiology Radiology 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).

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Emergency Department Pediatrics Sepsis Hospitals 40