RebelEM

JULY 3, 2023

Pregnant or incarcerated patients Documentation for systolic BP is incomplete Intervention: Administration of IV calcium within 60 min prior to or 30 min after IV diltiazem administration in patients with AF/AFL with RVR. Limitations: The primary and secondary outcomes were nearly all disease oriented and not patient oriented.

Administration 77

Administration Outcomes Documentation/Coding Emergency Department 77

RebelEM

JUNE 19, 2023

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? 1.00 (0.9 – 1.12) Secondary Outcome Mortality 24h 9.7% Prehospital Tranexamic Acid for Severe Trauma.

Outcomes 99

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 99

Taming the SRU

MAY 11, 2024

3% HTS appears to be safe for peripheral IV administration and does not require a central line. The available data does not support any benefit of administration of hyperosmolar therapy in the setting of a TBI. When administered IM, midazolam administration appears superior in terms of time to sedation (Nobay et al.).

Administration 81

Administration Resuscitation Research Fluid Resuscitation 81

Sensible Medicine

AUGUST 21, 2023

Administrative data sets are often collected for the purpose of billing, or costing, or administrative organization, and thus are extremely vulnerable to up coding or intentional or accidental omissions. ” For example, mortality is a patient outcome—provided it can be reliably ascertained.

Administration 88

Administration Outcomes Research COPD 88

EMDocs

AUGUST 24, 2023

Blood cultures were collected from patients before the admiration of antibiotics (gold standard), and then again 30 – 120 min following administration of antibiotics. Yields from the post-antibiotic set of blood cultures were then compared against the pre-antibiotics administration set. Difference of 12% (95% CI 5.4 Ann Intern Med.

Administration 67

Administration Sepsis Shock Outcomes 67

American Medical Compliance

APRIL 24, 2024

What you will learn: HIPAA regulations Covered entities Administrative areas Breaches The HITECH Act Details Course length: 30 minutes. Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve healthcare outcomes.

Administration 52

Administration Outcomes 52

RebelEM

FEBRUARY 1, 2024

Tenecteplase, a modified version of alteplase, is being increasingly utilized for AIS due to its favorable pharmacological profile, ease of administration, and cost effectiveness. Limitations : Open label study design Outcome assessments were done via telephone interview. mg/kg at this time for the potential treatment of AIS.

Stroke 119

Stroke Blood Transfusions Outcomes EMS 119

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. Researchers from the US Army performed a retrospective registry study on a sample of military casualties over four years.

Military 113

Military Blood Transfusions Outcomes Administration 113

American Medical Compliance

APRIL 16, 2024

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve healthcare outcomes. American Medical Compliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education to physicians.

Patient Safety 98

Patient Safety Administration Outcomes 98

EMDocs

MAY 25, 2023

mg/kg or 10 mg Seizures must persist for at least 5 minutes after administration of the prespecified benzodiazepines. In light of these data, I will give levetiracetam due to its less severe side effects and ease of administration. mg/kg or 10 mg Intravenous lorazepam 0.1 mg/kg or 4 mg Intravenous midazolam 0.2

Seizures 62

Seizures Administration Outcomes Anaphylaxis 62

Don't Forget the Bubbles

DECEMBER 25, 2023

Interpreting Research Outcomes with a Little Bathroom Humour You have learned a method for how to read a research paper , and now you are faced with a bunch of outcomes. There are primary, secondary, composite , and safety outcomes. What are these outcomes? We know there is a bias towards reporting positive outcomes.

Research 83

Research Outcomes Fractures Hospitals 83

The Skeptics' Guide to EM

JUNE 17, 2023

The National Heart, Lung, and Blood Institute (NHLBI) released an expert panel report in 2014 with evidence-based guidelines for management of sickle cell disease recommending timely administration of parenteral opioids for VOE. [7] IN fentanyl has been safely used to treat pain in pediatric patients.

Emergency Department 70

Emergency Department Pediatrics Administration Head Injuries 70

EMDocs

JUNE 8, 2023

and 9 hours after onset of symptoms, with non-infarcted brain tissue, does the administration of alteplase improve functional outcome at 90 days? and 9 hours of symptom onset; stroke symptoms that started during sleep were assumed to have started halfway between the actual last known well and the time of wake-up. to 53.54, p=0.053).

Stroke 76

Stroke Administration Outcomes Documentation/Coding 76

Core Ultrasound

MARCH 25, 2024

The IVC is unable to reliably tell you anything about fluid responsiveness but fluid responsiveness is a flawed outcome and we have to start taking a more holistic view on the administration of fluid. If one is going to access the collapsibility of the IVC one should probably look at it in the transverse plane as well 3.

Administration 98

Administration Sepsis Ultrasounds Outcomes 98

RebelEM

APRIL 29, 2024

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Intravenous vs intraosseous adrenaline administration in cardiac arrest: A protocol for systematic review and meta-analysis. Resuscitation. 2012 PMID: 21893125. 9 Zhang W et al. Medicine (Baltimore). PMID: 33350794 10 Meilandt C.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

The Skeptics' Guide to EM

MARCH 18, 2023

Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. 1-3] Possible benefits include reduction in duration of symptoms and improvement of outcomes in hospitalized patients.

Pediatrics 40

Pediatrics Infectious Diseases Administration Outcomes 40

Cook County EM Blog

APRIL 27, 2022

2019.09.007 What : Retrospective cohort study of all droperidol administrations between January 2012 and April 2018 at an academic and pediatric emergency department in the US with 77,000 annual visits. Zero deaths were attributed to droperidol administration. Zero deaths were attributed to droperidol administration.

Administration 52

Administration EKG/ECG Emergency Department EMS 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. percent to 38.3

Research 52

Research Airway Management Stroke Outcomes 52

Taming the SRU

MAY 5, 2023

Despite the complexity and heterogeneity of patients with sepsis, there have been few interventions which have been demonstrated to decrease mortality: early antimicrobial and fluid administration (Levy, Evans et al. 2018, Kuttab, Lykins et al. 2019, Evans, Rhodes et al. 2021, Im, Kang et al. vs 33.2%; OR, 0.42; 95% CI 0.32-0.55;

Sepsis 52

Sepsis Shock Administration Resuscitation 52

EMDocs

OCTOBER 14, 2023

Spoon Feed More aggressive systolic blood pressure (SBP) goals, beyond keeping it <180 mmHg, probably don’t make much of a difference in outcomes for patients who have undergone endovascular therapy for ischemic stroke. Source Peripheral administration of norepinephrine: a prospective observational study. avoided a CVC entirely.

Stroke 62

Stroke Administration Outcomes 62

ACEP Now

AUGUST 22, 2023

Intravenous insulin shifts potassium into cells, thereby lowering serum potassium within an hour of administration. A Common Case Hypoglycemia following insulin administration for hyperkalemia is common, occurring in approximately one in six patients (about 17 percent). 5,6 However, the difference between strategies was 0.17

Emergency Department 52

Emergency Department Administration Outcomes Research 52

EMDocs

JULY 20, 2023

A second primary outcome was added at the 30-month time frame by request of the FDA, the trial was still blinded at that time. A second primary outcome was added at the 30-month time frame by request of the FDA, the trial was still blinded at that time. POWER: 86% to detect a 1-point difference in the group’s first primary outcome.

Stroke 71

Stroke Outcomes Head Injuries Psychiatric 71

Ziqitza HealthCare Ltd

JUNE 18, 2023

Ziqitza Healthcare ltd embraces precision medicine by leveraging AI to analyze genomic data, enabling the delivery of tailored therapies to patients for improved treatment outcomes. Ziqitza Limited incorporates AI-powered systems to streamline administrative tasks, allowing their staff to focus more on direct patient care.

Documentation/Coding 52

Documentation/Coding Administration Ambulance Services Outcomes 52

American Medical Compliance

APRIL 23, 2024

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve healthcare outcomes. American Medical Compliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education to physicians.

Research 52

Research Administration Outcomes 52

Don't Forget the Bubbles

OCTOBER 4, 2023

In the same journal , we learned that in fetuses with transposition of great arteries (TGA), a better prenatal diagnosis led to poorer early postoperative outcomes. A Randomized Controlled Trial of a NICU Language Intervention for Parents of Preterm Infants and Two-Year Language Outcomes. As always, more research seems needed.

Pediatrics 111

Pediatrics Fractures Outcomes Research 111

The Skeptics' Guide to EM

APRIL 29, 2023

Case: You are moonlighting at the Veterans Administration emergency department (ED) and are caring for an Iraq veteran complaining of post-traumatic stress disorder (PTSD) and severe anxiety. Clinical Question: What is the effect of TMH, versus in-person consult, on 30-day outcomes and processes of care during the visit?

Psychiatric 40

Psychiatric Emergency Department Urgent Care Academics 40

American Medical Compliance

APRIL 29, 2024

This course will equip caregivers and administrative staff with the necessary tools and knowledge to identify, prevent, and address these grievous issues effectively. Unfortunately, instances of abuse are all too common in these settings, necessitating a robust response to protect some of our most vulnerable citizens.

Elder Abuse 52

Elder Abuse Documentation/Coding Administration Outcomes 52

American Medical Compliance

APRIL 29, 2024

For medical practitioners and health facility administrators, this training course offers valuable insights and practical solutions for integrating sustainable practices into your professional activities. Healthcare settings can be transformed to be more sustainable and prepared for the challenges posed by a changing climate.

Administration 52

Administration Outcomes Hospitals 52

PulmCCM

NOVEMBER 6, 2023

TEG or ROTEM) is becoming a more widely used tool to help guide the administration of blood products in hemorrhage from trauma, although its effects on meaningful clinical outcomes remain uncertain. Thromboelastometry (e.g., The others either improved without it (n=17), deteriorated (n=2) or experienced technical failures (n=8).

Operations 98

Operations Blood Transfusions Resuscitation Infectious Diseases 98

Pediatric EM Morsels

SEPTEMBER 22, 2023

Crystalloid may help, but neurogenic shock may not respond to fluid administration. Orenstein JB, Klein BL, Gotschall CS, Ochsenschlager DW, Klatzko MD, Eichelberger MR. Age and outcome in pediatric cervical spine injury: 11-year experience. Alpha 1 agonists are necessary to maintain appropriate blood pressure. J Pediatr Surg.

Shock 273

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 273

Downeast Emergency Medicine

APRIL 26, 2021

2][3] If earlier treatment with TXA is better, would there be benefit in its administration in the prehospital setting? 4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] JAMA Neurol.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

American Medical Compliance

MARCH 11, 2024

Understanding the Significance Dental recordkeeping includes the systematic documentation of a patient’s oral health history, examinations, diagnoses, treatments, and outcomes. Hence, these records serve as a vital communication tool among dental professionals. Ready to elevate your dental practice’s compliance standards?

Documentation/Coding 105

Documentation/Coding Best Practices Operations Outcomes 105

Pediatric EM Morsels

JULY 28, 2023

Risk Factors that seem to stay consistent: Administration of Bicarb for correction of acidosis has been shown to be associated with cerebral edema and DOES persist after correcting for severity of DKA! Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. Then we’ve likely got DKA.

Fluid Resuscitation 212

Fluid Resuscitation Pediatrics Resuscitation Research 212

JournalFeed

OCTOBER 29, 2022

WATEFALL RCT Spoon Feed Conservative fluid administration in patients with acute pancreatitis can achieve similar clinical outcomes compared with aggressive resuscitation, with less risk of volume overload. However, with a possible signal of long term benefit, I will keep prescribing steroids in these patients.

Administration 40

Administration Resuscitation Outcomes 40

RebelEM

AUGUST 7, 2023

Traditional RSI entails preoxygenation followed by near-simultaneous administration of an induction agent followed by a neuromuscular blocker. Rapid sequence intubation can be modified for patients who are agitated or combative and not tolerating standard preoxygenation. Re-oxygenation with BMV can increase airway-related adverse events (i.e.

Head Injuries 85

Head Injuries Outcomes Airway Management Burns 85

Sensible Medicine

NOVEMBER 28, 2023

People can rise through the academic ranks as gifted clinicians, creative and effective educators, and talented administrators. [i] The primary outcome was stroke or systemic embolism and the primary safety outcome was major bleeding. Being perfectly honest, not all the articles have aged well.

Stroke 81

Stroke Academics Outcomes Administration 81

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%

Sepsis 84

Sepsis Administration Documentation/Coding Fractures 84