Don't Forget the Bubbles

NOVEMBER 20, 2023

Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. Royal Children’s Hospital. Royal Children’s Hospital, Melbourne. Thorough history taking and detailed examination can aid in diagnosis. DOI: 10.1016/j.joms.2006.11.039

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. She had a low-grade fever and an episode of vomiting before coming to the hospital. Hospital Admitted Patient Care Activity.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

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. A 2007 review of the literature concluded that there was no difference in analgesia between IM ketorolac and PO ibuprofen ( Arora 2007 ).

Administration 63

Administration Emergency Department EMS Research 63

ACEP Now

AUGUST 1, 2023

How does that apply to the role of the board certified emergency physician? Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. When those same fundamentals done right achieve great success, they aren’t little at all.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

ALiEM

JANUARY 22, 2024

A 40-year-old male, tailor by occupation, was brought to the Emergency Department with complaints of high-grade fever for the past 11 days. The patient during his hospital stay developed ARDS and was on mechanical ventilation for 20 days. 2007 Dec;21(4):997-1011, ix. References Botelho-Nevers E, Raoult D. 2007.08.002.

Academics 64

Academics Documentation/Coding Emergency Department Hospitals 64

EMDocs

MAY 26, 2023

Patients may be brought to hospital by police under restraint (e.g. Emerg Med Clin North Am. Structured team approach to the agitated patient in the emergency department. Emerg Med Australas. West J Emerg Med. Eur J Emerg Med. 2007 Oct;14(5):265-8. Deaths due to physical restraint. 2009.07.003.

Pediatrics 98

Pediatrics Emergency Department Psychiatric Documentation/Coding 98

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Unsuspected Critical Illness Among Emergency Department Patients Presenting for Acute Alcohol Intoxication. Annals of Emergency Medicine. J Emerg Med. Ann Emerg Med. Lancet Neurol.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

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. A 2007 review of the literature concluded that there was no difference in analgesia between IM ketorolac and PO ibuprofen ( Arora 2007 ).

Administration 52

Administration Emergency Department EMS Research 52

PEMBlog

MAY 24, 2023

Alice Kuo and Ilene Claudius Podcast EIIC: Safe Control of the Agitated Patient Webinar Series with Dr. Emerg Med Clin North Am. Structured team approach to the agitated patient in the emergency department. Emerg Med Australas. West J Emerg Med. Eur J Emerg Med. 2007 Oct;14(5):265-8. 2009.07.003.

Emergency Department 59

Emergency Department Pediatrics Psychiatric Administration 59

The Skeptics' Guide to EM

MAY 21, 2017

Background: Heroin use has been increasing in the USA since 2007 (1). Some heroin users may refuse further treatment or transport to the emergency department after receiving naloxone in the field and awaking. If transported to hospital, they may also refuse further treatment or observation in the emergency department.

Emergency Department 52

Emergency Department Administration Academics EMS 52

The Skeptics' Guide to EM

MARCH 18, 2023

Association of early oseltamivir with improved outcomes in hospitalized children with influenza, 2007-2020. Guest Skeptic: Dr. Marisu Rueda-Altez is a pediatric infectious disease fellow at Children’s National Hospital in Washington, DC. JAMA Pediatr. JAMA Pediatr. Nasopharyngeal PCR testing is positive for Influenza A.

Pediatrics 40

Pediatrics Infectious Diseases Administration Outcomes 40

ACEP Now

AUGUST 12, 2024

A 35-year-old male presented to the emergency department complaining of chest pain that started 1.5 He was hospitalized two months prior and had a normal stress test. 5 Studies looking at this phenomenon in the emergency department setting for patients presenting with chest pain are lacking. 2007 Aug;30(8):403.

EKG/ECG 52

EKG/ECG Emergency Department Hospitals 52

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. Risk Factors for Opioid-Related Adverse Drug Events Among Older Adults After Hospitalization for Major Orthopedic Procedures. Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use. J Patient Saf. Goodwin J.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Wellness 52

EMDocs

JUNE 16, 2023

Episode 4 covered management of the agitated child in the pre-hospital environment. And now we’re here at our destination, the place we know and love, the emergency room to talk about what we should be doing for the growing volume of children with mental health problems boarding in the emergency department.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

The Skeptics' Guide to EM

SEPTEMBER 7, 2018

Guest Skeptic: Dr. Ben Lawton is a paediatric emergency physician in Brisbane Australia. He divides his time between a tertiary children’s hospital and a community hospital that is busy enough to have its own paediatric […] The post SGEM#228: Winds of Change – High Flow Nasal Oxygen for Acute Bronchiolitis? NEJM March 2018.

Dehydration 40

Dehydration Pediatrics Hospitals Academics 40

Don't Forget the Bubbles

MAY 29, 2023

A qualitative study of 2,815 pre-hospital clinicians reported that nearly half of the respondents had experienced incivility from professional teams at least once a week. Bad manners in the Emergency Department: Incivility among doctors. Internet] 2007; 505:1181–1197. link] Isn’t it just ‘part of the job?’ Acad Manage J.

Leadership 98

Leadership Patient Safety Academics Research 98

EB Medicine

MAY 3, 2019

This month, we’re moving into uncharted territories for the podcast… we’re talking psychiatry Nachi: Specifically, we’ll be discussing Depressed and Suicidal Patients in the emergency department. It’s also important to elicit any psychiatric history, including prior hospitalizations. Talk to you next month!

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

RebelEM

DECEMBER 1, 2022

Background: Pneumothorax management is a common clinical condition in the emergency department (ED) occurring in patients of varying ages and caused by multiple etiologies, including spontaneous, traumatic, and iatrogenic pneumothorax. Regardless of the cause, a thoracostomy is often required for treatment (Currie 2007 ).

Outcomes 52

Outcomes Hospitals Research Critical Access 52

EMDocs

OCTOBER 21, 2023

In hospital mortality estimated at 30-40%. 17 65-78% of survivors have significant disability one month after hospital discharge. link] January 24, 2007. Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department. Updated 2022 Oct 15]. In: StatPearls [Internet].

EMS 98

EMS Stroke Outcomes Hospitals 98

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. After a short period of recovery in the hospital, she is discharged home in stable condition with follow-up with OBGYN. Ultrasonography.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

Taming the SRU

MARCH 14, 2023

Case 1 Fussy 1 month old A 1-month-old (ex-34 week premature) infant comes to your emergency department for fussiness. After a several week NICU stay for prematurity, the infant has been generally healthy and this is his first trip back to the hospital since discharge. More on this below as we work through a few cases….

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Dr. Smith's ECG Blog

OCTOBER 20, 2013

in Vienna found that 27 of 765 (4%) of out of hospital cardiac arrests (OHCA) were due to SAH. Only 1 of 27 survived, after 45 days in the hospital, with a cerebral performance category of 2; this patient had ventricular fibrillation. Data collected included demographics, initial rhythm, EKG, emergency department (ED) CT and outcomes.

Resuscitation 52

Resuscitation EKG/ECG Hospitals Emergency Department 52

Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

RebelEM

JANUARY 23, 2023

2007 Jul-Aug;28(4):418-26. Multicenter study of emergency department visits for insect sting allergies. Multicenter study of emergency department visits for food allergies. Patients were randomized in a 1:1 ratio. The effectiveness of IV cetirizine was determined to be statistically non-inferior. PMID: 17883909.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Urgent Care Emergency Department 52

Northwestern EM Blog

SEPTEMBER 12, 2022

Written by: August Grace, MD (NUEM ‘24) Edited by: Andrew Rogers, MD, MBA (NUEM ‘22) Expert Commentary by : Andra Farcas, MD (NUEM ‘21) Introduction In the setting of trauma, most hospitals are adept at treating and managing patients with a variety of injuries. Time begins after the first patient arrives at the hospital [8].

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Hazardous Materials 52

Pediatric Emergency Playbook

AUGUST 1, 2017

One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis. 2007; 16:27-33.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. Blood Pressure Variability Predicts Poor In-Hospital Outcome in Spontaneous Intracerebral Hemorrhage. 2007 Jul 18;2007(3):CD000277. 2022 Jul;53(7):e282-e361.

Stroke 101

Stroke Outcomes EMS Seizures 101

Don't Forget the Bubbles

DECEMBER 16, 2024

Clear history taking In the Emergency Department, healthcare professionals should prioritise thorough history-taking when assessing potential suspected cases. European Centre for Disease Prevention and Control. Measles facts [Internet]. cited 2024 Oct 24] WHO. Risk assessment for measles resurgence in the UK: 2023 [Internet].

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59

Pediatric Emergency Playbook

JUNE 1, 2016

Pulmonary embolism in the pediatric emergency department. Fluid balance and cardiac function in septic shock as predictors of hospital mortality. 2007; 35:64-8. Pediatrics. 2013 Oct;132(4):663-7. Dellinger RP, Levy MM, Rhodes A, et al. Micek ST, McEvoy C, McKenzie M, Hampton N, Doherty JA, Kollef MH. 2013; 17:R246.

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

EB Medicine

JUNE 6, 2019

Taylor and Shaukat of Emory and Coney Island Hospital respectively for their efforts in peer reviewing this huge topic. Jeff: An interesting question for your abdominal pain patient is to ask about the ride to the hospital. Jeff: Before we dive into the meat and potatoes of this month’s issue, let me also recognize Drs.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Int J Emerg Med. Eur J Emerg Med. Emerg Med J. doi: 10.1097/MEJ.0b013e32836437cf.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

Dr. Smith's ECG Blog

APRIL 8, 2015

Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to general hospital: the EGSYS score. 2) Boston syncope rule: J Emerg Med. 2007 Oct; 33(3): 233–239. The ROSE (Risk Stratification of syncope in the emergency department) Study. Heart 2008;94(12):1620–6.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

Don't Forget the Bubbles

FEBRUARY 7, 2024

My first real encounter with the healthcare system took place when I was about seven years old and had to go into hospital for an orchidopexy, so I can empathize with all the young people who come through our emergency department with acute testicular pain. I have long been fascinated by testicles. This dropped to 79.3%

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

PHEM Cast

MARCH 3, 2019

Ketamine-propofol combination (ketofol) versus propofol alone for emergency department procedural sedation and analgesia: a randomized double-blind trial. Ann Emerg Med. Morphine and Ketamine Is Superior to Morphine Alone for Out-of-Hospital Trauma Analgesia: A Randomized Controlled Trial. Ann Emerg Med.

Emergency Department 52

Emergency Department Head Injuries Pediatrics Hospitals 52

Pediatric Emergency Playbook

JANUARY 1, 2017

Surgical pain is not “erased” by opioids ( Thomas 2003 , Poonai 2014 ); treating pain improves specificity to certain surgical emergencies with retained diagnostic accuracy ( Manterola 2007 ). Committee on Bioethics and Committee on Hospital Care. Acad Emerg Med. References American Academy of Pediatrics. Pediatrics.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

JULY 17, 2023

13 Depending on the hospital staffing, this may be a gastroenterology consult or a surgical consult. It is important to assess the patient’s medical comorbidities, as an endoscopic detorsion is a procedure occasionally performed in the ED by a gastroenterologist with an emergency physician providing support for sedation and monitoring.

Operations 98

Operations EMS Fluid Resuscitation Resuscitation 98

EMDocs

MAY 29, 2023

Authors: Rachel Kelly, MD (EM Resident Physician, Stony Brook University Hospital) and Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Inflammatory biomarkers in hospitalized adults with suspected infection.

Infectious Diseases 58

Infectious Diseases Emergency Department EMS Hospitals 58