Don't Forget the Bubbles

NOVEMBER 29, 2023

A retrospective cohort analysis of the ED portion of the National Hospital Ambulatory Medical Care Survey from 2006 to 2009 in the US revealed that less than one-half of patients undergoing ETI in the ED received sedative drugs while in the ED. Pediatric Emergency Care 28(11): p 1129-1131, November 2012. | DOI: 10.1097/PEC.0b013e3182713316

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

EMDocs

DECEMBER 1, 2024

Treatment significantly shortens the duration of illness, and early initiation of therapy can prevent severe complications and reduce the length of hospitalization. 2012 Jun 30;43(2):175-80. However, some experts recommend doxycycline even in pregnant patients. pregnant patients). MMWR Morb Mortal Wkly Rep. 2003;52(50):1209-1211.

EMS 101

EMS Infectious Diseases Shock Airway Management 101

ETM Course

JUNE 28, 2015

Just over a year ago London HEMS performed the first pre-hospital regtrograde endovascular balloon occlusion of the aorta (REBOA). Morrison et al Aortic Balloon Occlusion Is Effective in Controlling Pelvic Hemorrhage J Surg Res 2012; 177(2): 341–7 9. J Trauma 2011; 71(3): 720–725 8. Scott et al.

Hospitals 52

Hospitals Shock Resuscitation Military 52

RebelEM

MAY 25, 2023

Lancet 2010 [10] >20,000 adult trauma patients with SBP <90mmHg Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs Placebo given within 8hrs of injury In-hospital mortality by 28d reduced (14.5% NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

EMDocs

AUGUST 22, 2024

3,4 Notably, institutions receiving federal funding (such as hospitals receiving Medicare reimbursement) must abide by Title VI of the 1964 Civil Rights Act, which entitles persons with NELP to language assistance. Improving patient safety systems for patients with limited English proficiency: a guide for hospitals. Lion KC, et al.

Documentation/Coding 100

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

EMDocs

NOVEMBER 7, 2023

2012 Apr;99(4):532-9. The recurrence rate and length of hospital stay were the same. Hospital stay was significantly shorter in the observation group (2 versus 3 days; P = 0·006).  Antibiotics Do Not Reduce Length of Hospital Stay for Uncomplicated Diverticulitis in a Pragmatic Double-Blind Randomized Trial. Clin

Sepsis 108

Sepsis Best Practices Hospitals Outcomes 108

EMDocs

JANUARY 11, 2025

2012 May-Jun;13(3):283-289. link] Wu CH, Huang CC, Wang LJ, Wong YC, Wang CJ, Lo WC, Lin BC, Wan YL, Hsueh C. Value of CT in the Discrimination of Fatal from Non-Fatal Stercoral Colitis. Korean J Radiol. link] Sacerdote, M., Limback, J., & Zhu, J. Fecal Impaction and Nonperforated Stercoral Colitis: Red Flags for Poor Outcomes.

EMS 94

EMS Sepsis Shock Fluid Resuscitation 94

RebelEM

APRIL 29, 2024

Many clinicians don’t consider IO placement while others consider it a last resort or only a pre-hospital procedure. 2012 PMID: 21893125. Intravenous vs.intraosseous vascular access during out-of-hospital cardiac arrest – protocol for a randomized clinical trial. Resuscitation. 9 Zhang W et al. Medicine (Baltimore).

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

EMDocs

JULY 25, 2024

The brother’s wife calls the airport police who are able to locate him and send him to a nearby hospital. A lawsuit is filed by the patient’s family against the PA-C, the oncoming EP, both CC’s, and the hospital. Oct 04, 2012. We have a 2-hour meeting once a month and case consultations every 3 months. Applebaum PS.

Documentation/Coding 100

Documentation/Coding Hospitals Patient Safety Emergency Department 100

EMDocs

FEBRUARY 7, 2024

3 Increasing Strikes and Unions Labor actions in healthcare can disrupt normal hospital operations, potentially impacting costs and threatening patient quality of care. One study from the National Bureau of Economic Research on nursing strikes in New York State from 1984 to 2004 found that hospital mortality increased by 19.4%

Hospitals 95

Hospitals Research Patient Safety Wellness 95

ALiEM

SEPTEMBER 1, 2023

2012 Oct;55(7):930-9. Epub 2012 Jun 19. Author information Ho Tai-Hung, MD Resident Physician Taipei Veterans General Hospital | The post SAEM Clinical Images Series: A Dangerous Cause of Abdominal Pain appeared first on ALiEM. Cheng NC, Yu YC, Tai HC, Hsueh PR, Chang SC, Lai SY, Yi WC, Fang CT. Clin Infect Dis. PMID: 22715175.

Academics 64

Academics Hospitals 64

Sensible Medicine

DECEMBER 11, 2023

This is a picture I made in 2012. Instead of measuring AF with a monitor, like most studies, the authors decided to measure what is most important to patients: time to any hospital episode related to treatment for atrial arrhythmia. Think of it as building an electric fence around the pulmonary veins. The colored tubes are the PVs.

Operations 116

Operations Hospitals 116

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). Eye (Lond).

Emergency Department 64

Emergency Department Fractures Academics Hospitals 64

PulmCCM

JUNE 26, 2023

Antipsychotics have been overused in hospitalized patients, in and out of ICUs. mg doses, up to 20 mg/day) or placebo, there was no difference in survival out of the hospital at 90 days. An expert panel broadened the definition of acute respiratory distress syndrome (ARDS). No outcomes regarding the delirium itself were reported (i.e.,

Outcomes 98

Outcomes Ultrasounds Hospitals Wellness 98

EMDocs

JULY 13, 2024

A) Administer ceftriaxone 500 mg IM and doxycycline 100 mg PO B) Consult OB/GYN for incision and drainage C) Establish IV access and administer clindamycin and gentamicin D) Prescribe doxycycline with metronidazole and ensure close OB/GYN follow-up Answer: C Most postpartum infections are identified after hospital discharge. Epub 2012 Mar 14.

OB/GYN 81

OB/GYN EMS Sepsis Fluid Resuscitation 81

ALiEM

JANUARY 8, 2024

Her hospital course was complicated by tachyarrhythmias requiring cardioversion, and Takostubo physiology. 2012 Jul;51(7):1278-84. Epub 2012 Feb 29. This patient was admitted requiring 40 L HFNC, then two days later required intubation for severe ARDS and was placed on VV-ECMO the same day. Rheumatology (Oxford). PMID: 22378718.

Academics 60

Academics Hospitals Outcomes 60

Don't Forget the Bubbles

MARCH 18, 2024

The Royal Children’s Hospital in Melbourne summarises them in an easy-to-follow flow diagram (figure 1). Think about nutrition References The Royal Children’s Hospital Melbourne. 2012 Mar 19 [cited 2023 Nov 30];55(1):33–41. 2012 Jul 19 [cited 2023 Nov 30];345:e4565. Royal Hospital for Children- Nephrology.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

The Skeptics' Guide to EM

APRIL 8, 2023

John Brown PhD is a Professor of Health Services Research in Ireland who has been studying rural healthcare issues since 2012. The objective of that study was the following: * To investigate how the’ natural experiment’ of reconfiguring the emergency healthcare system in Denmark affected in-hospital and 30-day mortality on a national level.

Stroke 56

Stroke Emergency Department COPD Academics 56

ALiEM

OCTOBER 16, 2023

Patients with Lemierre Syndrome will require surgical consultation and hospital admission. 2012 Oct;12(10):808-15. Epub 2012 May 25. Given the propensity for thrombus development (Figure 2), anticoagulation may be considered, but its indication here remains controversial. References Kuppalli K, Livorsi D, Talati NJ, Osborn M.

Academics 60

Academics Wellness Emergency Department Hospitals 60

PHEM Cast

APRIL 16, 2018

2012; 73: 102-10. Critical Care; 2012. Effect of adrenaline on survival in out of hospital cardiac arrest: randomised double-blind placebo controlled trial. Ultrasound during TCA: Cureton et al. The heart of the matter: utility of ultrasound of cardiac activity during traumatic arrest. Slessor et al. Leis CC et sl.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

Don't Forget the Bubbles

SEPTEMBER 30, 2024

examined 977,907 first-time ED presentations by children aged 0-15 across thirteen acute hospital trusts (between April 2014 and March 2017), trying to figure out how many were non-urgent. A 2011-2012 Australian study by Blake et al. Nearly 1 in 5 returned within seven days, and around 8% required hospital admission.

Emergency Department 89

Emergency Department Research Pediatrics Hospitals 89

Pediatric Emergency Playbook

AUGUST 1, 2017

2012; 43(1):49-51. BMJ 2012; 345:e5521. 2012; 3:247-250. 2012; 92:527-39. Management of the child after enema-reduced intussusception: hospital or home? 2012; 30:426-431. 2012; 29:231-236 Blakely ML et al. Intestinal Malrotation – Not Just the Pediatric Surgeon’s Problem. J Am Coll Surg. J Emerg Med.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 86

Sepsis Shock Resuscitation Fluid Resuscitation 86

PEMBlog

MAY 24, 2023

2012 Jan;109(3):27-32. 2012 Feb;13(1):35-40. For more information, please visit HRSA.gov To learn more about the Emergency Medical Services for Children Innovation and Improvement Center visit [link] Email km@emscimprovement.center Follow on Twitter @EMSCImprovement References Berzlanovich AM, Schöpfer J, Keil W. Dtsch Arztebl Int.

Emergency Department 59

Emergency Department Pediatrics Psychiatric Administration 59

The Skeptics' Guide to EM

DECEMBER 7, 2018

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. Background: The AHA has five steps in the Chain-of-Survival for out-of-hospital cardiac arrest (OHCA). JAMA 2012 and Cournoyer et al. JAMA 2009, Hagihara et al.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

Dr. Smith's ECG Blog

MARCH 13, 2013

In multivariate analysis, STE in lead V 4 R on admission electrocardiography remained a strong independent variable associated with acute HF and the combined end point of primary VF, acute HF, or death during hospitalization. Wong, 2012) STE in aVR of at least 0.5 Wong, 2012) STE in aVR of at least 0.5 Wong, 2012)" 1.

EKG/ECG 52

EKG/ECG Hospitals Outcomes Wellness 52

EMDocs

MAY 26, 2023

Patients may be brought to hospital by police under restraint (e.g. 2012 Jan;109(3):27-32. 2012 Feb;13(1):35-40. Conversely they may need to be present for patient and staff safety What if a patient arrives in handcuffs in police custody? Deaths due to physical restraint. Dtsch Arztebl Int. PMC3272587. West J Emerg Med.

Pediatrics 94

Pediatrics Emergency Department Psychiatric Documentation/Coding 94

RebelEM

NOVEMBER 2, 2022

grams/kg on day 3 of treatment Patients with a single episode of SBP should be considered for antibiotic prophylaxis (with norfloxacin, ciprofloxacin or TMP/SMX) ( Runyon 2012 ) Take Home Points SBP is a difficult diagnosis to make because presentations are variable. Management of Adult Patients with Ascites Due to Cirrhosis: Update 2012.

EMS 52

EMS Administration Hospitals 52

PHEM Cast

FEBRUARY 25, 2021

Prognostication Better outcomes: Rescued and BLS commenced < 5-10 min Children Those who have not aspirated Water temperature < 10 o C, core body temperature 33-35 o C Neurologically intact on arrival at hospital Minimum blood pH > 7.1, References Szpilman D, Bierens JJ, Handley AJ, Orlowski JP (2012) Drowning.

Resuscitation 52

Resuscitation Hospitals Outcomes Wellness 52

The Skeptics' Guide to EM

JANUARY 14, 2018

Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. A study from Bindman et al.

Emergency Department 52

Emergency Department Ultrasounds Hospitals 52

The Skeptics' Guide to EM

JUNE 4, 2017

A systematic review by the authors of the present study confirmed a possible benefit of the pan scan, but it showed a need for a well-designed, large, prospective randomized clinical trial with patient oriented outcomes ( Sierink et al 2012 ). Reference: Sierink et al.

Radiology 52

Radiology Radiology CPR Hospitals 52

ALiEM

MARCH 1, 2024

Her mom convinced her to go to the ED and she first went to an outside hospital, but was referred to come to our institution. link] Published November 19, 2012. She reported a 10-day history of worsening right eye pain following being punched in that eye. She had been managing her pain with ice and had not taken any OTC medications.

Dislocations 60

Dislocations Academics Ultrasounds Hospitals 60

Pediatric Emergency Playbook

MARCH 1, 2017

2012 Aug;28(8):750-2. An update on out-of-hospital airway management practices in the United States. 2012 Feb;114(2):349-68. 2012 Feb;22(2):156-60. Comparison of direct laryngoscopy to Pediatric King LT-D in simulated airways. Pediatr Emerg Care. Carlson JN, Mayrose J, Wang HE. Prehosp Emerg Care. 2010 Jan-Mar;14(1):31-5.

Airway Management 52

Airway Management Pediatrics Resuscitation Hospitals 52

PHEM Cast

APRIL 10, 2016

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine; 2012 Jun 27;20(1):1–1. 2012 Jan;30(1):51–6. Severe Sepsis in Pre-Hospital Emergency Care. 2012 Dec 15;186(12):1264–71. Prehospital Sepsis Project (PSP): knowledge and attitudes of United States advanced out-of-hospital care providers.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

ALiEM

DECEMBER 4, 2023

A 49-year-old male presented to the emergency department of an academic hospital with the chief concern of penile pain. The patient was recently admitted to the hospital eight days prior to presentation for purulent urethral discharge where he received a course of topical antibiotics and was discharged. References Nunley JR.

Academics 60

Academics Seizures Hospitals Emergency Department 60

The Skeptics' Guide to EM

DECEMBER 17, 2022

AEM December 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. AEM December 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. years ( 2 ).

Blood Transfusions 52

Blood Transfusions Fractures EMS Emergency Department 52

Don't Forget the Bubbles

DECEMBER 16, 2024

Since January 2024, measles cases in the UK have surged, reaching 2,563 reported casesthe highest level since 2012. Following a 2012 outbreak, an emergency maternal pertussis vaccination programme was introduced in the UK, offering the vaccine to women in the third trimester of pregnancy.

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59