RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. Paper: Owyang CG, et al. J Crit Care. Crit Care Explor. Crit Care Med. Am J Respir Crit Care Med.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Pediatric EM Morsels

MAY 24, 2024

In 2009, more than 9,000 children died from accidental injuries. Ann Emerg Med. PECARN prediction rules for CT imaging of children presenting to the emergency department with blunt abdominal or minor head trauma: a multicentre prospective validation study. Low Risk Inta-Adbominal Trauma: Pediatric Trauma is Dangerous!

Pediatrics 161

Pediatrics Blood Transfusions EMS Fractures 161

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the Emergency Department, he initiated ‘ The Pause.’ 23 (2), pp.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

ACEP Now

DECEMBER 17, 2024

We deal with difficult and traumatizing situations daily, and nowhere is this more apparent than in the emergency department, where sickness, violence, and death are routine. Trends in labor unionization among US health care workers, 2009-2021. Second, we pushed for better access to therapy and mental health benefits.

Burns 97

Burns Hospitals Documentation/Coding Emergency Department 97

Taming the SRU

DECEMBER 11, 2023

1,2] Patients at risk for suicide often interact with emergency medical care. Suicide-related behavior (SRB) accounts for 1% of all Emergency Department (ED) visits; additionally, greater than 8% of patients visiting emergency departments are likely experiencing suicidal ideation at the time of the encounter.[3-5]

EMS 95

EMS Psychiatric Emergency Department Poisoning 95

Pediatric Emergency Playbook

SEPTEMBER 1, 2020

2009; 39(1):e23-e27. The use of prophylactic flucloxacillin in treatment of open fractures of the distal phalanx within an accident and emergency department: a double-blind randomized placebo-controlled trial. Tuft Fracture Yeh PC et al. Pediatric Hand Fractures. Techniques in Orthopaedics. Seymour Fracture Nellans et al.

Fractures 52

Fractures Pediatrics Emergency Department 52

Taming the SRU

APRIL 14, 2024

This revealed that ultrasound can improve the ability to reduce an incarcerated inguinal hernia and may decrease the rate of emergency surgery. (1) 1) Table 1 - Study Protocol Table 2 - Results Conclusion Hernias are often encountered in the emergency department as an acute or non-acute finding. 4, 1 July 2009, p.

Ultrasounds 92

Ultrasounds Emergency Department Pediatrics Radiology 92

RebelEM

AUGUST 30, 2023

Imaging Gadolinium enhanced MRI – modality of choice, highly sensitive and specific ( Mylona 2009 ). Evaluation and Treatment of Acute Back Pain in the Emergency Department. Orthopedic Emergencies 2015 May; 33(2) 311-26. 2009 Aug; 39(1):10-7. Simon’s Emergency Orthopedics. PMID: 25892724 Gouliouris T, et al.

Infectious Diseases 103

Infectious Diseases Fractures Radiology Radiology 103

The Skeptics' Guide to EM

JULY 8, 2023

Case: A 57-year-old woman with hypertension, hyperlipidemia and type-2 diabetes mellitus presents to the emergency department (ED) with fever, cough, myalgias, headache and congestion. Managing editor of EM:RAP and Associate Editor at REBEL EM. It’s flu season and you’ve already seen 15 people with the same symptoms.

CDC 93

CDC Hospitals EMS Emergency Department 93

RebelEM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

RebelEM

JUNE 5, 2023

One study from a county in Massachusetts found that of all nonfatal opioid doses seen in the emergency department from 2011-2015, 1 in 20 patients subsequently died within one year of initial visit with 66% of these deaths being directly related to an opioid overdose (4). Drug Alcohol Depend 2009; 104:73. PMID 33392580.

Emergency Department 98

Emergency Department Hospitals Outcomes EMS 98

RebelEM

APRIL 29, 2024

World J Emerg Surg 2023 PMID: 36918947 3. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med 2009 PMID: 20157465 4. Am J Emerg Med PMID: 19041528 5. Intraosseous versus central venous catheter utilization and performance during inpatient medical emergencies.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

PEMBlog

MAY 24, 2023

Emerg Med Clin North Am. 2009 Nov;27(4):655-67, ix. Structured team approach to the agitated patient in the emergency department. Emerg Med Australas. 2009 Jun;21(3):196-202. Alice Kuo and Ilene Claudius Podcast EIIC: Safe Control of the Agitated Patient Webinar Series with Dr. Coburn VA, Mycyk MB.

Emergency Department 59

Emergency Department Pediatrics Psychiatric Administration 59

RebelEM

MARCH 8, 2023

Emergency Department Management: Emergency ophthalmology consultation. Emergency surgical management indicated if concomitant retinal tear, vitreous hemorrhage, or retinal detachment. Symptom characteristics ( Hollands 2009 ) Any flashers/floaters: (+) LR 1.2 and (–) LR 0.9. >10 floaters, (+) LR 8.1-36

Stroke 52

Stroke Emergency Department Ultrasounds Outcomes 52

RebelEM

FEBRUARY 5, 2024

Sites: Investigators recruited patients at 31 French emergency departments at university and nonuniversity hospitals Duration : June 1, 2009 to March 31, 2015. Recruitment from only emergency departments may not represent the broader clinical context.

Outcomes 105

Outcomes Hospitals Research Emergency Department 105

Pediatric Emergency Playbook

MARCH 1, 2018

2009; 123(3):841-8 Herman M, Le A. Emerg Med Clin North Am. Pediatric Opthalmology in the Emergency Department. The crying infant: diagnostic testing and frequency of serious underlying disease. Pediatrics. The crying infant. 2007 Nov;25(4):1137-59. The infant with acute, unexplained, excessive crying. Pediatrics.

Pediatrics 52

Pediatrics Emergency Department 52

Cook County EM Blog

MAY 1, 2023

The Case: A 56-year-old male with no significant past medical history presents to the emergency department with worsening swelling, pain, and erythema of the right elbow. Patient Course: In the emergency department, the patient received lab work that was remarkable for WBC 11.8, 2009 Jun 25. J Emerg Med.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Outcomes 52

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. 2009 Jan;11(1):66-72. Fever was documented to be 102°F and was not associated with any chills or rigors. Infect Dis Clin North Am. 2007 Dec;21(4):997-1011, ix. doi: 10.1016/j.idc.2007.08.002.

Academics 64

Academics Documentation/Coding Emergency Department Hospitals 64

The Skeptics' Guide to EM

JULY 29, 2023

Another core element of emergency department (ED) and pre-hospital care is the assessment for potential spinal injuries [1,2]. Clinical Question: How has the rate of pre-hospital spinal immobilization/spinal motion restriction changed from 2009 to 2020? We have also covered concussions ( SGEM#112 , SGEM#331 , and SGEM#362 ).

Head Injuries 75

Head Injuries EMS Research Emergency Department 75

EMDocs

SEPTEMBER 7, 2023

2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergency department. Fatal Poisoning Among Young Children from Diethylene Glycol-Contaminated Acetaminophen — Nigeria, 2008—2009”. 6, 8 July 2009, pp. References: Abubukar et al.

Poisoning 66

Poisoning CDC Administration Emergency Department 66

EB Medicine

DECEMBER 1, 2018

Jeff: In fact, a meta-analysis on vaccine effectiveness from 2004-2015 found that the pooled effectiveness against influenza B was 54%, against the H1N1 pandemic in 2009 was 61%, and against the H3N2 virus was 33%. J: So that wraps up episode 23 - Influenza: Diagnosis and Management in the Emergency Department.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

EMDocs

JULY 9, 2024

The emergency department takes care of some of the highest risk patients with the worst access to health care and social services Over the past 20 years, many researchers have created and validated social needs screeners Some examples: iHELP, WE CARE, SEEK, USDA 2-item food insecurity questionnaire Does screening make a difference?

Pediatrics 55

Pediatrics Emergency Department Research Burns 55

ACEP Now

OCTOBER 15, 2023

In 2009, a consensus statement from the American Diabetes Association (ADA) discussed using a low-dose infusion (0.1 1 Additionally, the consensus statement discussed the emerging use of subcutaneous insulin to treat DKA. However, as with many treatments, there has been substantial de-escalation in intensity of therapy over time.

Hospitals 80

Hospitals Operations Emergency Department Research 80

EMDocs

MAY 26, 2023

Emerg Med Clin North Am. 2009 Nov;27(4):655-67, ix. Emerg Med Clin North Am. 2009 Nov;27(4):655-67, ix. Structured team approach to the agitated patient in the emergency department. Emerg Med Australas. 2009 Jun;21(3):196-202. Deaths due to physical restraint. Dtsch Arztebl Int. PMC3272587.

Pediatrics 77

Pediatrics Emergency Department Psychiatric Documentation/Coding 77

Taming the SRU

NOVEMBER 14, 2023

Chief complaints involving the ear are a common occurrence in Emergency Departments across the US and include presenting symptoms such as ear pain or fullness, hearing loss, redness, trauma, vertigo, and foreign bodies. A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6

Emergency Department 92

Emergency Department Pediatrics Wellness Documentation/Coding 92

RebelEM

FEBRUARY 22, 2023

difficult to see due to corneal edema) Emergency Department Management All patients should get emergency ophthalmologic consultation Start with eye drops (see table below) and add systemic medications if severe or refractory symptoms/IOP. Decreased visual acuity, Cup to disc ratio >0.6 Cup to disc ratio >0.6

Emergency Department 52

Emergency Department EMS Wellness 52

PEMBlog

MAY 11, 2023

There is inconclusive evidence that it’s better than placebo for IVs too – it may help… ( see Auerbach, 2009 ). Acad Emerg Med, 2017 This was a single-center (one academic Pediatric Emergency Department) randomized double-blind trial of J-Tip versus EMLA – topical anesthetic (TA) cream for pain relief in 66 infant LPs.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department Outcomes 52

ACEP Now

SEPTEMBER 5, 2024

While some issues are handled locally, many issues cannot be solved in our emergency department or hospital. As a community “pit doctor,” I believe I have a good understanding of the needs of emergency physicians. We must have a community of like-minded individuals working towards shared goals.

Leadership 98

Leadership PPE EMS Wellness 98

Dr. Smith's ECG Blog

JANUARY 1, 2024

AslangerE A 65-year-old gentleman presented to the emergency department after experiencing two recent ICD shocks in the preceding hours. This was contributed by Co-editor Emre Aslanger, an interventional cardiologist in Turkey.

EKG/ECG 102

EKG/ECG Shock Administration Emergency Department 102

ACEP Now

FEBRUARY 11, 2024

A 95-year-old female with a history of stage III chronic kidney disease (CKD), heart failure with reduced ejection fraction (HFrEF), and dementia with baseline orientation only to person and place, presented to the emergency department (ED) for upper extremity myoclonic jerking for one day. Published April 12, 2021.

Emergency Department 52

Emergency Department CDC Hospitals EMS 52

EM Curious

JULY 24, 2015

A Comparison of Ultrasound-guided Three-in-one Femoral Nerve Block Versus Parenteral Opioids Alone for Analgesia in Emergency Department Patients With Hip Fractures: A Randomized Controlled Trial. Academic Emergency Medicine, 20(6), 584–591. Impact of ultrasound-guided femoral nerve blocks in the pediatric emergency department.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

The Skeptics' Guide to EM

OCTOBER 7, 2017

Steve is currently an Assistant Professor in the Department of Family Medicine at Western University working at the Fowler Clinic and the Roth McFarlane Hand and Upper Limb Centre. Case: A 43-year-old male presents to your local rural emergency department Monday morning after rolling his ankle during his usual weekend pickup basketball game.

Urgent Care 40

Urgent Care Emergency Department Fractures Wellness 40

Don't Forget the Bubbles

JULY 22, 2024

The most recent meta-analysis , published in 2016 (comparing eleven studies from 1986 to 2009), struggled to reach a consensus because the trials were too heterogeneous to make robust conclusions. Annals of Emergency Medicine. 2009 Jan 22;360(4):329–38. So, an up-to-date, high-quality meta-analysis iss much needed. N Engl J Med.

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. Point-of-Care Ultrasound on Management of Cellulitis Versus Local Angioedema in the Pediatric Emergency Department. Pediatr Emerg Care. J Emerg Med.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

The Skeptics' Guide to EM

FEBRUARY 10, 2018

Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. Case: Tom is a 4-year-old boy who comes into the emergency department with a wheeze following a viral illness. Meredith is also the director of a tertiary hospital paediatric emergency department.

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

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. Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 23, Issue 4, 2009. PMID: 34146921. 6 – Emma Kirk, Tom Bourne.

Ultrasounds 97

Ultrasounds Operations Radiology Radiology 97

PEMBlog

JULY 17, 2023

Gastrostomy Tube-Related Complaints in the Pediatric Emergency Department.” Pediatric Emergency Care, vol. 11, 2009, pp. The American Journal of Emergency Medicine, vol. Emergency Department Visits and Readmissions among Children after Gastrostomy Tube Placement.” New England Journal of Medicine, vol.

Pediatrics 52

Pediatrics Emergency Department Hospitals 52