RebelEM

FEBRUARY 21, 2024

IM ketorolac will provide better pain relief and the patient will be happier with her care since she got an ‘injection’ and, after all, she did come all the way to the hospital. Schwartz and colleagues performed an ingenious trial ( Schwartz 2000 ) Enrolled 64 ED patients with acute pain. Acad Emerg Med 2000; 7: 857-61.

Administration 63

Administration Emergency Department EMS Research 63

ACEP Now

SEPTEMBER 5, 2024

With elimination of CME funding in many of our hospitals and groups, it is crucial to continue to add value and communicate that value to residents before graduation. While some issues are handled locally, many issues cannot be solved in our emergency department or hospital. However, unlike 80 percent of U.S.

Leadership 98

Leadership PPE EMS Wellness 98

The Injectable Orange

FEBRUARY 14, 2017

link] In the early 2000’s, Safer Healthcare Now and other initiatives were launched to improve the 10% error rate in hospitals worldwide. Organisational resilience is not about individuals coping with poor working conditions; it’s about creating better environments in hospitals so that people can give great care.

Patient Safety 52

Patient Safety Research Hospitals 52

EMDocs

JULY 13, 2024

A) Administer ceftriaxone 500 mg IM and doxycycline 100 mg PO B) Consult OB/GYN for incision and drainage C) Establish IV access and administer clindamycin and gentamicin D) Prescribe doxycycline with metronidazole and ensure close OB/GYN follow-up Answer: C Most postpartum infections are identified after hospital discharge. 2000;8(2):77-82.

OB/GYN 88

OB/GYN EMS Sepsis Fluid Resuscitation 88

The Skeptics' Guide to EM

APRIL 17, 2021

Effect of Nebulized Magnesium vs Placebo Added to Albuterol on Hospitalization Among Children With Refractory Acute Asthma Treated in the Emergency Department: A Randomized Clinical […] The post SGEM#327: MAGNUM PA – Nebulized Magnesium for Pediatric Asthma first appeared on The Skeptics Guide to Emergency Medicine. Reference: Schuh et al.

Pediatrics 52

Pediatrics PPE Emergency Department Hospitals 52

Mind The Bleep

APRIL 2, 2023

As hospitals are trying to recruit you and you’ll be working with many others who have made the same transition, you will find it friendly and welcoming. Compared to the UK, SHOs tend to earn salaries that are about 20-30% more working fewer hours in better-staffed hospitals.

Hospitals 59

Hospitals Wellness 59

The Skeptics' Guide to EM

MARCH 20, 2021

Background: Historically most patients with PEs have been admitted to the hospital in the USA. This is in contrast to Canada where papers in the early 2000 demonstrated the safety of out-patient management of PEs ( Kovacs ). The radiologist notes a distal sub-segmental PE on the right.

Academics 52

Academics Hospitals Wellness 52

Advanced Emergency Nursing from AENJ

OCTOBER 8, 2017

I can recall when a major metropolitan hospital had an unattended "First Aid Room" to which one's personal physician or a resident might be called should one come to the hospital with a problem. Journal of Emergency Nursing , 29 (5), 431-439. [ PDF ] Fadale, J. As we celebrate: reflections on Anita Dorr and early ENA days.

Emergency Nursing 40

Emergency Nursing Emergency Department Hospitals Academics 40

ACEP Now

AUGUST 1, 2023

Our Indiana ACEP colleagues have helped us all as emergency physicians in championing the passage of state legislation mandating a physician leading a hospital’s emergency department to be physically present in that hospital.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

RebelEM

AUGUST 28, 2023

IM ketorolac will provide better pain relief and the patient will be happier with her care since she got an ‘injection’ and, after all, she did come all the way to the hospital. Schwartz and colleagues performed an ingenious trial ( Schwartz 2000 ) Enrolled 64 ED patients with acute pain. Acad Emerg Med 2000; 7: 857-61.

Administration 52

Administration Emergency Department EMS Research 52

Sensible Medicine

SEPTEMBER 25, 2023

Patients may develop a disease that requires admission to the hospital, mostly because of lung problems, such as the need for oxygen. Indirect organ damage is common in medical conditions that are severe enough to warrant admission to the hospital. The disease might affect other organs—either directly or indirectly.

Infectious Diseases 52

Infectious Diseases Hospitals Outcomes Research 52

Sensible Medicine

AUGUST 7, 2024

This is an astounding difference in the quality of sleep, and to this day, premature infants in the hospital are slept on their stomachs. A google Ngram of the term “tummy time” shows the phrase taking off in American English around the year 2000.

CDC 113

CDC Documentation/Coding Research Pediatrics 113

Taming the SRU

JANUARY 29, 2024

Hospital Course The patient was initiated on a therapeutic heparin drip in the emergency department with vascular surgery consultation. She had improvement of the swelling in her left arm with return of sensation and function during her five-day hospital course. 2000 Dec;45(6):644-6. Vasc Endovascular Surg. Epub 2016 Feb 11.

Emergency Department 95

Emergency Department Fractures Hospitals Operations 95

The Skeptics' Guide to EM

APRIL 24, 2021

Date: April 19th, 2021 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). Dr. Martel is a practicing emergency physician at Hennepin County medical center in Minneapolis, Minnesota since 2000.

Emergency Department 40

Emergency Department Research Outcomes Documentation/Coding 40

Don't Forget the Bubbles

NOVEMBER 15, 2023

Many years ago, there was a large body of evidence in reports from Northern Irish hospitals showing children who received large volumes of hypotonic IV fluids subsequently developed hyponatraemic encephalopathy and cerebral oedema. As well as considering volume, hyponatraemia is a harmful consequence of incorrect administration of fluids.

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

Dr. Smith's ECG Blog

SEPTEMBER 12, 2023

SQTS is a relatively new diagnosis that has only been recognized as a distinct clinical entity since 2000. As Family Medicine Attending ( working in and out of the hospital ) — I religiously scrutinized the ECGs of all patients I encountered in whom serum calcium levels were elevated.

EKG/ECG 68

EKG/ECG Hospitals 68

Pediatric Emergency Playbook

JANUARY 1, 2018

Incidence and trends of pediatric ovarian torsion hospitalizations in the United States, 2000-2006. Fetal ovarian cysts management and ovarian prognosis: a report of 82 cases. 2009;44:868; author reply 868-9. Guthrie BD, Adler MD, Powell EC. Pediatrics 2010;125:532-8. Epub 2010 Feb 1. Houry D, Abbott JT. 2001;38:156-9.

Pediatrics 52

Pediatrics Ultrasounds Radiology Radiology 52

ETM Course

SEPTEMBER 27, 2022

EZIO essentially has a monopoly on intraosseous access, being used in almost all Emergency Departments and ambulance/pre-hospital systems around Australia and New Zealand. We have just done this to 6 flat drills we had laying around, saving them from landfill and saving $2000 in the process.

Emergency Department 52

Emergency Department Hospitals Shock 52

RebelEM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Hospitals should focus on both systemic factors and bedside physician and/or respiratory therapist interventions to increase LPV utilization in times of ED boarding and crowding for all patients. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Dr. Smith's ECG Blog

OCTOBER 17, 2024

The patient had a protracted hospitalization and did not survive. PR depression — has been shown to be a relatively common ECG sign associated with clinically silent PE ( Kudo et al — JACC 39(12): 2000-2004, 2002 ). PR depression is marked and seen in multiple leads in this tracing.

EKG/ECG 72

EKG/ECG EMS Shock Ultrasounds 72

PEMBlog

SEPTEMBER 13, 2023

2000; 55(5):616-623. Practice parameter: Evaluating a first nonfebrile seizure in children. Report of the Quality Standards Subcommittee of the American Academy of Neurology, the Child Neurology Society, and the American Epilepsy Society.

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 52

RebelEM

JULY 20, 2023

INTRODUCTION You’re moonlighting in a remote access hospital. EMS radios in for a burn patient and to anticipate a difficult airway. You can hear the tension in their voice. They’re rolling up now. The patient is horribly burned. Kovacs G, Bullock G, Ackroyd-Stolarz S, Cain E, Petrie D. Ann Emerg Med. PMID: 11020676.

EMS 75

EMS Burns Airway Management Wellness 75

RebelEM

JANUARY 23, 2023

“Definition, Classification, and Routine Diagnosis of Urticaria: A Consensus report11this Consensus Report Is the Result of a Panel Discussion during the International Clinically Oriented ESDR Symposium ‘Urticaria 2000’.” Journal of Investigative Dermatology Symposium Proceedings , vol. 2, 2001, pp. 2, 2001, pp.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Taming the SRU

AUGUST 30, 2023

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. 2000 Aug;30(1):17-24. . + Procalcitonin (PCT) Etiology: PCT was first discovered in 1984. days (secondary endpoint) [51].

Infectious Diseases 90

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 90

EB Medicine

AUGUST 6, 2019

Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. Jeff: Also, worth mentioning here is the importance of hematology input in developing hospital-wide protocols for reversal agents, especially if availability of certain agents is limited.

Emergency Department 40

Emergency Department Stroke Wellness Resuscitation 40

The Trauma Pro

FEBRUARY 23, 2024

The American Pediatric Surgical Association (APSA) published a practice guideline way back in 2000 that outlined a consistent way to care for children with solid organ injuries. Unfortunately, they were very conservative, recommending days of bedrest, extended NPO status, very frequent blood draws, and a lengthy hospital stay.

Pediatrics 199

Pediatrics Hospitals Resuscitation 199

Pediatric EM Morsels

JULY 21, 2023

Journal of veterinary emergency and critical care (San Antonio, Tex. 2019): 478–483. Ash, Kristian et al. Performance Evaluation and Validation of the Animal Trauma Triage Score and Modified Glasgow Coma Scale with Suggested Category Adjustment in Dogs : A VetCOT Registry Study.” Journal of veterinary emergency and critical care (San Antonio, Tex.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

EMDocs

FEBRUARY 12, 2025

The patient also reported significant pain and had a Hospital Anxiety and Depression Scale (HADS) score indicating severe anxiety and depression. Trends in Radiation Therapy among Cancer Survivors in the United States, 2000-2030. 1 Questions: What is the most likely diagnosis for the skin condition observed in this patient?

Best Practices 56

Best Practices Documentation/Coding Radiology Radiology 56

ACEP Now

SEPTEMBER 3, 2024

Hahnemann University Hospital in Philadelphia closed in 2019, a year and a half after it was acquired along with St. Christopher’s Hospital for Children by private equity (PE) firm Paladin Healthcare Capital for 170 million dollars. 14 Dr. Stinson remembers what it was like to work for a PE-owned hospital early in her career. “I

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

EMDocs

MAY 15, 2024

Consider risk factors for multi-drug resistant microbes: Recent IV antibiotics Hospitalization within 90 days. COVID-19 and ACS COVID increases the risk of hospitalization, pneumonia, pain, and ACS in SCD patients. National Acute Chest Syndrome Study Group [published correction appears in N Engl J Med 2000 Sep 14;343(11):824].

Blood Transfusions 103

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 103

EMDocs

OCTOBER 5, 2024

They are found primarily in hospital specimens but are increasing in frequency in samples from the community. Imipenem confers highest risk of seizures ESBL-E are often hospital acquired infections and can prolong hospital stay or lead to worse outcomes. The gastrointestinal tract is the main reservoir for ESBL-E.

EMS 97

EMS Infectious Diseases Sepsis Hospitals 97

ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. There are at least 600 TBI-related hospitalizations and 175 TBI-related deaths per day. 2,3 TBI outcomes are profoundly linked to the timing and quality of care provided before patients reach the hospital.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

EMDocs

MAY 28, 2024

Consider risk factors for multi-drug resistant microbes: Recent IV antibiotics Hospitalization within 90 days. COVID-19 and ACS COVID increases the risk of hospitalization, pneumonia, pain, and ACS in SCD patients. National Acute Chest Syndrome Study Group [published correction appears in N Engl J Med 2000 Sep 14;343(11):824].

Blood Transfusions 97

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

Don't Forget the Bubbles

DECEMBER 2, 2024

An international team joining DFTB Bubble Wrap from Aghia Sophia Childrens Hospital ED , Athens, Greece, tell us what is new in thepaediatric literature Led by Spyridon Karageorgos, a Paediatrician enthusiastic about Paediatric Emergency Medicine, reducing antibiotic use in paediatric patients, and Medical Education. Why does it matter?

Documentation/Coding 98

Documentation/Coding Pediatrics Emergency Department Fractures 98

RebelEM

JUNE 26, 2024

Am J Emerg Med 2000; 18: 721-9. Definition: A serum potassium level > 5.5 patients can jump from peaked T waves to sine wave) Management Basics: ABCs, IV, O 2 , Cardiac Monitor and, 12-lead EKG Identify + treat underlying cause of hyperkalemia (i.e. rhabdomyolysis -> hydration) Remove inciting factors (i.e.

EKG/ECG 58

EKG/ECG Administration Burns EMS 58

EMDocs

JUNE 1, 2023

Take Aways: The data do not suggest that targeted hypothermia improves neurological function, reduces death, or reduces hospital length of stay as compared to normothermia. Bradycardia: 18.8% Average ventilator days (8.3 Bradycardia: 18.8% Average ventilator days (8.3 Bradycardia: 18.8% Average ventilator days (8.3 Bradycardia: 18.8%

Hyperthermia / Hypothermia 83

Hyperthermia / Hypothermia Outcomes Hospitals Emergency Department 83

RebelEM

MAY 18, 2023

Adherence was sustained throughout the duration of the trial Authors achieved separation between groups in terms of the amount of fluid given between both strategies Limitations: Convenience sample of enrolled patients mostly during weekdays may have caused a selection bias (Only enrolled ≈1500 patients from 60 hospitals over a near 4 year period).

Sepsis 103

Sepsis Shock Resuscitation Outcomes 103