ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. 2019;154(7):e191152.

Documentation/Coding 98

Documentation/Coding Fluid Resuscitation Resuscitation EMS 98

Dr. Smith's ECG Blog

OCTOBER 23, 2023

2007 Oct;30(10):1267-72. Macroscopic T-Wave Alternans: A Red Flag for Code Blue. Molon G, Costa A, Bertolini L, Zenari L, Arcaro G, Barbieri E, Targher G. Relationship between abnormal microvolt T-wave alternans and poor glycemic control in type 2 diabetic patients. Pacing Clin Electrophysiol. doi: 10.1111/j.1540-8159.2007.00849.x.

EKG/ECG 120

EKG/ECG Documentation/Coding Psychiatric EMS 120

Don't Forget the Bubbles

NOVEMBER 20, 2023

Document the size, consistency and location in the notes to compare if they represent. They may grow again with subsequent upper respiratory tract infections. This waxing and waning course is normal, and families should be reassured and given red flag features that necessitate further assessment. References Al-Khateeb T, Al Zoubi F.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Hospitals 124

Cook County EM Blog

MAY 15, 2023

A code STEMI was activated, and the patient was given sublingual nitroglycerin and morphine for his pain. 2007 Jan;15(1):16-21. A posterior EKG was immediately obtained showing very mild ST elevation in V7 and V8. For reference, in men and women at any age >0.05mm in leads V7-V9 is considered a STEMI. Neth Heart J. Alpert, Allan S.

EKG/ECG 52

EKG/ECG Documentation/Coding Wellness 52

Taming the SRU

NOVEMBER 14, 2023

Foreign body removal steps Assess hearing before and after the procedure and document any suspected damage/injury prior to removal attempts so that these will not later be attributed to the procedure (6). 2007 Oct;26(10):879-91. 2007 Jun;121(6):530-4. Accessed November 9, 2023. Emerg Med Clin North Am. 25(1):23-39. Pattanaik S.

Emergency Department 86

Emergency Department Pediatrics Wellness Documentation/Coding 86

PulmCCM

FEBRUARY 19, 2024

At Shands (the level 1 trauma center admitting adults), the panel relates the impressive results that mortality fell by 58%, and unplanned codes by 47% “after the widespread implementation of patient/ family activated RRT/MET.” Over six years of study (2007-2013): There were 83 MET calls activated by parents (~1.2

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). 2007 Aug;24(8):569-71. PMID: 16342377. (6) 6) Malatesha G, Singh NK, Bharija A, Rehani B, Goel A. Emerg Med J.

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

Don't Forget the Bubbles

FEBRUARY 26, 2024

2007 Jan 1;25(1):6-9. uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2019. Pediatric Critical Care Medicine. 2002 Apr 1;3(2):181-4. Beers SL, Abramo TJ, Bracken A, Wiebe RA. Bilevel positive airway pressure in the treatment of status asthmaticus in pediatrics. The American journal of emergency medicine.

Pediatrics 72

Pediatrics Research Documentation/Coding Outcomes 72

Pediatric Education

DECEMBER 10, 2023

The medical record also documented that the family had been provided with education regarding infant safe sleep practices during the newborn period. One study of US National Center for Health Statistics found from 2007-2016 that infants’ deaths from strangulation/suffocation increased for all groups studied.

Pediatrics 40

Pediatrics Documentation/Coding Research Hospitals 40

ACEP Now

AUGUST 1, 2023

emergency department deserves access to an emergency physician no matter their zip code. Three take home points for what I believe. There is no substitution for the physician led team. Every patient in a U.S. At no point should a physician role be replaced by a NPP for any reason, but especially as a perceived profit/control strategy.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Sensible Medicine

APRIL 29, 2024

In this section, they documented the variations in analytic method (for instance, the choice of model and co-variates). Then they applied the specification curve analysis to one specific database—the NHANES (National Health and Nutrition Examination Survey) from 2007 to 2014. Here is what Zeraatkar and colleagues did.

Documentation/Coding 138

Documentation/Coding Stroke Shock Research 138

ACEP Now

DECEMBER 11, 2023

These changes are of note because data regarding limited efficacy were presented to the FDA in 2007 and 2015. An internal Schering-Plough study, first presented in 2007, described the metabolism and pharmacokinetics of a single oral dose of phenylephrine in 14 healthy volunteers. References U.S. Food and Drug Administration.

Administration 64

Administration Outcomes Research Documentation/Coding 64

Don't Forget the Bubbles

JULY 26, 2023

Claudius et al, Pediatrics 2007 here a US-based study showed that of all admitted patients only 14% had a subsequent clinical course requiring admission. The presence of these pathways is documented inutero and they usually regress by around 20 weeks gestation. Do all infants with ALTEs need to be admitted?

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

PEMBlog

JUNE 14, 2023

Boarding of Mentally Ill Patients in Emergency Departments: American Psychiatric Association Resource Document. Children’s Mental Health Emergency Department Visits: 2007-2016. Pediatrics March 2023; 151 (3): e2022057383. 10.1542/peds.2022-057383 2022-057383 Nordstrom K, Berlin JS, Nash SS, Shah SB, Schmelzer NA, Worley LLM.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

Sensible Medicine

JULY 24, 2023

At the time, in 2007, the cardiology world was stunned to learn that opening partially blocked coronary arteries—in stable patients—did not lead to fewer heart attacks or less cardiac death compared to tablets alone. But there had been two placebo-controlled drug trials that documented a 45-55 second increase in exercise time.

Documentation/Coding 94

Documentation/Coding Academics Ultrasounds Wellness 94

EMDocs

MAY 26, 2023

2007 Oct;14(5):265-8. Restraints should not be applied indefinitely, and multiple reevaluations should be done to determine when it is safe to remove restraints. West J Emerg Med. 2012 Feb;13(1):35-40. PMC3298214. Melamed E, Oron Y, Ben-Avraham R, Blumenfeld A, Lin G. The combative multitrauma patient: a protocol for prehospital management.

Pediatrics 75

Pediatrics Emergency Department Psychiatric Documentation/Coding 75

EB Medicine

JUNE 6, 2019

Nachi: Few things are more important prior to discharge of an abdominal pain patient than documenting repeat exams and a PO trial. Nachi: A 2007 study suggests that using the Alvarado score along with bedside ultrasound might allow for rapid and inexpensive diagnosis of appendicitis. Jeff: True. The max score is therefore 10.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Dr. Smith's ECG Blog

JULY 22, 2023

Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. Drugs that have been associated with Brugada ECG patterns include tricyclic antidepressants, anesthetics, cocaine , methadone, antihistamines, electrolyte derangements, and even tramadol. [2]. Circ Res, 85(9), 803-809. [6]:

EKG/ECG 67

EKG/ECG Hyperthermia / Hypothermia Documentation/Coding Wellness 67

Northwestern EM Blog

SEPTEMBER 12, 2022

Other things listed on tags can be a patient’s name, bar code, MRN or other tracking criteria. Florida Department of Health, www.urmc.rochester.edu/MediaLibraries/URMCMedia/flrtc/documents/WNY-Hospital-Medical-Surge-Planning-For-Mass-Casualty-Incidents.pdf. These patients are then able to be treated based on the level of care needed.

Mass Casualty Incidents 52

Mass Casualty Incidents Hospitals EMS Operations 52

EMDocs

JUNE 16, 2023

Boarding of Mentally Ill Patients in Emergency Departments: American Psychiatric Association Resource Document. Children’s Mental Health Emergency Department Visits: 2007-2016. Pediatrics March 2023; 151 (3): e2022057383. 10.1542/peds.2022-057383 2022-057383 Nordstrom K, Berlin JS, Nash SS, Shah SB, Schmelzer NA, Worley LLM.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

Dr. Smith's ECG Blog

JULY 11, 2018

His astute observation is worthy of brief discussion: Rituparna et al document a case study report, in which J waves appeared to be induced by ischemia ( Pacing Clin Electrophysiol 30(6):817-819, 2007 ). The proposed mechanism is complex.

EKG/ECG 52

EKG/ECG Hospitals Documentation/Coding 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. Drugs that have been associated with Brugada ECG patterns include tricyclic antidepressants, anesthetics, cocaine , methadone, antihistamines, electrolyte derangements, and even tramadol. [2]. Circ Res, 85(9), 803-809. [6]:

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Wellness Documentation/Coding 52

Pediatric Emergency Playbook

JUNE 1, 2017

The best documented cormorbidity is sickle cell disease, although other pro-thrombotic conditions also put the child at risk. 2007; 2:2-11. Myocardial infarction in an adult resulting from coronary aneurysms previously documented in childhood after an acute episode of Kawasaki’s disease. 2007; 5(3):172-176. 15:1002-1004.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

EB Medicine

MAY 3, 2019

Next, schedule a follow up appointment, ideally within a week of discharge, and lastly, document the patient’s preferred follow up resources and steps taken to get them there. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%. Talk to you next month! Most Important References 1. Owens PL, Mutter R, Stocks C.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

EB Medicine

DECEMBER 1, 2018

Antigen drift refers to small point mutations to the viral genes that code for H and N. In 2007-2008, an oseltamivir-resistant H1N1 strain emerged globally. There are actually 16 different H subtypes and 9 different N subtypes, but only H1, H2, H3, and N1 and N2 have caused epidemic disease.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful. 2007 Oct; 33(3): 233–239. Syncope and cause of death were identified by codes from the International Classification of Disease, Ninth Revision. 2) Boston syncope rule: J Emerg Med.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52