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

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.

Documentation/Coding 64

Documentation/Coding Academics Emergency Department Hospitals 64

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 86

Ultrasounds Emergency Department Pediatrics Radiology 86

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 65

Poisoning CDC Administration Emergency Department 65

ALiEM

OCTOBER 2, 2023

A 6-year-old male presented to the pediatric emergency department (PED) for scalp lesions. Epub 2009 Aug 11. Pediatr Emerg Care. He was seen by his pediatrician 2 weeks prior and prescribed antibiotics and a delousing shampoo for suspected cellulitis versus lice infestation. cm in the long axis diameter.” J Laryngol Otol.

Ultrasounds 75

Ultrasounds Pediatrics Academics Emergency Department 75

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 81

Head Injuries EMS Research Emergency Department 81

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

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 95

CDC Hospitals EMS Emergency Department 95

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

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 102

Resuscitation Administration Emergency Department Hospitals 102

Taming the SRU

MAY 27, 2024

Shortness of breath is one of the most common complaints presenting to emergency departments. A less common but more emergent scenario is the presentation of a patient to the emergency department with a large pleural effusion causing hypoxia and respiratory distress. 2009 Mar;26(1):82-5. Staes W, Funaki B.

Emergency Department 80

Emergency Department Ultrasounds Radiology Radiology 80

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 81

Emergency Department Hospitals Outcomes EMS 81

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

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

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 77

Infectious Diseases Fractures Radiology Radiology 77

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

PHEM Cast

MARCH 3, 2019

Emergency Medicine Journal. Ketamine-propofol combination (ketofol) versus propofol alone for emergency department procedural sedation and analgesia: a randomized double-blind trial. Ann Emerg Med. Emerg Med J. Ketamine for paediatric sedation/analgesia in the emergency department. Emerg Med J.

Emergency Department 52

Emergency Department Head Injuries Hospitals Pediatrics 52

The Skeptics' Guide to EM

APRIL 16, 2022

Case: A 55-year-old man comes into the emergency department (ED) for increasing knee pain and decrease in function. Background: Musculoskeletal complaints are one of the most common presentations to emergency departments. JAMA Feb 2009 looked at the ACC/AHA guidelines from 1984 to 2008. Tricoci et al.

Military 40

Military Operations Emergency Department Pediatrics 40

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 86

Emergency Department Pediatrics Wellness Documentation/Coding 86

The Skeptics' Guide to EM

JULY 9, 2022

Great emergency care takes a team from the prehospital setting, emergency department, inpatient and outpatient all working together. They published their findings in Annals of EM 2009. While this is true, we are part of the team that diagnose and treat acute stroke patients. Any brief comments on this reanalysis?

Stroke 52

Stroke Emergency Department EMS Outcomes 52

PEMBlog

OCTOBER 18, 2023

Initially in the emergency department he was generally well-appearing with normal vital signs. Clinical features of neonatal toxic shock syndrome-like exanthematous disease emerging in Japan. There were no measured fevers at home or known sick contacts. No medication exposures. Mom was GBS negative. link] Takahashi, N.,

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

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 52

Leadership PPE EMS Wellness 52

The Skeptics' Guide to EM

MARCH 7, 2020

Patey’s Disclaimer: I am not an expert on PPE (Personal Protective Equipment), Influenza/HINI/Coronavirus, Journal Reviews or Emergency Department management of pandemics. Patey and I) are experts on asking questions on the frontline of a Rural Emergency Department to ensure quality, and most importantly, effective patient care.

Emergency Nursing 40

Emergency Nursing PPE Emergency Department Administration 40

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

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

The Skeptics' Guide to EM

MAY 12, 2018

Case: A 24-year-old male is brought into the emergency department by police. He is brought to the emergency department extremely agitated and despite being held down by two police and three security guards he is still trying to bite the staff.

Psychiatric 52

Psychiatric Emergency Department Hospitals Wellness 52

Taming the SRU

JANUARY 1, 2024

It is a relatively new procedure first described in 2009 (13). Ann Emerg Med. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med. 2009 Sep 11;2(3):155–60. J Emerg Med. J Emerg Med. 2009 Nov;37(4):419. 2020 Aug;76(2):134–42.

Emergency Department 84

Emergency Department Ultrasounds Administration Burns 84

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Published 2009 Jun 10. Am J Emerg Med. Resuscitation.

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

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 92

Ultrasounds Operations Radiology Radiology 92

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 96

EKG/ECG Shock Administration Emergency Department 96

Dr. Smith's ECG Blog

JUNE 8, 2023

2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: A Report of the American College of Cardiology Solution Set Oversight Committee. Eur Heart J 2009 4 Lemkes et al. Kontos et al. J Am Coll Cardiol 2022 Nov 15;80(20):1925-1960 2. Welsh et al. Busk et al.

EKG/ECG 61

EKG/ECG Documentation/Coding EMS Emergency Department 61

The Skeptics' Guide to EM

DECEMBER 5, 2020

Case: A 50-year-old female presents to your community emergency department in the middle of the night with new-onset constant but mild vertigo and nausea. As an alternative diagnostic method, the HINTS exam was first established in 2009 to better differentiate central from peripheral causes of AVS [4].

Stroke 40

Stroke Documentation/Coding Emergency Department Hospitals 40

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9% Do not prepare a sterile field (but be as clean as possible). Do not transport to an alternative location.

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

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

Don't Forget the Bubbles

MAY 29, 2023

Academy of Management Learning & Education [Internet] 2009: 8:2:301–303. Emergency Medical Journal [Internet] 2022;39;52-56. Bad manners in the Emergency Department: Incivility among doctors. [Review of Cultivating Communities of Practice: A Guide to Managing Knowledge, by Wenger E, McDermott R, Snyder WM].

Leadership 97

Leadership Patient Safety Academics Research 97

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Holbrook MD September 01, 2013 Umbilical Cord Prolapse and Other Cord Emergencies Marybeth Lore, MD Complications of Labor and Delivery by Jeanie Ward Pulmonary Embolism: Evaluation in the pregnant patient. 2014) Emergency Care Institute, New South Wales. Postpartum Emergencies. 2009) Trauma in the Obstetrical Patient.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

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 Documentation/Coding Academics 52