Emergency Medicine Journal

JULY 24, 2023

Background Improving out-of-hospital cardiac arrest (OHCA) prognosis within the working-age population is important, but no studies have investigated the effects of COVID-19 pandemic specifically on the working-age population with OHCAs. The primary outcome was neurologically favourable 1-month survival (cerebral performance category 1 or 2).

Resuscitation 52

Resuscitation Outcomes CPR Hospitals 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives The prevalence of multimorbidity, the presence of two or more long-term conditions (LTCs) is increasing, and it is associated with poor health outcomes. This study describes the impact of multimorbidity in patients attending ED on 30-day mortality and other patient-centred outcomes in an ED setting.

Emergency Department 40

Emergency Department Outcomes Hospitals 40

Emergency Live

DECEMBER 13, 2023

Conapo calls for reflection on firefighter resources following the Tivoli fire Fire Management and Concerns The fire at Tivoli Hospital (province of Rome) has highlighted the need for adequate coverage by the Firefighters to handle emergency situations.

Hospitals 52

Hospitals Outcomes 52

Emergency Medicine Journal

OCTOBER 26, 2023

Background Blood transfusion for bleeding trauma patients is a promising pre-hospital intervention with potential to improve outcomes. However, it is not yet clear which patients may benefit from pre-hospital transfusions. Decisions are influenced by experience and are subject to bias.

Blood Transfusions 52

Blood Transfusions Hospitals Outcomes 52

Emergency Medicine Journal

OCTOBER 26, 2023

Objective Over 300 000 cases of out-of-hospital cardiac arrests (OHCAs) occur each year in the USA and Europe. Primary outcome was survival at hospital discharge with a good neurological outcome. Conclusion In a two-tiered rescue system, survival from OHCA at hospital discharge doubled over a 13-year study period.

Resuscitation 75

Resuscitation Basic Life Support Hospitals CPR 75

Emergency Medicine Journal

NOVEMBER 28, 2023

Background Comprehensive geriatric assessment (CGA) has been shown to improve outcomes in hospitalised older adults; however, there is currently no compelling evidence to support CGA interventions within the emergency department (ED). The primary outcome was incidence of hospital admission following the index ED attendance.

Emergency Department 40

Emergency Department Outcomes Hospitals 40

The Trauma Pro

MAY 3, 2024

Various hospital outcomes were tabulated, including hospital charges, mortality, and discharge location. AE and PPP have equivalent outcomes. You can feel comfortable that outcomes will be the same as AE. This eliminated patients who might have received other additional management that could cloud the data.

Fractures 147

Fractures Documentation/Coding Radiology Radiology 147

EM Ottawa

FEBRUARY 12, 2024

Patients who sustain an out-of-hospital cardiac arrest without signs of ST elevation had no improvement in mortality or functional neurological outcomes when transported to a cardiac arrest centre compared to standard of care. Methodology: 5/5 Usefulness: 3/5 Patterson T, et al. 2023 Oct 14;402(10410):1329-1337.

Hospitals 47

Hospitals Outcomes 47

The Skeptics' Guide to EM

APRIL 22, 2023

Effect of early high-flow nasal oxygen vs standard oxygen therapy on length of hospital stay in hospitalized children with acute hypoxemic respiratory failure: the PARIS-2 randomized clinical trial. Secondary Outcomes: * Length of oxygen therapy from the time of randomization * Length of hospital stay starting from arrival in the ED

Hospitals 52

Hospitals Pediatrics Emergency Department Outcomes 52

The Skeptics' Guide to EM

FEBRUARY 3, 2023

Temperature Control After In-Hospital Cardiac Arrest: A Randomized Clinical Trial. September 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You are working an overnight shift at a small rural hospital. Circulation. Circulation.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Outcomes Documentation/Coding 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Meaningful measurement for older people living with frailty would include additional person-centred outcomes of healthcare knowledge, shared decision-making, and situational security. Method and Design Older people living with frailty and receiving acute healthcare were recruited at three UK hospitals.

Outcomes 40

Outcomes Administration Hospitals Research 40

Emergency Medicine Journal

NOVEMBER 28, 2023

Method and Design Data was obtained from 20 EDs and associated acute hospitals from 1/11/20201-31/10/2022. Results and Conclusion After controlling for key variables, results indicated that ED outcomes showed more seasonal and regional variation than APC outcomes ( figure 1 ).

Emergency Department 40

Emergency Department Hospitals Outcomes Research 40

The Skeptics' Guide to EM

APRIL 27, 2024

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care.

Resuscitation 87

Resuscitation Airway Management EMS Outcomes 87

Emergency Medicine Journal

NOVEMBER 28, 2023

This audit aims to investigate the relationship between time delay to treatment and its effect on HBOT efficacy and novelly, 30-day patient outcomes, to better support recommendations for healthcare providers. Method and Design The audit included 33 DCS patients treated at Whipps Cross Hospital, London (May 2021-December 2022).

Outcomes 40

Outcomes Hospitals 40

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. However, human data is sorely lacking.

CPR 52

CPR Outcomes Resuscitation EMS 52

The Skeptics' Guide to EM

FEBRUARY 25, 2023

2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Case: A 6-month-old boy presents to […] The post SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

PulmCCM

MAY 12, 2024

Source: Wikipedia Thanks to advances in critical care in recent decades, many more patients today survive out-of-hospital cardiac arrest to hospital discharge. Unfortunately, neurologic outcomes have remained poor over that time, with most survivors of out-of-hospital cardiac arrest remaining severely disabled.

Hospitals 59

Hospitals Outcomes 59

University of Maryland Department of Emergency Med

JULY 1, 2023

Shock index (heart rate/systolic blood pressure) has been used to predict trauma outcomes. This study from American Journal of Emergency Medici. Click to view the rest

Hospitals 71

Hospitals Shock Outcomes 71

The Skeptics' Guide to EM

OCTOBER 5, 2019

Guest Skeptic: Clay Odell is a Paramedic/RN for New London Hospital EMS in New Hampshire, USA which provides 9-1-1 coverage and Mobile Integrated Healthcare […] The post SGEM#269: Pre-Hospital Nitroglycerin for Acute Stroke Patients? Hypertension is common in acute stroke and is a predictor of poor outcome [ 1 ].

Stroke 52

Stroke Hospitals Outcomes EMS 52

The Bottom Line

MARCH 22, 2024

In patient with out-of-hospital cardiac arrest, how does the MIRACLE2 score compare with previously reporting scoring systems, for predicting poor neurological outcome at hospital discharge?

Outcomes 62

Outcomes Hospitals 62

EM Literature of Note

APRIL 11, 2024

The most notable feature of this trial is the simple, negative topline result – rollout of this intervention had no reliably measurable effect on patient-oriented outcomes relating to disease progression or acute clinical deterioration. “Pragmatic Trial of Hospitalization Rate in Chronic Kidney Disease” [link] Tweet

Outcomes 101

Outcomes Administration Hospitals Wellness 101

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

PulmCCM

MAY 3, 2024

While outcomes from acute ischemic stroke due to large vessel occlusion in the anterior circulation have improved substantially in the era of thrombolytics and mechanical thrombectomy, overall outcomes remain poor. ” However, that was in the era before mechanical thrombectomy. Along with endovascular thr… Read more

Stroke 52

Stroke Outcomes Hospitals 52

RebelEM

JUNE 1, 2023

Background: Achieving ROSC in out of hospital cardiac arrest (OHCA) is no easy feat but, care doesn’t end with ROSC. 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.

Outcomes 133

Outcomes Resuscitation Hospitals CPR 133

Emergency Medicine Journal

APRIL 22, 2024

Methods This was a multicentre prospective observational study of adult ED patients presenting to five Australian hospitals between November 2020 and September 2021. The primary outcome was index AMI, including type 1 or 2 non-ST segment elevation MI (NSTEMI) or ST-elevation MI (STEMI) following presentation.

Emergency Department 98

Emergency Department Outcomes EKG/ECG Hospitals 98

Taming the SRU

MARCH 27, 2024

Effect of prehospital high-dose glucocorticoid on hemodynamics in patients resuscitated from out-of-hospital cardiac arrest: a sub-study of the STEROHCA trial. The primary outcome was cumulative norepinephrine use during the first 48 hours of admission. Crit Care 2024;28(1):28. There were 114 patients included in the final analysis.

Resuscitation 87

Resuscitation Outcomes CPR Hospitals 87

Emergency Medicine Journal

FEBRUARY 20, 2024

The objective of this study is to evaluate outcomes of reversal with these agents in patients with isolated traumatic brain injuries (TBI). Primary outcome includes rate of mortality/hospice at hospital discharge. Secondary outcomes include a composite of serious hospital complications.

Hospice 74

Hospice Outcomes Hospitals 74

RebelEM

APRIL 22, 2024

Intervention: Target PaO2 = 60 mm Hg Control: Target PaO2 = 90 mm Hg Outcome (primary): Absolute number of days without life support in 90 days defined as the absence of mechanical ventilation, circulatory support, or kidney replacement. Outcomes (secondary): 90-day all-cause mortality. CI) Secondary Outcomes 90-day Mortality 34.7%

Outcomes 72

Outcomes Best Practices EMS Shock 72

RebelEM

FEBRUARY 1, 2024

Limitations : Open label study design Outcome assessments were done via telephone interview. mg/kg, max 25mg) vs. intravenous alteplase (0.09 mg/kg followed by 0.81 vs Alteplase 34.8% Unadjusted risk difference 2.1% [ 95% CI -2.6 mg/kg, max 25mg) vs. intravenous alteplase (0.09 mg/kg followed by 0.81 vs Alteplase 34.8% mg/kg followed by 0.81

Stroke 119

Stroke Blood Transfusions Outcomes EMS 119

PHARM

SEPTEMBER 21, 2023

Maintaining physiology of brain tissue to the greatest extent possible through optimal management of blood pressure, airway, ventilation, and oxygenation, improves patient outcome. We assessed systolic blood pressure (SBP), end-tidal partial pressure of CO2 (PetCO2), and PaCO2 at hospital admission as well as prehospital and on-scene time.

Hospitals 40

Hospitals Resuscitation Wellness Outcomes 40

The Bottom Line

JUNE 19, 2023

In patients resuscitated from out-of-hospital cardiac arrest (OOHCA) does targeted mild hypercapnia compared to targeted normocapnia improve 6-month neurological outcomes?

Resuscitation 98

Resuscitation Outcomes Hospitals 98

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Major trauma is a leading cause of death and disability worldwide, and many healthcare systems seek to improve outcomes following severe injury with provision of pre-hospital critical care (PHCC).

Ambulance Services 40

Ambulance Services Hospitals Research Outcomes 40

Emergency Medicine Journal

JANUARY 22, 2024

Methods This was an open-label randomised control trial conducted in a tertiary care teaching hospital in India from 11 November 2021 to 30 November 2022. The primary outcome was symptom resolution at 6 hours and 12 hours. The low-dose group had longer median hospital stay (12 hours vs 72 hours), more frequent MACE (3.8%

Outcomes 75

Outcomes Hospitals 75

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Date: November 10th, 2021 Reference: Andersen, et al: Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest. Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrests first appeared on The Skeptics Guide to Emergency Medicine. JAMA Sept 2021.

Advances Cardiac Life Support (ACLS) 40

Advances Cardiac Life Support (ACLS) Hospitals Emergency Department Resuscitation 40

RebelEM

OCTOBER 30, 2023

This could dilute any beneficial effects seen Lack of blinding may bias results (Although mortality is a solid objective primary outcome, bias may still creep in terms of management) Discussion: Authors were looking for an absolute mortality difference of 7% from baseline mortality of 26% with a 90% power. Cryoprecipitate Group: 25.3%

Administration 112

Administration Blood Transfusions Outcomes Hospitals 112

PulmCCM

SEPTEMBER 28, 2023

Systemic corticosteroids (such as intravenous dexamethasone) improve outcomes in severe pneumonia due to SARS-CoV-2 infection. It makes sense that inhaled steroids might improve outcomes from less severe infections. There have been no reported deaths, but ten people were hospitalized and six had unknown hospitalization status.

COPD 95

COPD Stroke Academics Hospitals 95

Emergency Medicine Journal

APRIL 22, 2024

This month’s update comes from the Emergency Department at Northern General Hospital, Sheffield. Kampan et al Topic: Analgesia Outcome rating: Head turner Inadequate management of acute pain in older adults contributes to adverse outcomes including decline in mobility, cognition and mood.

Emergency Department 52

Emergency Department Outcomes Hospitals 52