Pediatric EM Morsels

JULY 21, 2023

Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. 2011 Apr;48(4):331-2. J Surg Res. 2019 Sep;241:112-118. doi: 10.1016/j.jss.2019.03.038. 2019.03.038. Epub 2019 Apr 22. PMID: 31022676. Gill MR, Reiley DG, Green SM. 2004;43:215-223. Rowley G, Fielding K. 1991;337:535-538.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Taming the SRU

JULY 2, 2023

End-Tidal CO2 monitoring has a variety of uses in the Emergency Department. Capnography in the emergency department: a review of uses, waveforms, and limitations." The Journal of emergency medicine 53.6 2011): 544-549. 2011): 189-196. Annals of emergency medicine 63.2 2017): 829-842.

Emergency Department 88

Emergency Department Pediatrics CPR Administration 88

EMDocs

AUGUST 3, 2024

Source Serious outcomes among emergency department patients with presyncope: A systematic review. Acad Emerg Med. Source Trends in Initial Anticoagulation Among US Patients Hospitalized With Acute Pulmonary Embolism 2011-2020. Ann Emerg Med. 2024 Jun 9. doi: 10.1111/acem.14943. Online ahead of print. 2024.05.009.

Emergency Department 75

Emergency Department Outcomes Hospitals 75

Emergency Medicine Journal

JANUARY 22, 2024

We assessed safety and efficacy data from 10 years (2011–2021) of our N 2 O PPS programme. Methods Prospectively collected data from a sedation registry at a paediatric emergency department (PED) were reviewed. Analgesic potency could be increased by combining N 2 O and intranasal fentanyl (INF).

Emergency Department 40

Emergency Department Outcomes 40

The Skeptics' Guide to EM

OCTOBER 14, 2023

Case: A 5-year-old boy presents to the emergency department (ED) with his parents for fever and fatigue. That episode reviewed the 2011 Fleming et al systematic review for the normal ranges of HR and RR in children from birth to 18 years of age. He has had three days of high fevers at home. Does he have sepsis?”

Pediatrics 87

Pediatrics Sepsis Urgent Care Emergency Department 87

RebelEM

FEBRUARY 12, 2024

There are greater than 2 million annual emergency department visits for suspected renal colic in the US, and Ct scanning is performed for more than 90% of patients who receive a diagnosis of kidney stone. 2011; 18(7):699-707. What Your Gut Says: We need a CT report to diagnose a kidney stone. 2002; 225(2):441-449.

Radiology 84

Radiology Radiology Emergency Department Ultrasounds 84

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. 2011 Oct 18;183(15):E1152. Epub 2011 Sep 12. Fever was documented to be 102°F and was not associated with any chills or rigors. Curr Infect Dis Rep. 2009 Jan;11(1):66-72.

Documentation/Coding 64

Documentation/Coding Academics Emergency Department Hospitals 64

Taming the SRU

SEPTEMBER 25, 2023

Musculoskeletal injuries are a common occurrence, representing a substantial number of Emergency Department visits on an annual basis. 1) Oftentimes, Emergency Physicians are the first provider patients encounter after an injury. 2011 Jan-Feb;50(1):62-7. References 1. J Am Acad Orthop Surg Glob Res Rev. J Foot Ankle Surg.

Fractures 101

Fractures Operations Emergency Department EMS 101

RebelEM

SEPTEMBER 13, 2023

patients that take ACE inhibitors (but 20-30% of all angioedema presentations to the Emergency Department) 3 times more common in Black Americans ( Kostis 2005 ) 0.01 Angioedema in the Emergency Department: An Evidence Based Review. Emergency Medicine Practice. of people who take NSAIDs ( Nzeako 2010 ).

Allergic Reactions 105

Allergic Reactions Airway Management Anaphylaxis Emergency Department 105

The Skeptics' Guide to EM

JANUARY 20, 2024

Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University School of Medicine and Health Sciences. Case: A 4-year-old girl comes to the emergency department complaining of pain with urination.

Pediatrics 71

Pediatrics Anaphylaxis Emergency Department Outcomes 71

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). Ann Emerg Med. PMID 33392580. PMID 33392580.

Emergency Department 98

Emergency Department Hospitals Outcomes EMS 98

PulmCCM

JUNE 12, 2023

Temperature management (or fever avoidance) should begin immediately after cardiac arrest (ideally in the emergency department, for out-of-hospital arrests) and continued for at least 72 hours.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

Greater Sydney Area HEMS

FEBRUARY 20, 2024

It is currently the subject of future research and publication in the emergency department setting. 2011; 106 : 732–737. [iv] At the very least, knowledge of it as an option in the armamentarium of retrieval and critical care providers is important. i] Leibowitz A, Oren-Grinberg A, Matyal R. The Lancet.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

Taming the SRU

FEBRUARY 12, 2024

HISTORY OF PRESENT ILLNESS A female in her 30s arrives to the emergency department via emergency medical services. She arrives in the emergency department agitated and unable to answer questions appropriately. The patient is agitated on a backboard with C-collar in place. N Engl J Med. Sep 8; 365(10): 883-91.

Administration 79

Administration Fractures Anaphylaxis Head Injuries 79

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. Epub 2011 Dec 2. Endophthalmitis following open-globe injuries. Eye (Lond).

Emergency Department 64

Emergency Department Academics Hospitals Fractures 64

ALiEM

AUGUST 28, 2023

A 44-year-old female presented to the emergency department with the complaint of a “stone under [her] tongue.” Larger, more superficial sialoliths may benefit from excision in the emergency department. The emergency physician made a single 1 cm incision over the calculus and a 0.5 2011 Dec;145(6):935-9.

Dehydration 52

Dehydration Emergency Department Academics Hospitals 52

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? An implementation science approach improves language access in the emergency department. February 2011. Department of Health and Human Services. Annals of Emergency Medicine. Pediatric Emergency Care. Pediatric Emergency Care.

Documentation/Coding 82

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 82

PHEM Cast

DECEMBER 12, 2016

Emergency thoracotomy in thoracic trauma: a review. Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. World Journal of Emergency Surgery; 2006: 1:4. Survival after Emergency Department thoracotomy: review of published data for last 25 years.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

Dr. Smith's ECG Blog

MAY 20, 2024

Diagnosis of Type I vs. Type II Myocardial Infarction in Emergency Department patients with Ischemic Symptoms (abstract 102). Annals of Emergency Medicine 2011; Suppl 58(4): S211. The only study I'm aware of that looked at this was mine, in which 4% of Type II MI had New ST Elevation. Murakami MM.

EKG/ECG 129

EKG/ECG Hospitals Wellness Emergency Department 129

EMDocs

JUNE 13, 2024

References : “Sign Right Here and You’re Good to Go”: A Content Analysis of Audiotaped Emergency Department Discharge Instructions. EM, April 2011. A record that the patient acknowledged receipt of discharge instructions is a valuable defense. Vashi A, Rhodes K. emDOCs Podcast – C. Medscape eMedicine.

Documentation/Coding 77

Documentation/Coding Patient Safety Emergency Department Hospitals 77

ALiEM

DECEMBER 20, 2024

Eczema herpeticum: making the diagnosis in the emergency department. J Emerg Med. 2011 Feb;40(2):167-9. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. 2007.11.049.

Infectious Diseases 52

Infectious Diseases Pediatrics Academics Emergency Department 52

Don't Forget the Bubbles

AUGUST 7, 2023

The controversy around what is ‘normal’ in infants’ and children’s vitals was demonstrated in a 2011 systematic review by Fleming et al. Evaluating the Pediatric Early Warning Score (PEWS) System for Admitted Patients in the Pediatric Emergency Department. Acad Emerg Med. What did previous studies show? Pediatrics.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

ACEP Now

JANUARY 13, 2024

As a member of the Air Force, deployed to Afghanistan in 2011, I have seen war where I should have seen it—in a designated war zone. As an emergency medicine resident, I have seen the toll that workplace violence is taking on our specialty, our patients, and our entire medical community. Ann Emerg Med , 2021;78(4):S8.

Emergency Department 52

Emergency Department Resuscitation Patient Safety Hospitals 52

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 93

Emergency Department Pediatrics Wellness Documentation/Coding 93

Don't Forget the Bubbles

MAY 29, 2023

Bad manners in the Emergency Department: Incivility among doctors. Burnout and Workplace Incivility Among Emergency Medical Services Practitioners: A Preliminary Report , Prehospital Emergency Care [Internet] 2023 Okuyama A, Wagner C, Bijnen B. Internet] 2011:41(1):41-47. BMJ Open [Internet] 2020;10: e035471.

Leadership 98

Leadership Patient Safety Academics Research 98

Don't Forget the Bubbles

MAY 24, 2023

Airway complications are also more likely to occur in the emergency department (ED) than in the operating theatre. 2011 May;106(5):617–31 Cook TM. Intubation of the Critically Unwell Child in the Emergency Department. difficult intubations in neonates and infants. Around two-thirds of these were unanticipated.

Airway Management 98

Airway Management Teamwork Pediatrics Emergency Department 98

The Skeptics' Guide to EM

JULY 17, 2021

Case: Six-year-old Morten comes into your emergency department (ED) with what looks like pneumonia. This is because most pneumonias in this age-group are caused by viral pathogens ( Bradley et al 2011 ). Bradley et al 2011 ). He is the co-founder of website lead of Don’t Forget the Bubbles ( DFTB ).

Pediatrics 52

Pediatrics Emergency Department Wellness 52

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. His work of breathing increased during his emergency department visit, and he was started on high flow nasal cannula at 30 L/min with improvement in his respiratory status.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Taming the SRU

AUGUST 30, 2023

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. 2011 Jan;3(1):118-27. In 7 studies with 4164 patients, PCT with a cut-off > 0.1 ng/mL, 0.25-0.5

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

The Skeptics' Guide to EM

NOVEMBER 1, 2022

AEM October 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called First10EM.com Case: A 19-year-old man presents to the emergency department (ED) with his first time anterior should dislocation after trying to recreate one of his favourite scenes in the movie Lethal Weapon.

Dislocations 47

Dislocations Ultrasounds Emergency Department 47

The Skeptics' Guide to EM

FEBRUARY 13, 2021

Pediatrics 2020 Case: A 4-year-old immunized girl presents to the emergency department (ED) with a fever and rhinorrhea for the […] The post SGEM#319: Is it Aseptic Meningitis or More Than This? first appeared on The Skeptics Guide to Emergency Medicine. Reference: Mintegi S et al. Reference: Mintegi S et al.

Pediatrics 52

Pediatrics Emergency Department Hospitals 52

EMDocs

SEPTEMBER 9, 2023

2021.0052 Emergency Department Management of Extensor Tendon Lacerations – Page 3 of 4. Ann Emerg Med. Emergency Medicine Residents’ Association; 2022:10-11. Extensor tendon repair in the emergency department. J Emerg Med. Emergency Orthopedics. Medicine (Baltimore). 2019;98(44):e17823.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

Taming the SRU

JANUARY 29, 2024

She was concerned that this was not improving and decided to come to the emergency department (ED). Hospital Course The patient was initiated on a therapeutic heparin drip in the emergency department with vascular surgery consultation. 2011 Dec;77(12):1606-12. She had not had any blood clots previously.

Emergency Department 93

Emergency Department Fractures Hospitals Operations 93

The Skeptics' Guide to EM

JUNE 14, 2017

It has been said that it can take 17 years for 14% of research to reach the patients’ bedside ( Morris et al 2011 ). Talk I: Knowledge Translation in the Digital Age The first talk was on knowledge translation (KT) in the digital age. A number of examples of the KT problem were provided.

Emergency Department 52

Emergency Department Research 52

The Skeptics' Guide to EM

SEPTEMBER 12, 2020

Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. It was an opportunity to share my journey and give an important message about kindness. Shanafelt et al. Mayo Clin Proc 2015 * Shanafelt et al.

Emergency Department 52

Emergency Department Wellness 52

ALiEM

MARCH 7, 2024

Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). Point-of-care ultrasound for the detection of hydronephrosis in emergency department patients with suspected renal colic.

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). 2011 Apr 1;78(2):202-9. The junior staff member remains silent throughout the debrief and does not attend their shift the following day.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105