Fascia Iliaca Block in Hip and Femur Fractures to Reduce Opioid Use.

Background: Fascia iliaca compartment block (FICB) has become a keystone technique for acute pain management in patients with hip and proximal femur fractures.

Objectives: To demonstrate that administering FICB preoperatively to patients with hip or proximal femur fractures in the emergency department (ED) is likely to reduce opioid use and related complications, and to decrease hospital length of stay (LOS).

Methods: An unblinded study of adult patients with hip and proximal femur fractures who consented to receive an FICB with 30 cc of bupivacaine with epinephrine administered in the ED.

Retrospective Evaluation of Return Rates in Pediatric Patients Treated With Inhaled Racemic Epinephrine for Croup.

Objectives: To determine if the length of observation (< 2 hours vs ≥ 2 hours) following treatment of croup with inhaled racemic epinephrine in the emergency department (ED) is associated with return rates (within 48 hours after treatment) in pediatric patients.

Methods: We conducted a retrospective review of patients' medical records from February 2010 through June 2018 for pediatric patients (male and female, ≤ 12 years of age) diagnosed with croup in the ED, treated with racemic epinephrine, and discharged from the ED.

Results: We evaluated patients observed for less than 1 hour, 1 to 2 hours, and greater than 2 hours to determine difference in return rates within 48 hours.

Supraglottic airway device placement by respiratory therapists.

Objective: Respiratory Therapists (RTs) are some of the first staff to arrive at in-hospital incidents where cardiopulmonary resuscitation (CPR) is needed, yet at some facilities, their ability to intubate is limited by hospital scope of practice. During the intubation process, CPR is often interrupted which could potentially increase the likelihood of adverse patient outcomes. Training RTs to secure the airway using non-intubation methods may reduce or eliminate time for CPR interruptions and allow for earlier continuous/uninterrupted chest compressions.

Finding the key to a better code: code team restructure to improve performance and outcomes.

Code teams respond to acute life threatening changes in a patient's status 24 hours a day, 7 days a week. If any variable, whether a medical skill or non-medical quality, is lacking, the effectiveness of a code team's resuscitation could be hindered. To improve the overall performance of our hospital's code team, we implemented an evidence-based quality improvement restructuring plan.