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. 2011 Feb 15; Epub 2010 Aug 27. Paper: Owyang CG, et al. J Crit Care. N Engl J Med.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Pediatric EM Morsels

JULY 5, 2024

We collected data directly from the bedside clinician which enabled us to gather pertinent patient symptoms and physical examination findings that may not be well documented in the medical record, but more accurately identify the child’s injuries.” Ann Emerg Med. 2010; doi:10.1016/j.annemergmed.2010.08.038. 2010.08.038.

Pediatrics 164

Pediatrics Head Injuries Dislocations Research 164

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 97

EMS Psychiatric Emergency Department Poisoning 97

ACEP Now

OCTOBER 26, 2023

Using Maryland state law as a guide, the American College of Emergency Physicians (ACEP) and the Emergency Department Practice Management Association (EDPMA) lobbied for passage of federal protections beginning in the mid-1990s. 1997: Congress enacts the PLP for Medicare and Medicaid managed care plans via BBA ’97.

Documentation/Coding 124

Documentation/Coding Hospitals Emergency Department Administration 124

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 94

Emergency Department Pediatrics Wellness Fractures 94

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. 1, 2010, pp. Metabolism of DEG adapted from Bessenhofer, et al. Accessed August 2022. Besenhofer, Lauren M.,

Poisoning 92

Poisoning CDC Administration Emergency Department 92

ALiEM

OCTOBER 7, 2024

A 52-year-old female with a past medical history of hypertension and prediabetes presented to the emergency department with double vision that started one day prior to arrival. F; O2 saturation 96% on room air General : No acute distress, well-appearing Neurologic : AOx3; Following commands. 2010 Dec;14(6):502-5.

Academics 64

Academics Emergency Department Pediatrics Wellness 64

The Skeptics' Guide to EM

OCTOBER 10, 2020

Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergency department, specifically the use of ketamine. His twitter handle is @PainFreeED.

Emergency Department 52

Emergency Department Research Wellness 52

EB Medicine

SEPTEMBER 1, 2018

Jeff: Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the September 2018 issue of Emergency Medicine Practice - Emergency Department Management of North American Snake envenomations.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

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

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Jeff: Well that’s kind worrisome. Additionally, back in 2010, it was estimated that 6.6% That’s almost half of the population.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EM Curious

JULY 24, 2015

Identify the triangle shaped femoral nerve, lateral to the femoral artery, as well as the iliopsoas muscle and the fascia illiaca running over its surface. Get your tip as close as possible to the nerve, and under the fascia illiaca, then inject (well, after aspirating first, of course). Academic Emergency Medicine, 20(6), 584–591.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

RebelEM

JANUARY 23, 2023

Despite being highly effective in treating acute allergic reactions, first-generation H1 antihistamines cross the blood-brain barrier and bind to H1 receptors, which can lead to undesirable side effects, including drowsiness, sedation, fatigue, and decreased cognition (Church MK 2010). 2010 Apr;65(4):459-66. Epub 2010 Feb 8.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

Taming the SRU

OCTOBER 30, 2024

Case #2: Facial Swelling CT imaging has seen a significant increase in the last 20 years. ​ Although there has been an increase in imaging, diagnostic yield has remained relatively stable​ Factors the impact imaging decision includes reliability of the physical exam as well as extrinsic factors such as consultants and admitting services.​

Hospitals 52

Hospitals Emergency Department EKG/ECG Documentation/Coding 52

PHEM Cast

MARCH 17, 2016

video cast from Emergency Medicine colleagues in the States discussing and demonstrating techniques for optimal bag-valve-mask ventilation. Annals of Emergency Medicine. Preoxygenation, reoxygenation, and delayed sequence intubation in the Emergency Department. The Journal of Emergency Medicine. Weingart SD.

Airway Management 52

Airway Management Burns Emergency Department Resuscitation 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. A 21-year-old man presents to the emergency department for pain and swelling in his ear beginning 3 days ago. Am J Otolaryngol 2010; 31:21. Roy S, Smith LP.

EMS 104

EMS Emergency Department Pediatrics Wellness 104

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. They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. Pediatr Emerg Care. PMID: 34398861.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

EB Medicine

AUGUST 6, 2019

Nachi: Well, I’m sure more of those studies are still coming. Nachi: However, in 2010, the FDA approved the first DOAC, a real game-changer. Nachi: Well that was a ton of information and background on the DOACs. Nachi: But do note that the literature directly comparing the DOACs is far more limited and mostly of poor quality.

Emergency Department 40

Emergency Department Stroke Wellness Resuscitation 40

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). As may be seen in the table below, there are several themes as well a range of stringency. WHO - Who Needs an LP in the ED? Patients with concern for infection (i.e.,

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

EMDocs

JANUARY 4, 2024

3 Bupropion blocks the reuptake of dopamine and norepinephrine, as well as antagonizes acetylcholine at nicotinic receptors. Case Follow-up: The patient required a dose of lorazepam in the emergency department. Am J Emerg Med. 2010; 48(8):800-5 Robinson S. American Journal of Emergency Medicine.

Seizures 92

Seizures EKG/ECG Poisoning Shock 92

EMDocs

AUGUST 7, 2023

Physician gestalt and clinical decision-making tools such as the Wells’ ( [link] or Geneva ( [link] scores are helpful when assessing a patient’s pre-test probability, which is categorized as low, moderate, or high risk. Published 2010 Mar 30. Ann Emerg Med. 2010;340:c1475. 2014 Apr 23-30;311(16):1694]. doi:10.1001/jama.2014.2135

EMS 95

EMS Wellness Emergency Department 95

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Case: A 6-month-old boy presents to the emergency department (ED) with three days of worsening cough, cold symptoms, and fever. 4] This association seems to hold true in the pediatric literature as well. [5-6] Pediatric Crit Care Med. Parents note that he has been progressively more tired and difficult to arouse.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

Broome Docs

APRIL 6, 2023

PMID: 35780790 [ open access here ] Stiell IG, Clement CM, Grimshaw JM, Brison RJ, Rowe BH, Lee JS, Shah A, Brehaut J, Holroyd BR, Schull MJ, McKnight RD, Eisenhauer MA, Dreyer J, Letovsky E, Rutledge T, Macphail I, Ross S, Perry JJ, Ip U, Lesiuk H, Bennett C, Wells GA. 2010 Oct 5;182(14):1527-32. Epub 2010 Aug 23.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

RebelEM

MARCH 23, 2023

The 30-day emergency department readmission rate and all-cause 30-day readmission were significantly lower only when adjusted for propensity scores. of symptom-triggered phenobarbital versus symptom-triggered lorazepam in the emergency department (n=44). A randomized, blinded clinical trial (Hendey et al.)

Emergency Department 52

Emergency Department Burns Outcomes Hospitals 52

Don't Forget the Bubbles

MAY 6, 2024

This multicentre retrospective cohort study looked at 202 children in California aged 1- 24 months who presented acutely between 2010 and 2021. While the use of oral corticosteroids to treat wheeze in asthma is well-established, evidence for their benefit in viral-induced wheeze is mixed.

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

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. J Emerg Med. Amer J Surg.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. ng/mL, 0.25-0.5

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Dr. Smith's ECG Blog

NOVEMBER 19, 2022

Written by Bobby Nicholson MD, with edits by Meyers A woman in her 50s with past medical history of heart failure, prior stroke, atrial fibrillation on Eliquis, lung cancer in remission, and CKD, presented to the emergency department for evaluation of cough and shortness of breath. 2010 Mar-Apr;43(2):144-5. What do you think?

EKG/ECG 52

EKG/ECG Stroke Emergency Department Wellness 52

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. 2010 Apr;38(4 Suppl):S495-501.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

Northwestern EM Blog

SEPTEMBER 12, 2022

It is well known that most hospitals in large population centers already operate at or near full capacity [4]. It is important that these patients do not take up too many hospital resources or staff as they are likely well enough to survive with minimal therapeutic interventions. Grace and Rogers. What did happen? Mittman, B.

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Hazardous Materials 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

All went well. Preeclampsia/ Eclampsia - Emergency Department Resources. {3 abstracts} Luckett-Gatopoulos, S. Postpartum Emergencies. Emergency department evaluation and management of peripartum cardiomyopathy. Emergency department evaluation and management of peripartum cardiomyopathy.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

Northwestern EM Blog

JANUARY 24, 2022

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. To reverse these effects as well as refractory hypotension, hydrocortisone is the preferred agent due to both its glucocorticoid and mineralocorticoid properties. 2010; 36: 2019-2029.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

PEMBlog

JUNE 5, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

However, none of the formulas have proven to be definitively better than another and none are well correlated with outcomes or events! the QT-RR relationship exhibits substantial intersubject variability as well as a high intrasubject stability. JACC 55(9):934-947; 2010 ]. How well did the nomogram work in this derivation study?

EKG/ECG 52

EKG/ECG Outcomes Wellness Hospitals 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). While ABGs and VBGs usually correlate well, there are a few situations where this correlation is disturbed.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

Pediatric Emergency Playbook

APRIL 1, 2017

Look for a small tip diameter (to fit in the ear canal as well as the nose) and a strong “hold” (at least a 3-lb hold). Am J Emerg Med. Emergency department management of foreign bodies of the external ear canal in children. button batteries in the nose or ears).29,30 Pediatrics. 2013;132(2):275-281. doi:10.1542/peds.2013-0260.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52