EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Providers should respect and utilize this mode of communication, as well as document the patient’s request for a non-certified interpreter.

Documentation/Coding 100

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 100

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. 2012): 2470-2478.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

RebelEM

FEBRUARY 24, 2025

RESUS SCENARIO Picture this: you just arrived at your shift at the local emergency department. Well, the established cutoff for the distensibility index is 18%. Oct 2012; PMID: 23043910 Kumar A, et al. For more than just the correctness of terminology, the distensibility index should then be calculated.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. Tilly is normally fit and well, with no significant past medical history. Pediatrics, 2012. by her father. Bachur, R.G.,

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

EMDocs

DECEMBER 11, 2023

In October 2022, the American College of Cardiology released an updated expert consensus decision regarding the evaluation of chest pain in the emergency department. This included the addition several new STEMI equivalents [4] on ECG that warrant “prompt evaluation for emergency coronary angiography.” Ann Emerg Med.

EKG/ECG 119

EKG/ECG Emergency Department Academics Operations 119

SheMD

OCTOBER 15, 2023

Yes, I am a woman, yes I am a feminist, yes I am a physician, yes I am in academic leadership for a well-known emergency department… The yes’s are many, but what do I have to say that is so meaningful or useful that people would want to publish it? Well first of all, I didn’t do it in my 20’s, and I didn’t do it in residency.

Emergency Department 52

Emergency Department EMS Leadership Academics 52

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4. Crit Care Med.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

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. 2012 Feb;26(2):212-7. American Academy of Ophthalmology. 2023, March 23).

Emergency Department 64

Emergency Department Academics Fractures Hospitals 64

ALiEM

OCTOBER 16, 2023

An otherwise healthy 34-year-old male presented to the Emergency Department with two weeks of anterior neck pain. Additional Images Physical Exam Vitals : BP 115/80; HR 120; T 101°F; RR 16; O2 sat 97% General : Well appearing in no acute distress HEENT : Poor dentition, mild trismus. 2012 Oct;12(10):808-15.

Academics 60

Academics Wellness Emergency Department Hospitals 60

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. Point-of-care ultrasound may show well-demarcated, round, and hypoechoic material in the stomach and first part of the duodenum, though it can underestimate the number of beads present. Mirza and Sheikh reported perhaps the first unfortunate case in 2012.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. Nachi: This month’s team parsed through roughly 1200 articles as well as guidelines from the eastern association for surgery in trauma also known as EAST.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EMDocs

JULY 25, 2024

Do them well and document the process, preferably at the bedside. Literature-based Recommendations for Suicide Assessment in the Emergency Department: A Review. Oct 04, 2012. Assure and document the patient’s resources and safety net if discharged. Handoffs are a high-risk exchange. Applebaum PS. Ronquillo L et al.

Documentation/Coding 100

Documentation/Coding Hospitals Patient Safety Emergency Department 100

Don't Forget the Bubbles

OCTOBER 10, 2024

Adopting this approach would reduce time in surgery for the child as well as the financial cost of nail bed repair. Exploring communication preferences and risk thresholds of clinicians and parents of febrile infants under 90 days presenting to the emergency department: a qualitative study. Arch Dis Child. Epub ahead of print.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

Taming the SRU

FEBRUARY 5, 2024

Traumatic brain injury (TBI) accounts for millions of Emergency Department visits annually. While moderate and severe TBI is often managed on an inpatient basis, patients presenting with mild TBI, or concussion, are often managed solely by Emergency physicians.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

Northwestern EM Blog

SEPTEMBER 26, 2022

Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The Emergency Department is a challenging work environment for a variety of reasons.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

PHEM Cast

MARCH 17, 2016

Taken from Weingart & Levitan 2012. Annals of Emergency Medicine. 2012; 59(3): 165-175. Annals of Emergency Medicine. Preoxygenation, reoxygenation, and delayed sequence intubation in the Emergency Department. The Journal of Emergency Medicine. 2014; 65(4): 349-355. Weingart SD.

Airway Management 52

Airway Management Burns Emergency Department Resuscitation 52

ALiEM

OCTOBER 20, 2023

A 50-year-old Caucasian female with a history of hypertension, coronary artery disease, and insulin-dependent diabetes mellitus presents to the emergency department with a complaint of painful sores on the top of her left foot. 2012 Jul;16(4):614-20. Additional Images Physical Exam Vitals : T 37.2°C; Indian J Endocrinol Metab.

Academics 64

Academics Emergency Department Wellness Research 64

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

Emlyn’s blog and podcast since 2012. Case: You are working the afternoon shift in the paediatric emergency department. Your shift is almost over and the department finally seems to be under control. She is a medical education enthusiast and has been an editor and regular contributor to the St.

Pediatrics 52

Pediatrics Emergency Department Sepsis Wellness 52

ACEP Now

FEBRUARY 13, 2024

A 77-year-old man presented to the emergency department (ED) with hip pain following a fall. See below: Fascia iliaca Serratus anterior Erector spinae The risks of opioid medications, especially in the elderly, has been well described. Trends in opioid prescriptions among part D medicare recipients from 2007 to 2012.

Ultrasounds 52

Ultrasounds Emergency Department Hospitals Wellness 52

The Skeptics' Guide to EM

DECEMBER 12, 2020

Case: A 52-year-old previously healthy woman presents to your emergency department (ED) with an abscess on her left forearm. She is systemically well and there is no sign of tracking, so you decide to perform incision and drainage in the ED. Kirsty is also the creator of the wonderful infographics called #PaperinaPic.

Operations 52

Operations Outcomes Academics Research 52

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. Lee HC et al.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

The Skeptics' Guide to EM

OCTOBER 3, 2020

Date: October 2nd, 2020 Guest Skeptic: Dr.Barbra Backus is an emergency physician at the Emergency Department of the Erasmus University Medical Center in Rotterdam, the Netherlands. The effect of the combination of ticagrelor and aspirin on prevention of stroke has not been well studied.

Stroke 40

Stroke Emergency Department Research Wellness 40

EMDocs

SEPTEMBER 23, 2023

Physical exam reveals a well-appearing female in no acute distress. A 23-year-old man with no significant medical history presents to the emergency department for evaluation of a syncopal episode. 2012 May;9(5):752-9. The patient states that this has never happened before. Neurological exam is also unremarkable.

EMS 102

EMS EKG/ECG Documentation/Coding Emergency Department 102

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. Tikkanen, J. Wellens, H., &

EKG/ECG 132

EKG/ECG Documentation/Coding Wellness Emergency Department 132

Taming the SRU

MARCH 14, 2023

Case 1 Fussy 1 month old A 1-month-old (ex-34 week premature) infant comes to your emergency department for fussiness. He appears well and is triaged to an ESI 4. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

The Skeptics' Guide to EM

MARCH 10, 2018

She has epistaxis that has not resolved despite twenty minutes of well applied anterior pressure. The American College of Chest Physicians published some evidence-based recommendations in 2012 on anticoagulation therapy [1]. We will put a link in the show notes to the protocol. Reference: Zahed et al.

Blood Transfusions 40

Blood Transfusions Emergency Department Shock Hospitals 40

Pediatric Emergency Playbook

DECEMBER 1, 2016

If the otherwise healthy child one month and older is: Euvolemic Not hypoxic Well appearing He can likely go home. The short answer is that the American Academy of Pediatrics, the UK’s National Institute for Health and Care Excellence, as well as the Canadian Pediatric Society currently recommend against them. 2012 Mar;129(3):e605-10.

Pediatrics 40

Pediatrics Emergency Department Hospitals Wellness 40

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

Pediatric Emergency Playbook

APRIL 1, 2016

Brain natriuretic peptide (BNP) In adults, we typically think of a BNP Luckily, we have data in children with congenital heart disease as well. used BNP in the emergency department to differentiate heart failure from respiratory causes in infants and children with heart failure and those with no past medical history.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

PEMBlog

MAY 11, 2023

Injectable lidocaine, when done well, is reliable – but it can take years to master the ideal technique that doesn’t create a giant mound of subcutaneous lidocaine that can impact needle entry and landmarks. Pediatr Emerg Care. 2012 Jul;28(7):687-90. Acad Emerg Med. doi: 10.1097/PEC.0b013e31825d210b.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department Academics 52

EM Guide Wire

NOVEMBER 2, 2020

Nebulized Mg sulfate treatment shows no significant effect on respiratory function or hospital admission High-Dose Magnesium Sulfate Infusion for Severe Asthma in the Emergency Department Efficacy Study All patients of 6–16 years old who failed to improve after 2 hours of standard therapy for asthma. 2015;169(2):186-188.

Pediatrics 52

Pediatrics Anaphylaxis Emergency Department Administration 52

Sensible Medicine

SEPTEMBER 29, 2023

The promise is that well-constructed and validated prediction models will lead to diseases being diagnosed earlier and treatment for the right patients, in the right place, at the right time. In some cases, models that appear to perform well may pose risks to patients if used to make clinical decisions. 2012 05;9(5):1-13. [5]

Research 60

Research Hospitals Academics Emergency Department 60

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

If you think your patient is the perpetrator, he may well be an innocent, or even an off-duty or undercover officer. Ballistic injuries in the emergency department. Emergency medicine practice, 13(12), 1-30. 8, 2012 12:12 a.m. Do not compromise your care. Gustafson, C. G., & Visintainer, C. By John Fund.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

We can use intranasal drugs for analgesia, for anxiolysis, for seizures – but not all drugs used for those purposes will perform well – or at all – via the IN route. 2012 Jul-Aug;8(4):237-41. Intranasal sufentanil provides adequate analgesia for emergency department patients with extremity injuries. J Opioid Manag.

Administration 40

Administration Seizures Emergency Department Ultrasounds 40

Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Taming the SRU

APRIL 10, 2023

HOSPITAL COURSE The patient was initially found to be hypotensive in the Emergency Department with a blood pressure of 87/58 mmHg. She received 2 mg intranasal Narcan from paramedics with improvement in respiratory status, but in the emergency department (ED) she remains somnolent and is unable to provide further history.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Administration Emergency Department 52