The Trauma Pro

MARCH 8, 2024

The literature on this topic was searched from 1960 to 2021, and only observational and randomized studies were included. The reviewers then used these papers to answer three questions. T he impact on medical errors could not be evaluated because only one study assessed this. These and their answers are outlined below.

EMS 147

EMS Wellness 147

Board Bombs

APRIL 28, 2024

Please don't click away- we will make this lesson quick, entertaining, and painless (would you expect anything less from us?) Want to experience the greatest in board studying? Please don't click away- we will make this lesson quick, entertaining, and painless (would you expect anything less from us?) Pillboxes and Pituitary.

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The Trauma Pro

APRIL 30, 2024

Today, I’ll look at an earlier review article summarizing some smaller studies comparing it to angioembolization. Interestingly, the use of AE and PPP vary geographically. Angioembolization has been a mainstay in the US for some time, and PPP has been more commonly used in Europe.

Radiology 147

Radiology Radiology Research Fractures 147

St. Emlyn

DECEMBER 30, 2023

St.Emlyn's - Emergency Medicine #FOAMed We generally try and review studies that are close to use in practice. but occasionally we spot something that is just interesting and which might give us a clue as … JC: Selective aortic arch perfusion. St Emlyn’s Read More » The post JC: Selective aortic arch perfusion.

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RebelEM

APRIL 29, 2024

Studies have compared IO to peripheral intravenous (PIV) and central venous (CVC) access for resuscitation. Several studies have shown IO placement times <20 seconds ( 3 ) but usually less than 1 minute ( 3-6 ), near 100% first-pass success rate ( 3-7 ), similar flow rates to that of a central line ( 6) , and little or no complications.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

Pediatric EM Morsels

FEBRUARY 2, 2024

In one ED study, ALL cases of missed travel-related illness did not have a documented travel history in their ED note , whereas 90% of the identified travel-related illnesses had a provider documented travel history (Greenky 2022) Those who are visiting friends and relatives (VFR) are typically at highest risk. 2014 Dec;31(6):678-87.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

The Trauma Pro

SEPTEMBER 26, 2023

I periodically publish a chart that shows how much radiation exposure our patients get from various trauma imaging studies. There are some alternatives available to us, including the good old physical exam, conventional x-rays, and ultrasound. If clinical suspicion is high, it may be necessary to order these higher-dose studies anyway.

Radiology 288

Radiology Radiology Ultrasounds Wellness 288

The Trauma Pro

FEBRUARY 23, 2024

The Vanderbilt group performed a retrospective study comparing hospital and ICU length of stay, patient costs, readmission, and death rates using the two guidelines. Bottom line: This study leaves a lot to be desired. This paper doesn’t really teach us much since all the conclusions are extremely weak.

Pediatrics 259

Pediatrics Hospitals Resuscitation 259

The Trauma Pro

SEPTEMBER 14, 2023

They were also excluded from the study if their pneumothorax met the 2-cm rule. The authors studied how many patients could be observed, how many needed tube drainage, observation failure, and later need for a VATS procedure or thoracotomy.

Resuscitation 162

Resuscitation Hospitals Wellness 162

The Trauma Pro

DECEMBER 19, 2023

LQP is not used at most US trauma centers. It is more commonly used in Europe, and a study there suggested that the use of thawed plasma increased short term mortality when compared to liquid plasma. Will this translate into better survival when used in the MTP for trauma? But don’t hold your breath.

Military 147

Military Hospitals Resuscitation 147

The Skeptics' Guide to EM

DECEMBER 16, 2023

11-17) Microaggressions and discrimination towards patients have been studied in other healthcare settings, but there has been little research on this topic that specifically investigates EDs.(10-11) 7-10) Discrimination, implicit bias and microaggressions are common in healthcare encounters involving persons from marginalized groups.(11-17)

Emergency Department 119

Emergency Department Research Outcomes 119

Sensible Medicine

JANUARY 26, 2024

Ans: they get praised and promoted In this essay, I am going to explain to you why the recent study CONTACT-2— presented now at a cancer conference— is a problematic trial. The control arm has to the best available care that you would give the patient if they were not in the study. After they progressed on this trial (i.e.

Documentation/Coding 117

Documentation/Coding 117

The Trauma Pro

FEBRUARY 9, 2024

First, the patient has passed all the initial decision points that would send us straight to the OR (ABC problems in ATLS jargon). The recommended study is a CT angio of the neck. The nail is not palpable on either side. And the patient only complains of a little discomfort when he swallows. What to do?

Wellness 147

Wellness 147

Emergency Medicine Journal

APRIL 22, 2024

‘Free vapes given to smokers at hospitals could help thousands quit, study suggests.’ This randomised, controlled study conducted by Pope and colleagues at 6 UK emergency departments (ED) recruited patients attending for any reason who smoked daily. Of course COSTED wasn’t just about vapes. Is it a good.

Emergency Department 52

Emergency Department Hospitals 52

The Trauma Pro

MAY 12, 2023

This retrospective study looked at a convenience sample of 75 patients, distributed between patients who had splenic injury that was either not treated, removed (splenectomy), or embolized. Bottom line: This study is interesting because it gives us a glimpse of the time course of leukocytosis in patients with injured spleens.

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Sensible Medicine

DECEMBER 30, 2023

But, the study does not use US staging (which enriches for occult advanced disease and makes it more likely to win). The study does not provide Osimertinib upon recurrence — which was already the US standard of care — and also distorts the trial. Here is what the drug did for survival.

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The Trauma Pro

SEPTEMBER 21, 2023

A group in the Czech Republic performed a prospective study that assigned patients to receive scene resuscitation with either one unit of packed cells plus one unit of plasma, or two units of low titer group O whole blood. The study was performed over a three year period. This study is woefully small, and confusing to read.

Resuscitation 147

Resuscitation Outcomes 147

The Skeptics' Guide to EM

JANUARY 6, 2024

National Assessment of Pediatric Readiness of US Emergency Departments during the Covid-19 Pandemic. National Assessment of Pediatric Readiness of US Emergency Departments during the Covid-19 Pandemic. Two previous studies conducted assessing the state of nationwide pediatric readiness were conducted in 2003 and 2013.

Emergency Department 128

Emergency Department Pediatrics Anaphylaxis Leadership 128

The Trauma Pro

SEPTEMBER 20, 2023

A few centers have toyed with the use of cold platelets, but there have been concerns about their ability to clot and their useful life after transfusion. Researchers from the US Army performed a retrospective registry study on a sample of military casualties over four years. I see two major issues with this study.

Military 113

Military Blood Transfusions Outcomes Administration 113

The Trauma Pro

JUNE 2, 2023

They performed a propensity score-matched cohort study, comparing functional recovery in patients undergoing early vs. late decompression after sustaining a central cord injury. However, only 186 were eligible for propensity score matching, with half in each study group (early vs. late decompression). 2022;157(11):1024-1032.

Hospitals 246

Hospitals 246

Sensible Medicine

FEBRUARY 12, 2024

One of the big issues with this theory was that studies had failed to show a strong relationship in time between the stroke and the irregular rhythm. None of these patients had AF at the time of study entry. The Most Important Lesson Professor Kamel has shown us science done well. The main problem was the aberrant rhythm.

Wellness 124

Wellness Stroke EKG/ECG Academics 124

Sensible Medicine

APRIL 24, 2024

The answer is: no one knows because proponents of MRI and ultrasound, whether in dense or regular breasts, are not conducting the appropriate studies to figure this out. Consider supporting us by subscribing. Finding tumors does not guarantee you make women better off. Thankfully, there is Sensible Medicine. Subscribe now

Ultrasounds 133

Ultrasounds Outcomes 133

EB Medicine

AUGUST 1, 2023

In this episode, Sam Ashoo, MD, and TR Eckler, MD, interview Al Sacchetti, MD, about the August 2023 Emergency Medicine Practice article, Evidence-Based Management of Pulmonary Embolism in the Emergency Department Etiology/pathophysiology Risk factors Differential diagnosis Prehospital care ED history and physical exam Diagnostic scoring systems (..)

Emergency Department 98

Emergency Department EKG/ECG 98

University of Maryland Department of Emergency Med

OCTOBER 13, 2023

This large UK and US study looked at the addition of high dose cryoprecipitate to mass transfusion protocols and found: “Among pat. Click to view the rest

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Pediatric EM Morsels

JUNE 9, 2023

Let us, however, not forget that children are, in fact, people … and people who have liver damage may develop portal hypertension and that creates another reason to bleed horrifically. Let us take a minute to digest a morsel on Acute Esophageal Variceal Bleeding in Children. Type & Cross and check Coagulation Studies and CBC.

Pediatrics 152

Pediatrics Head Injuries Airway Management Administration 152

Taming the SRU

MAY 10, 2024

r3 taming the sru: traumatic arrests WITH Dr. wright Trauma is the 3rd leading cause of death in the US and Canada. hypovolemia, PTX, and cardiac tamponade are common causes of death in the setting of a traumatic arrest and CPR is unlikely to be beneficial in any of these causes based on available animal studies. Role of epi in TCA?

Leadership 73

Leadership CPR Head Injuries Outcomes 73

Sensible Medicine

AUGUST 21, 2023

John, thank you for your recent outstanding podcasts, and this recent reference to two important and thoughtful papers on observational studies. The reasons are multiple, but I will articulate a few: Most epidemiological studies are done from large data sets that are not collected for the purpose of research.

Administration 88

Administration Outcomes Research COPD 88

University of Maryland Department of Emergency Med

OCTOBER 7, 2023

This article reminds us that using a small bore chest tube to drain traumatic hemothorax is supported by small studies and the Easterm So. Click to view the rest

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Sensible Medicine

OCTOBER 19, 2023

In my opinion, the study was unethical. Given the low risks to children from COVID‐19 and a potential for stigmatization, we questioned whether there was minimal risk to children participating in a recent study published in JAMA Pediatrics. This study was conducted under the auspices of public health surveillance.

Documentation/Coding 125

Documentation/Coding Pediatrics Research Outcomes 125

Emergency Medicine Journal

MARCH 21, 2024

‘It is not our differences that divide us. A pivotal study conducted by Khosla et al 1 illuminates the disproportionate impact of COVID-19 on people of colour in the USA, shedding light on the urgent need to address these disparities. Studies over the last 4 years have tried to explain the.

Documentation/Coding 52

Documentation/Coding Outcomes 52

The Trauma Pro

MAY 3, 2024

In the previous post in this series, I described an early review article summarizing several older studies comparing these two hemorrhage control techniques for pelvic fractures. They scanned five years of data from the National Inpatient Sample, which included data from 35 million inpatient admissions in the US.

Fractures 147

Fractures Documentation/Coding Radiology Radiology 147

Medagadget

JUNE 19, 2023

The recent COVID-19 pandemic has spurred scientists to develop a better understanding of respiratory disease – after all, some of the most contagious diseases are spread through the air, so understanding how they infect and develop in lung tissue would go a long way towards helping us to be better prepared for the next pandemic.

Research 90

Research 90

EMDocs

DECEMBER 4, 2023

The facility does not have ultrasound (US) availability at the time of the patient’s presentation, as the sonographer comes to the hospital only 2 days a week. Bilateral swelling and/or redness (-1 point) Fever (-1 point) An alternate diagnosis to DVT is as likely or more likely (-2 points) Can DVT be ruled out without an US?

Ultrasounds 69

Ultrasounds Wellness Documentation/Coding EMS 69

Sensible Medicine

JUNE 26, 2023

I am posting the “Study of the Week” today and John will be publishing a “My Favorite Article” piece later in the week. i] That long introduction brings us to an article published in the NEJM last week, Cardiovascular Safety of Testosterone-Replacement Therapy. This was designed as a non-inferiority study.

Stroke 91

Stroke Wellness 91

Emergency Medicine Journal

APRIL 22, 2024

1–3 The COVID-19 pandemic has disrupted the global healthcare system as evidenced by a national study in England showing reduced admissions and higher 90-day mortality for common acute surgical conditions. Age-standardised mortality rates (ASMR) per 100 000 population were calculated using the 2010 US Census as the standard population.

Sepsis 52

Sepsis 52

Emergency Medicine Journal

APRIL 22, 2024

The randomised controlled trial by Pope et al reported in this issue of the Emergency Medicine Journal, adds to a growing literature on the use of e-cigarettes as a smoking cessation intervention, providing evidence in a novel, pragmatic setting—emergency departments (EDs).

Administration 52

Administration Emergency Department 52

Emergency Medicine Journal

FEBRUARY 20, 2024

However, this month, our authors have done the hard work for us with four original manuscripts and an accompanying commentary around the specific condition of acute aortic syndromes (AAS). This prospective study recruited >5000 participants in just a 40-day window across 27 UK EDs. An informal themed issue.

Emergency Department 52

Emergency Department Research 52