Pediatric EM Morsels

JULY 21, 2023

2008 Apr;39(4):1347-8. Epub 2008 Feb 28. PubMed: 29631516] van Heuven AW, Dorhout Mees SM, Algra A, Rinkel GJ. Validation of a prognostic subarachnoid hemorrhage grading scale derived directly from the Glasgow Coma Scale. doi: 10.1161/STROKEAHA.107.498345. 107.498345. PMID: 18309166.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Taming the SRU

JUNE 12, 2023

In 2008, this led to greater than 316,000 emergency department (ED) visits and about 9,500 hospitalizations [1]. However, there have been no studies statistically powered well enough regarding dog bite lacerations to confirm or dispute this claim. In the United States, approximately 4.5 million people are bitten by dogs annually [1].

Infectious Diseases 102

Infectious Diseases Emergency Department Administration Academics 102

Dr. Smith's ECG Blog

MAY 31, 2023

It is one of the few OMI patterns that is really well described: de Winter’s T-waves. Here is her astonishing reply: "Well, they still haven’t taken her to the Cath Lab yet!!!! de Winter et al in N Engl J Med 359:2071-2073, 2008. And now this finding is even formally endorsed as a "STEMI equivalent" in the 2022 ACC guidelines!!!

EKG/ECG 81

EKG/ECG Outcomes Academics Wellness 81

EMDocs

SEPTEMBER 7, 2023

DGA concentrates in the kidney tissue and causes nephrotoxicity, as well as neurotoxicity. Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. Fatal Poisoning Among Young Children from Diethylene Glycol-Contaminated Acetaminophen — Nigeria, 2008—2009”.

Poisoning 65

Poisoning CDC Administration Emergency Department 65

Dr. Smith's ECG Blog

APRIL 17, 2023

4) There is well formed J-point notching. He also stated he "just didn't feel well" starting about 14 hours prior to presentation, but the chest pain was only noticed about 2 hours prior to presentation. de Winter et al in N Engl J Med 359:2071-2073, 2008. 3) The shape of the T-wave is just "not right". See text ).

EKG/ECG 52

EKG/ECG Documentation/Coding Emergency Department Psychiatric 52

ACEP Now

SEPTEMBER 5, 2024

Creation of an accurate database of emergency physicians living and working within a state, as well as a network of each states’ EM groups and ED medical directors would help chapter leaders disseminate relevant information, strengthen advocacy efforts, and plan regional solutions summits to focus on unique challenges.

Leadership 98

Leadership PPE EMS Wellness 98

EMDocs

DECEMBER 11, 2023

There are multiple criteria systems for diagnostic an acute myocardial infarction in this population, as well as patients with ventricular-paced rhythms. De Winter Sign [4,6] First described in 2008 this pattern be seen in proximal left anterior descending artery occlusion and should be evaluated by emergent angiography. Ann Emerg Med.

EKG/ECG 110

EKG/ECG Emergency Department Academics Operations 110

Taming the SRU

DECEMBER 11, 2023

8] While there is no standardized screening tool for SRB, there are well established trends that emergency medical providers may use to identify patients at risk.[9] Emergency Department Visits Related to Suicidal Ideation or Suicide Attempt, 2008-2017. 9] Adolescents and patients in their early twenties are at increased risk.[10]

EMS 96

EMS Psychiatric Emergency Department Poisoning 96

Don't Forget the Bubbles

SEPTEMBER 18, 2024

. ■ Case 1 focuses on a case seen in the emergency department and explores the common parental query of a “weak immune system” in a young child who has had several recurrent upper respirator tract infections back-to-back but is otherwise well. His parents are both fit and well and there is no family history of any medical conditions.

Emergency Department 78

Emergency Department Wellness Infectious Diseases Pediatrics 78

EMDocs

FEBRUARY 7, 2024

Unionization of healthcare providers can create opportunities to improve staff’s financial and general well-being, but may also facilitate future strikes. Trainees and attending providers should be informed about both the opportunities that come with unionization, as well as the challenges that come with managing strikes.

Hospitals 76

Hospitals Research Patient Safety Wellness 76

Taming the SRU

OCTOBER 28, 2024

If their injury was from trauma, it would not be unreasonable to initiate trauma consult within the emergency visit, but also if the injury is isolated and the patient is well appearing, they could also follow up closely with the trauma clinic. 2008 Nov 03;3:59. 2008 Dec;65(6):1340-5. J Cardiothorac Surg. doi: 10.1097/TA.0b013e318169cd24.

COPD 78

COPD Pediatrics Emergency Department Ultrasounds 78

SheMD

OCTOBER 22, 2023

This happened to be around the time of the economic crisis of 2008. I had to sign a contract at the start promising that I wouldn’t work during medical school so that I could focus on becoming a well-trained physician. So, starting at the age of 18, I was on my own financially. I know others are not in the same situation.

Wellness 52

Wellness Academics 52

Cook County EM Blog

MARCH 31, 2022

The incubation period from infection to disease is approximately 15-90 days, and incubation is notably shorter if exposure occurs in well-innervated areas such as the face. Human Rabies Prevention – United States, 2008. As a sobering reminder, the appearance of the clinical signs and symptoms of rabies herald an almost certain death.

Infectious Diseases 52

Infectious Diseases Administration Wellness 52

PulmCCM

FEBRUARY 12, 2024

SCCM made its statement unilaterally, without the European Society of Intensive Care Medicine (ESICM), its partner on the 2008 and 2017 updates, or the American Thoracic Society (ATS). That could be because CIRCI is ill-defined, almost hypothetical. 3 days).

Shock 52

Shock Administration Sepsis Fractures 52

EMDocs

JULY 9, 2024

Addressing social determinants of health at well child care visits: a cluster RCT. JAMA Pediatr. 2016 Nov 7;170(11):e162521. doi: 10.1001/jamapediatrics.2016.2521. Epub 2016 Nov 7. PMID: 27599265. Garg A, Toy S, Tripodis Y, Silverstein M, Freeman E. Pediatrics. 2015 Feb;135(2):e296-304. doi: 10.1542/peds.2014-2888. Epub 2015 Jan 5.

Pediatrics 71

Pediatrics Emergency Department Research Burns 71

Dr. Smith's ECG Blog

JANUARY 20, 2024

Last ECG: Final Diagnosis: "NSTEMI" This patient will likely suffer heart failure and early death due to the diagnosis of "NSTEMI" Learning Points: Despite NSTEMI guidelines recommending emergent angiography for NSTEMI patients with refractory ischemic symptoms, this is simply not done in many systems, and this has been recorded in a study as well.

EKG/ECG 115

EKG/ECG Documentation/Coding Emergency Department Hospitals 115

EMDocs

JULY 25, 2024

Do them well and document the process, preferably at the bedside. Assure and document the patient’s resources and safety net if discharged. If PA-C’s are allowed to care for suicidal patients, their privileges should so specify. Handoffs are a high-risk exchange. Columbia-Suicide Severity Rating Scale (C-SSRS). Posner et al.

Documentation/Coding 81

Documentation/Coding Hospitals Patient Safety Emergency Department 81

Northwestern EM Blog

JANUARY 10, 2022

For those well-appearing neurologically intact hyponatremia patients w/ sodium levels > 120, further work-up & analysis of the underlying etiology can be deferred to the inpatient side. 2008 Nov;3(6):1852-60. Epub 2008 Aug 6. Waitzman’s additional commentary from the nephrology perspective. Campbell GA, Rosner MH.

Administration 52

Administration Seizures Emergency Department Wellness 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2021

Premature babies are at higher risk as well. 2008 Feb;88(1):27-43, vii-viii. Most indirect hernias are in boys (10-fold risk), and on the right (60%). 15% are bilateral. Hernias often bulge further with crying. For infants, in supine position, gently restrain their feet on the gurney. They hate it and will cry. Inguinal Hernia.

Pediatrics 40

Pediatrics Wellness 40

Maria Yang, MD

SEPTEMBER 13, 2023

We’ve never met, but my husband and I have “known” you since 2008 or so. We hope that you and yours remain healthy and well. After some sleuthing, I found his e-mail address and, pushing my reluctance aside, pressed send after writing this note: My name is Maria Yang and I live in Seattle, Washington.

Wellness 59

Wellness 59

The Skeptics' Guide to EM

SEPTEMBER 18, 2021

While the presentation of appendicitis can vary from patient to patient, as our emergency medicine colleagues know well, most patients are not diffusely peritonitic or systemically unwell. Omar et al published a study in 2008 showing just how safe laparoscopic appendectomies have become.

Operations 52

Operations Academics Ultrasounds Hospitals 52

Sensible Medicine

MAY 25, 2023

Jindal served as governor of Louisiana, 2008-16, and a U.S. If this would not help patients, whom would it help? .” ” The USPSTF might beg to differ about the significant unmet need, but we can all agree about the sizable new market. Investors take note. assistant secretary of health and human services, 2001-03. ” U.S.

Documentation/Coding 62

Documentation/Coding Academics Wellness 62

PHEM Cast

JULY 14, 2016

Crane T, Cooke MW, Wellings R, Wayte S, Higgins J. British Orthopaedic Association Standards for Trauma (BOAST); 2008. 2008 Apr 15;5(3):214–9. 2008 Apr 22;178(9):1141–52. Emergency Medicine Journal. 2013 May 13;30(6):516–6. MRI study of effectiveness of cervical spine immobilisation- a pilot study. 2007 Aug 1;:1–18.

Hospitals 52

Hospitals Fractures Shock Research 52

ACEP Now

SEPTEMBER 13, 2023

“We wanted to reach emergency physicians, nurses and others working in trauma as well as those at Health and Human Services and the Centers for Disease Control. as well as working closely on behalf of the association on projects with the White House and the Departments of Veterans Affairs, Defense, and Health and Human Services.

EMS 45

EMS Research Academics Military 45

ACEP Now

MAY 3, 2023

When she took the role in 2008, it was a newly created job tasked with expanding AARP’s approach to making health products and services available to its members from third party companies. Some people do really, really well as they age, and other people don’t,” Dr. Yeh said.

EMS 52

EMS Outcomes Emergency Department Hospitals 52

PulmCCM

OCTOBER 30, 2023

In 2008, the U.S. incidence of VAP has remained stubbornly persistent : though it declined from 20 cases to 15 per 1000 ventilated patients 2008-2015, the rate then crept back up to 17 per 1000 in 2017. The fact is, large, well-conducted studies with the power to find relatively small effects with high confidence take a long time.

Sepsis 52

Sepsis Shock Hospitals Outcomes 52

PulmCCM

FEBRUARY 5, 2024

Fever in the ICU: Guideline Update The Society of Critical Care Medicine (SCCM) and the Infectious Diseases Society of America (IDSA) issued an interim update to their 2008 recommendations for the management of fever in the ICU. Ultrasound is well-suited for identifying most serious biliary system abnormalities.

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

RebelEM

JULY 20, 2023

This can be plotted as a Forgetting Curve (Figure 2), the slope of which depends on many things – the quality of the teacher, if stress is included in the training, if you’re well fed, have good sleep, etc. This is the idea of learning something so well you bring yourself well above the line of competence.

EMS 75

EMS Burns Airway Management Wellness 75

ACEP Now

JANUARY 9, 2024

On physical examination, the child was non-toxic, well-nourished, alert, awake, and not in acute distress. 9 Lead exerts its toxic effects by interfering with various organ functions, primarily targeting the nervous system and hematopoietic system, as well as impairing liver and kidney functions. Adv Pediatr. 2014;61(1):313-33.

Poisoning 52

Poisoning Pediatrics Emergency Department Wellness 52

Taming the SRU

JANUARY 1, 2024

For laboratory testing, it is important to be aware that not all values obtained via an intraosseous line correlate well with peripheral venous samples (11). Additional Resources Please see a previous Taming the SRU post for extra tips and trouble-shooting tricks, as well as a video demonstration for IO access. 2008 Jan;26(1):31–8.

Emergency Department 91

Emergency Department Ultrasounds Administration Burns 91

Taming the SRU

MARCH 14, 2023

He appears well and is triaged to an ESI 4. She was doing well, but recently has had the “stomach flu” with a couple weeks of abdominal pain, nausea and vomiting. 2008) Shprecher, Schwalb, Kurlan. More on this below as we work through a few cases…. He has a weak cry and you notice bulging fontanelles. Neuroradiology. Amer J Rad.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Don't Forget the Bubbles

MARCH 11, 2024

There are many causes, and it is less well understood than plagiocephaly. Craniosynostosis Craniosynostosis is rare. It is due to the premature closure of the sutures rather than positional changes to an otherwise normal skull. References The ISPN Guide to Pediatric Neurosurgery (USA): Positional Plagiocephaly in Children Homepage.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

Sensible Medicine

SEPTEMBER 29, 2023

The promise is that well-constructed and validated prediction models will lead to diseases being diagnosed earlier and treatment for the right patients, in the right place, at the right time. In some cases, models that appear to perform well may pose risks to patients if used to make clinical decisions. 2008 Feb;117(6):743-53.

Research 58

Research Hospitals Academics Emergency Department 58

RebelEM

MARCH 13, 2023

Many studies suggest that increased time spent on scene correlates with worse outcomes for trauma (Stiell 2008) and all-cause incidence (Isenberg 2005) across all levels of prehospital care. 2008 Apr 22;178(9):1141-52. However, we might expect on-scene advanced trauma resuscitation to prolong prehospital time sizably.

Basic Life Support 52

Basic Life Support EMS Outcomes Resuscitation 52

EMDocs

APRIL 22, 2024

If RV pressure is extreme, it can exceed LV pressure causing paradoxical septal wall motion toward the LV as well. When RV pressures elevate, RA pressures increase as well given forward blood flow is obstructed. Rockville (MD): Office of the Surgeon General (US); 2008. 2008 Mar;28(3):370-2. Am J Prev Med. 2009.12.017.

Ultrasounds 81

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 81

The Skeptics' Guide to EM

MAY 11, 2019

Omar et al (2008) showed just how safe laparoscopic appendectomies have become. Background: The first documented appendectomy was done by Claudius Amyand in 1735. The standard treatment for acute appendicitis has been appendectomy ever since Charles McBurney described it in 1889.

Documentation/Coding 52

Documentation/Coding Operations Academics Ultrasounds 52

EMDocs

APRIL 13, 2024

If the hematoma is not drained it can cause disruption of blood supply to the cartilage and subsequent necrosis, as well as an increase in risk of infection. In: Textbook of Pediatric Emergency Procedures, 2nd edition, King C, Henretig FM (Eds), Lippincott, Williams & Wilkins, Philadelphia, PA 2008. link] Martinez NJ, Friedman MJ.

EMS 81

EMS Emergency Department Pediatrics Wellness 81