RebelEM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Hospitals should focus on both systemic factors and bedside physician and/or respiratory therapist interventions to increase LPV utilization in times of ED boarding and crowding for all patients. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Taming the SRU

FEBRUARY 19, 2024

Arterial lines require specialized monitoring and nursing resources which are not available in all hospital settings. 12) Axillary While axillary arterial line placement has been uncommon, in the age of facile ultrasound operators it may become a more advantageous and accessible site particularly in patients with high BMIs. Bouadma, L.,

Shock 59

Shock Resuscitation Ultrasounds Research 59

Taming the SRU

AUGUST 30, 2023

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. This finding was not significantly different among operators with different levels of experience, or between adults and children.

Infectious Diseases 89

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

ACEP Now

AUGUST 28, 2024

John Hospital in Detroit, MI, did not resolve their concerns about working conditions, staffing levels, or patient safety. But emergency doctor Michelle Wiener, MD, president of the striking union, Greater Detroit Association of Emergency Physicians, said she quickly started to notice some changes around the hospital. Markey (D-Mass.)

Emergency Department 98

Emergency Department Hospitals Patient Safety Leadership 98

ACEP Now

SEPTEMBER 3, 2024

Hahnemann University Hospital in Philadelphia closed in 2019, a year and a half after it was acquired along with St. Christopher’s Hospital for Children by private equity (PE) firm Paladin Healthcare Capital for 170 million dollars. 14 Dr. Stinson remembers what it was like to work for a PE-owned hospital early in her career. “I

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

EMDocs

OCTOBER 17, 2023

CT is the most useful examination for patients with suspected complications of colonic diverticulitis because of its reproducibility, superior diagnostic accuracy (98%)m accuracy for alternative diagnoses with a similar presentation, risk-stratification of patients for operative versus nonoperative treatment, and inpatient versus outpatient triage.

Radiology 93

Radiology Radiology Operations Best Practices 93

RebelEM

JUNE 19, 2023

Primary Results Patients enrolled from 15 emergency medical services at 21 hospitals across 3 countries over 7 years. The study is relatively small (CRASH2 enrolled > 20,000 patients); just 1300 patients from 21 hospitals over 7 years. Lancet 2010; 376(9734): 23-32. Resides in a facility for older persons.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

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

PHEM Cast

APRIL 19, 2016

Remember this, especially when managing adolescents; children may not be as interactive or as co-operative as you would expect for their age. If the prehospital team consider the patient to be futile they will take them to the nearest local hospital. This has a huge impact on the local hospital – is that fair?

Head Injuries 52

Head Injuries Ambulance Services Hospitals Leadership 52

Advanced Emergency Nursing from AENJ

DECEMBER 18, 2014

10 Commandments of Risk Management (Camp Operations) THE "20 Commandments" of EMTALA Ten Commandments For Malpractice Depositions The Top Ten Ways to Ensure Frustration, Miscommunication, and Poor Patient Care the Next Time You Provide (or Request) a Consult [N.B. PubMed PMID: 15261366. doi:10.1016/j.jemermed.2004.05.002

Mass Casualty Incidents 40

Mass Casualty Incidents Burns Urgent Care Pediatrics 40

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Still, except for the public hospital, other hospitals did little emergency work and would have unattended first aid or treatment room in which one could meet one's physician or have an intern provide care in the meanwhile. ." Rebuilding of EDs in proximity to Radiology, Blood Bank, OR, and ICU, becoming organic to the hospital.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Advanced Emergency Nursing from AENJ

MAY 3, 2014

Review of the Wellcome Library movies on YouTube (1945) [ links below in references ] is instructive as to resuscitative methods of the 1930s and 1940s: Manual methods; gas bag or bellows operated by hand or machine; an anesthesia gas machine; or iron lung. Evaluation: Manually Operated Resuscitators (1971) Emergency Care Research Institute.

Resuscitation 40

Resuscitation Military Operations Emergency Nursing 40

PEMBlog

JUNE 5, 2024

Epub 2010 Oct 29. Or patients with a substantial head or torso injury and substantial means that they’re going to require an intervention or observation in the hospital. Any patient with a cervical spine injury or a neurologic deficit They’re getting admitted to the hospital. Ann Emerg Med. 2011 Aug;58(2):145-55.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

It wrongly frightened some medical personnel as it was operated by a 50 psi wall source or from a step-down regulator from a tank (some thought the patient received wall 50 psi or 1500 psig from the tank directly to the lung. It was extremely well-liked by field personnel, but virtually unknown in hospitals. Pulmotor is 1907.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

Prevention of torsade depointes in hospital settings: a scientific statement from the American HeartAssociation and the American College of Cardiology Foundation. In addition, the QT can be volatile especially in ill hospitalized patients and some recommend continuous monitoring of the QTc for those at high risk. Drew BJ, et al.

EKG/ECG 52

EKG/ECG Outcomes Wellness Hospitals 52

Advanced Emergency Nursing from AENJ

MAY 27, 2014

It necessitated either switching cylinders from an oxygen device or having extra equipment; but when used outside a hospital was administered with an inhalator or resuscitator by rescue crews or in industrial or electrical, gas, or mining environments. The Therapeutic Use of Carbon Dioxid After Anesthesia and Operation. Henderson , Y.,

Resuscitation 40

Resuscitation Poisoning Research Administration 40

Pediatric Emergency Playbook

APRIL 1, 2017

16 found that of 142 patients evaluated at a single site university hospital, 61 had a foreign body. Steady the operating hand by placing your hypothenar eminence on the child’s zygoma or temporal scalp, to avoid jutting the instrument into the ear canal with sudden movement. Broncoscopy! Cohen et al.16 Pediatrics. 2013;132(2):275-281.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. From 2010 to 2011, the number of ED visits by children aged 12 to 17 years old due to synthetic cannabinoid use also has doubled. Counsel them on drug abuse also.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

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. Urgent senior review, decision making and operation 31.3%

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

EMDocs

NOVEMBER 4, 2024

Bhana, MD (EM Resident Physician, University of Massachusetts/UMass Chan Medical School); Clarence Kong, MD (Pain Fellow, Eastern Virginia Medical School – Virginia Health Sciences at Old Dominion University); Mani Hashemi, MD (EM Attending, HCA Florida Mercy Hospital); S.M. References: Chang HY, Daubresse M, Kruszewski SP, Alexander GC.

Emergency Department 106

Emergency Department Fractures Burns EMS 106

Pediatric Emergency Playbook

JANUARY 1, 2017

Assessing and managing children’s pain can be challenging, because they may not exhibit typically recognized signs and symptoms ( Srouji 2010 ). Neonatal observational scales have been validated in the intensive care and post-operative settings; ED-specific quantitative scales are lacking. Knowing the context of the episode may help.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Dr. Smith's ECG Blog

APRIL 8, 2015

in 2010 EM Clinics of North America (full text link) For an Exhaustive Review of Syncope and its full management outside the ED environment, go to the 2009 European Society of Cardiology Guidelines (full text pdf). Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to general hospital: the EGSYS score.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

Mind The Bleep

JANUARY 24, 2025

Pre-hospital management including intubation, IV fluids, cardiac monitoring, analgesia etc. Brachial Artery Injuries Operative Management and Predictors of Outcome. First aid such as irrigation, tourniquet use, reduction and splinting of fractures/dislocations. Annals of surgery. The effects of smoking on the wound healing process.

Dislocations 52

Dislocations Fractures Soft Tissue Injuries Infectious Diseases 52

Pediatric EM Morsels

MARCH 7, 2025

Tranexamic Acid Use in United States Children’s Hospitals. of IV form TXA [O’Neill 2020] Inexpensive ! Crit Care Explor. 2020;2(1):e0075. Published 2020 Jan 29. doi:10.1097/CCE.0000000000000075 0000000000000075 Nishijima DK, Monuteaux MC, Faraoni D, et al. J Emerg Med. 2016;50(6):868-874.e1. doi:10.1016/j.jemermed.2016.02.004

Pediatrics 231

Pediatrics Blood Transfusions Anaphylaxis Military 231

EMDocs

JANUARY 16, 2025

but PPV ranges from 25.1-39.5% years Internal validation cohort: 43,400 patients with mean age 3.7 years External validation cohort: 45,855 patients with mean age 2.6 years Best performing criteria identified by AUPRC and AUROC 4-organ-system model translated into the Phoenix Sepsis Score had best mortality prediction characteristics AUPRC of 0.23-0.38

Sepsis 94

Sepsis Pediatrics Shock Hospitals 94

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

They also proved that only expired air resuscitation guaranteed sufficient inflation volumes; that exhaled air was a suitable resuscitating gas; and that the operator would have continuous feedback from each breath. doi:10.4103/2229-5151.128014 ** Broad review of the spectrum of current out-of-hospital airway management. Deshmukh, S.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40

Mind The Bleep

SEPTEMBER 17, 2024

Epidemiology The number of animal bites presented to A&E is largely underestimated, as many who are bit don’t present to receive medical care 1 or won’t receive treatment in a hospital setting so they are not counted in the statistics for bites 2. Nevertheless, approximately 1-2% of attendances per year to A&E are from bites 3.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

Don't Forget the Bubbles

JULY 5, 2023

Afro-Caribbean patients should be screened for sickle cell before anaesthesia for possible pre-operative transfusion. GPs and local hospitals should provide easy access to medication and vaccinations to ensure good compliance. What medications would you give to control pain in hospital? What could be the differential diagnosis?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126