EMDocs

FEBRUARY 7, 2024

3 Increasing Strikes and Unions Labor actions in healthcare can disrupt normal hospital operations, potentially impacting costs and threatening patient quality of care. One study from the National Bureau of Economic Research on nursing strikes in New York State from 1984 to 2004 found that hospital mortality increased by 19.4%

Hospitals 98

Hospitals Research Patient Safety Wellness 98

Life in the Fast Lane

MAY 25, 2023

Lorcan Oliver and Mike Cadogan Frank Pantridge Frank Pantridge (1916-2004) was a Northern Irish cardiologist who created pre-hospital coronary care through the invention of the portable defibrillator

Hospitals 52

Hospitals Resuscitation 52

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below). PMID: 21422387 Wan S et al. Thrombolysis Compared with Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials. PMID: 15262836 Sharifi M et al.

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Stroke Outcomes Hospitals Administration 136

EMDocs

JANUARY 29, 2024

2004 Feb;35(2):520-6. Epub 2004 Jan 15. Blood Pressure Variability Predicts Poor In-Hospital Outcome in Spontaneous Intracerebral Hemorrhage. 2004 Jun;35(6):1364-7. Epub 2004 Apr 29. Castillo J, et al. doi: 10.1161/01.STR.0000109769.22917.B0. 0000109769.22917.B0. PMID: 14726553. 2022 Jul;53(7):e282-e361.

Stroke 99

Stroke Outcomes EMS Seizures 99

ACEP Now

MARCH 9, 2025

As hospital boarding, increased emergency department (ED) volumes, and complexity of patients have increased, so have wait times. After years of training to fully undress a patient for an exam at ABEM General Hospital, patients may now routinely be treated in street clothes sitting in a hallway chair. References Miles, SH.

Emergency Department 90

Emergency Department Point-of-Care Testing Documentation/Coding Hospitals 90

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. 2004 Sep 21;110(12):1605-11. Epub 2004 Sep 7. Circulation.

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Emergency Department Fractures Hospitals Operations 94

Dr. Smith's ECG Blog

OCTOBER 25, 2023

The patient was admitted to the ICU for close monitoring and electrolyte repletion and had an uneventful hospital course. See these other relevant cases: What are these bizarre bigeminal PVCs?? Polymorphic Ventricular Tachycardia Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management Cardiac Arrest.

EKG/ECG 124

EKG/ECG Seizures Hospitals Stroke 124

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.

Leadership 98

Leadership PPE EMS Wellness 98

Dr. Smith's ECG Blog

JULY 21, 2024

The patient was extubated on Day-3 of the hospital stay. The patient improved, and on Day-11 of the hospital stay — he was off inotropes and on a small dose of a ß-blocker. As we've often emphasized on Dr. Smith's ECG Blog — it is rare in practice to see LMCA occlusion, because most such patients die before reaching the hospital.

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EKG/ECG Shock Hospitals Sepsis 131

Don't Forget the Bubbles

DECEMBER 13, 2023

It is commonly seen in the first couple of years of life and accounts for 1-5% of paediatric hospital admissions for those under two. If available at your hospital, a referral to a feeding clinic to facilitate outpatient management will ensure all the relevant healthcare workers are involved. It is not a diagnosis. Eur J Pediatr.

Dehydration 98

Dehydration CDC Hospitals Wellness 98

RebelEM

AUGUST 14, 2023

4 XBJ received approval from the China Food and Drug Administration in 2004, 2 although the FDA of the United States has not approved it. 001) Hospital mortality: Placebo 22.8% XBJ is an herbal compound used in China to manage various inflammatory and infectious processes in recent years, including sepsis. vs. XBJ 14.2%

Sepsis 98

Sepsis Outcomes Administration EMS 98

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

Pediatric Emergency Playbook

OCTOBER 1, 2017

2004; 26(4): 163–167. Predictors of In-Hospital Mortality in Children After Long-Term Ventricular Assist Device Insertion. Ultrasound-guided refilling of an intrathecal baclofen pump—a case report. Childs Nerv Syst. 2013; 29:347–349. Yeh RN, Nypaver MM, Deegan TJ, Ayyangar R. J Emerg Med. Fan Y, Weng YG, Huebler M et al.

Pediatrics 52

Pediatrics Seizures Stroke Ultrasounds 52

The Skeptics' Guide to EM

FEBRUARY 6, 2021

Bernward Hospital in Hildesheim, Germany. Bernward Hospital in Hildesheim, Germany. You admit him to hospital and the next day he undergoes gastroscopy which is unremarkable. In the afternoon the patient is seen by a nurse when he is smoking “weed” (cannabis) in the garden of the hospital.

Hospitals 40

Hospitals Emergency Department Ultrasounds EMS 40

PHEM Cast

APRIL 21, 2021

2004 Aug;99(2):607-13, Hasegawa K et al. The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis. The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. J Trauma 2003; 54:444-453 Mort TC.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

Taming the SRU

FEBRUARY 5, 2024

2018) Epidemiology of lumbar punctures in hospitalized patients in the United States. Journal of the history of the neurosciences, 6(2), 147–153. Vickers A, Donnelly JP, Moore JX, Barnum SR, Schein TN, et al. PLOS ONE 13(12): e0208622. Glimåker M, Sjölin J, Åkesson S, Naucler P. Tunkel, A. Hartman, B. Kaplan, S. Kaufman, B. Scheld, W.

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

PHEM Cast

APRIL 19, 2016

One RTC – 3 perspectives’ – Darren North The fire service have only had a statutory duty to attend RTCs since 2004. If the prehospital team consider the patient to be futile they will take them to the nearest local hospital. This has a huge impact on the local hospital – is that fair? It can be a lonely place.

Head Injuries 52

Head Injuries Ambulance Services Hospitals Leadership 52

Urgent Care Ultrasounds

SEPTEMBER 14, 2020

After discussion with the on call emergency physician the patient was referred to hospital and admitted to the observation ward overnight. A CXR taken in hospital is shown below. 2004; 126(2):394-9. [<a href=” [link] ; target=”_blank”>pubmed</a>] Header Photo by uniqsurface on Unsplash

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Urgent Care Ultrasounds Hospitals 40

Pediatric Emergency Playbook

MARCH 1, 2017

An update on out-of-hospital airway management practices in the United States. 2004 Sep;39(9):1376-80. Prehosp Emerg Care. 2010 Jan-Mar;14(1):31-5. Diggs LA, Yusuf JE, De Leo G. Resuscitation. 2014 Jul;85(7):885-92. Ehrlich PF et al. Endotracheal intubations in rural pediatric trauma patients. J Pediatr Surg.

Airway Management 52

Airway Management Pediatrics Resuscitation Hospitals 52

PEMBlog

SEPTEMBER 24, 2024

Pulmonology and surgery were consulted during his hospital stay, and he has since had a left lower lobectomy after healing from his pneumonia. 2004 Nov;49(4):302-9. He remained off respiratory support and was discharged on day 3 of admission to complete the remainder of his antibiotic course at home. PMID: 442005; PMCID: PMC471015.

Pediatrics 52

Pediatrics Ultrasounds Hospitals Wellness 52

PulmCCM

OCTOBER 16, 2023

hospitals, between roughly one and four central line-associated bloodstream infections (CLABSI) occur per 1,000 days with a central line in place (catheter-days). per 1,000 catheter-days in a 2004 analysis across Michigan (or about 1 infection for every 40 people with a CVC for 10 days). How Often Do Central Lines Become Infected?

CDC 52

CDC Hospitals Ultrasounds Documentation/Coding 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2004; 199(4):628-635. Management of the child after enema-reduced intussusception: hospital or home? 2004 Aug;44(2):131-7. Acute Intestinal Obstruction in children: Experience in a Tertiary Care Hospital. Intestinal Malrotation in Children: A Problem-Solving Approach to the Upper Gastrointestinal Series. Radiographics.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Don't Forget the Bubbles

DECEMBER 16, 2024

In 2004, the UK introduced the acellular pertussis (aP) vaccine, replacing the whole-cell pertussis (wP) vaccine due to its association with fewer adverse events. Changes to vaccine schedule: Acellular vs whole cell vaccines Immunity against pertussis diminishes over time, whether acquired through natural infection or vaccination.

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

N Engl J Med [Internet] 2013;368(21):2004–13. Eur Cardiol [Internet] 2020;15:e20. Available from: [link] 4. Mechanisms of acute coronary syndromes and their implications for therapy. Available from: [link] Read more about MINOCA at this post: Hyperacute T-waves -- missed. Unfortunately — Cardiac MRI could not be done due to claustrophobia.

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EKG/ECG Ultrasounds Wellness Stroke 109

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.

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EKG/ECG EMS Shock Ultrasounds 73

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. PMID: 15383395. Pusic MV, Kessler D, Szyld D, Kalet A, Pecaric M, Boutis K.

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EMS Burns Airway Management Wellness 75

Dr. Smith's ECG Blog

JUNE 18, 2013

This formerly met "criteria" for thrombolytics in the ACC/AHA guidelines of 2004, though of course this amount of ST elevation is very nonspecific. He was admitted to the hospital for a "rule out." There is 1 mm of ST elevation at the J-point in leads V2 and V3. His first troponin was normal.

EKG/ECG 52

EKG/ECG Outcomes Emergency Department Hospitals 52

Advanced Emergency Nursing from AENJ

DECEMBER 18, 2014

2004 Aug;27(2):193-4. Research The Ten Commandments of Emergency Care Research (p59 ff ) From ACEP Mass Casualty Planning Management of Conventional Mass Casualty Incidents: Ten Commandments for Hospital Planning Lynn, M., Management of conventional mass casualty incidents: ten commandments for hospital planning. J Emerg Med.

Mass Casualty Incidents 40

Mass Casualty Incidents Burns Urgent Care Pediatrics 40

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]. . + Procalcitonin (PCT) Etiology: PCT was first discovered in 1984. However, it was not until a 1993 study that its significance was realized.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Don't Forget the Bubbles

MAY 28, 2024

Great Ormond Street Hospital. Neonatal pulmonary hypertension. Pediatric Critical Care Medicine , 11(2 Suppl), S79-S84. Persistent Pulmonary Hypertension of the Newborn (PPHN). Retrieved [20/03/23], from [link] The Regents of the University of California.

Sepsis 52

Sepsis Ultrasounds Pediatrics Research 52

RebelEM

JANUARY 23, 2023

2004 Feb;113(2):347-52. Clark S, Bock SA, Gaeta TJ, Brenner BE, Cydulka RK, Camargo CA; Multicenter Airway Research Collaboration-8 Investigators. Multicenter study of emergency department visits for food allergies. J Allergy Clin Immunol. PMID: 14767453. Journal of Investigative Dermatology Symposium Proceedings , vol. 2, 2001, pp.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Northwestern EM Blog

DECEMBER 20, 2021

The Kocher Criteria (originally developed in 1999 and validated in 2004) can be helpful in determining the likelihood of septic arthritis [6]. Terese Whipple, MD Assistant Professor Department of Emergency Medicine University of Iowa Hospitals and Clinics How To Cite This Post: [Peer-Reviewed, Web Publication] Ng, T. 2021, Dec 20).

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Pediatric Emergency Playbook

MAY 1, 2017

Hospital Stay for Healthy Term Newborn Infants. 2004; 114(1). The unwell child with or without current neurologic findings should have immediate exchange transfusion. References Benitz WE. Pediatrics. 2015; 135(5):948-53. Bhutani V et al. Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Another ECG was recorded 5 minutes later just before arrival at the hospital: Similar The patient was transported to a nearby suburban hospital with PCI capabilities while my partner cared for her. N Engl J Med [Internet] 2013;368(21):2004–13. These findings are diagnostic of an apical OMI as a result of LAD Occlusion.

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

Advanced Emergency Nursing from AENJ

APRIL 8, 2014

Chief, Department of Anesthesiology, Baltimore City Hospitals, Asst. LeFanu, James (1997) Hero who put himself through hell The Sunday Telegraph 16 February 1997 **Blog recounting Pask's intrepidity and personal experimentation. Sir Edward Sharpey-Schafer and his simple and efficient method of performing artificial respiration.

Resuscitation 40

Resuscitation Ambulance Services Research Military 40

Advanced Emergency Nursing from AENJ

SEPTEMBER 13, 2016

It is a 11:39 minute film, by Walter Reid Army Institute of Research Production of experimental research done by Peter Safar, MD, and associates, at Baltimore City Hospital's Department of Anesthesiology. Peter Safar: father of modern cardiopulmonary resuscitation. Clinical cardiology , 30 (1), 52-54. The incredible career of Peter J.

Resuscitation 40

Resuscitation CPR Emergency Nursing Basic Life Support 40

Don't Forget the Bubbles

JANUARY 27, 2025

However, the limitation with MRI scanning is the logistics of obtaining one in a busy hospital especially if it is an out-of-hours presentation of torsion. Aziz D, Davis V, Allen L, Langer JC (2004) Ovarian torsion in children: is oophorectomy necessary? CT prediction of the degree of ovarian torsion. Jpn J Radiol. Epub 2015 Jun 29.

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Ultrasounds Emergency Department Pediatrics Dehydration 76