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 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. An emergent ophthalmology consult is needed to plan for operative repair. 2023, March 23).

Emergency Department 64

Emergency Department Fractures Academics Hospitals 64

The Skeptics' Guide to EM

DECEMBER 12, 2020

AEM December 2020 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). A Randomized Controlled Trial of Novel Loop Drainage Technique Versus Drainage and Packing in the Treatment of Skin Abscesses.

Operations 52

Operations Outcomes Research Academics 52

Resus Review

SEPTEMBER 28, 2015

Inappropriate delay of establishing a surgical definitive airway with a cricothyrotomy has been documented in field and hospital operations 1,2. J Spec Oper Med. 2012; 12:17. This can be attributed to many factors including: Failure to recognize Can’t Intubate-Can’t Ventilate scenario.

Operations 52

Operations Documentation/Coding Hospitals 52

Cook County EM Blog

APRIL 7, 2022

He initially presented to an outside hospital where he was told he had an “ankle” fracture and was splinted with a short leg posterior splint. Treatment can be achieved non-operatively if only the posterior ligaments of the tibiofibular syndesmosis are partially damaged. Otherwise, most cases require operative repair.

Fractures 52

Fractures Operations Hospitals 52

ACEP Now

MARCH 13, 2024

1 Hospital boarding is the main driver of ED crowding, with patients nearly always awaiting transfer to inpatient beds and now more commonly, to other hospitals. When considering inter-hospital transfer, the patient’s goals of care should be paramount in guiding the process.

Ethical Issues 52

Ethical Issues Emergency Department Operations 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

EMDocs

DECEMBER 11, 2023

In addition to a posterior ECG, the ACC’s new recommendations emphasize consideration of an emergent TTE, though lack clarity in defining who should be the operator, stating “a clinician qualified in echocardiography” is necessary, without providing specific definitions. 2012 Dec;60(6):766-76. Ann Emerg Med. N Engl J Med.

EKG/ECG 119

EKG/ECG Emergency Department Academics Operations 119

Advanced Medical Reviews

SEPTEMBER 15, 2017

In 2012, they represented 2 percent of all primary care visits, and they are currently key catalysts of the broad move toward value-based care. FierceHealthPayer projected hundreds of thousands of dollars in savings from reduced ER/hospital admissions. Responding to millennial influence on healthcare technology and operations.

Operations 56

Operations Research Wellness Hospitals 56

Don't Forget the Bubbles

OCTOBER 10, 2024

This time the team from Bristol Royal Children’s Hospital ED tell us what is new in the world of paediatric literature… Led by Dr John Coveney a Paediatric Emergency Medicine Trainee in Bristol who has revived The Journal Club at Bristol Royal Children’s Hospital ED on a monthly basis. 2012 Aug 15;(8):CD004872.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

En route to the hospital the patient experienced multiple short-lasting episodes, with cramping and loss of consciousness. since what appears to be a major causative factor ( simultaneous ingestion of 9 herbal preparations ) is no longer operative. I measure the RR interval at 795ms and the QT interval at 475ms. mEq/L for K+ and 1.76

Seizures 114

Seizures EKG/ECG EMS Stroke 114

Don't Forget the Bubbles

JULY 26, 2023

This has been trialled (out of hospital) in known children with SVT. Upside-down position for the out of hospital management of children with SVT, Bronzetti et al, International Journal of Cardiology 2017 this showed that a modified position (upside down) improved cardioversion rates from 33% to 67%. www.cats.nhs.uk/wp-content/uploads/guideline-intubation.pdf

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Mind The Bleep

OCTOBER 22, 2024

Cardiological input is required at both district general hospitals and tertiary centres; therefore, as a consultant, you can choose where you would like to work. Cardiology applications typically open around November, and since 2012, there has been no Round 2 for Cardiology. When and where to apply?

Evidence-Based Practice 52

Evidence-Based Practice Academics Operations Hospitals 52

Northwestern EM Blog

MAY 16, 2022

were hospitalizations during f/u period; 26.4% were hospitalizations during f/u period; 26.4% There also were no significant differences in pain scores, hospitalizations, ED readmissions among the groups. Follow up CT should depend on the patient and ultrasound operator. vs. US 31.2% In this study, 40.7% Coursey, C.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

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

ETM Course

MAY 3, 2017

Simple windlass-style tourniquets are relatively inexpensive, easy to apply and easy to operate. If there will be a delay of more than an hour to definitive surgical care (for example, delayed retrieval or prolonged transport time), all efforts should be made to obtain vascular haemorrhage control by a surgeon in the referring hospital.

Military 52

Military Shock Hospitals Operations 52

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

BULLETIN-HOSPITAL FOR JOINT DISEASES NEW YORK, 64(3/4), 139. 8, 2012 12:12 a.m. ET Hostile Fire Environments Murphy’s Law of Combat Operations [includes coarse military humor] Firearms in the Entertainment Industry International Movie Firearms Database Horman, GS. Tejwani, N. C., & Egol, K. de Barros Filho, T. Marcon, R.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

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

Taming the SRU

MARCH 14, 2023

After a several week NICU stay for prematurity, the infant has been generally healthy and this is his first trip back to the hospital since discharge. Ultimately, definitive management is in the operating room with revision or replacement of the VP shunt. He has a weak cry and you notice bulging fontanelles. Neuroradiology. Amer J Rad.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Taming the SRU

FEBRUARY 19, 2024

Arterial lines require specialized monitoring and nursing resources which are not available in all hospital settings. Failure rates An ambispective, observational cohort study from 2012 - 2016 found that femoral arterial lines fail significantly less often than radial arterial lines with an absolute risk reduction of line failure of 20%.

Shock 59

Shock Resuscitation Ultrasounds Research 59

PEMBlog

JUNE 5, 2024

2012 Jan 13;61(RR-1):1-20. 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. MMWR Recomm Rep. PMID: 22237112.

Fractures 52

Fractures Pediatrics Radiology Radiology 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

EMDocs

NOVEMBER 16, 2024

4 Pain is the most common reason for presentation in the early post operative period. 5 Highest risk of dislocation early in the post operative course due to laxity of the soft tissue after surgery. 6 Hip flexion or adduction in the early post-operative period can cause atraumatic dislocations (typically avoided for 6 weeks post-op).

EMS 94

EMS Dislocations Fractures Operations 94

EMDocs

OCTOBER 23, 2023

Operative complications requiring surgical intervention or hospitalization occur in about 3-6% of all hysterectomies (5). difficile infection, and post-operative hemorrhage. Abscess and Infected Hematoma : This condition is typically delayed, occurring most commonly 10-14 days post-operatively.

OB/GYN 86

OB/GYN Operations EMS Ultrasounds 86

Advanced Emergency Nursing from AENJ

MAY 27, 2015

and all start shooting the hospital staff. Little attention has been given to the Hospital as the target of terror. Other issues in hospital security have been dealing with assaultive behavior of patients; workplace violence; active killer scenarios. Attacks have occurred upon hospitals in other countries, notably Yemen.

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40

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. Personal Communication.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

Pediatric Emergency Playbook

JANUARY 1, 2017

For example, a very anxious caregiver can easily transmit his or her anxiety to the child, which may either inhibit or amplify presentation of symptoms ( Bearden 2012 ). Neonatal observational scales have been validated in the intensive care and post-operative settings; ED-specific quantitative scales are lacking. 2012 Jul;37(6):680-6.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

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. According to data from 2012, of the 130 million people reporting illicit drug use within their lifetime, 25% were children between 12 and 17 years of age. Counsel them on drug abuse also.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Pediatric EM Morsels

MARCH 7, 2025

2012 Feb;147(2):113-9. Tranexamic Acid Use in United States Children’s Hospitals. of IV form TXA [O’Neill 2020] Inexpensive ! 2011 Mar26;377(9771):1096-101, 1101.e1-2. PubMed: 21439633] Morrison JJ, Dubose JJ, Rasmussen TE, Midwinter MJ. PubMed: 22006852] Nishijima DK, VanBuren JM, Linakis SW, et al. Crit Care Explor.

Pediatrics 231

Pediatrics Blood Transfusions Anaphylaxis Military 231

ACEP Now

FEBRUARY 19, 2025

AI started to make its mark in the ED by maximizing the efficiency of certain tasks like patient triage, clinical presentation diagnosis, mortality prediction, clinical decision making, and operational workflow management (see Figure 1). Published April 25, 2012. Published April 2012. References Edmondson AC. Life (Basel).

Teamwork 51

Teamwork Clinical Decision Support Systems Administration Radiology 51

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. Perkins, Z. De’Ath, H. Walsh, M., & Tai, N. Tiffanie Turnbull.

Dislocations 52

Dislocations Fractures Soft Tissue Injuries Infectious Diseases 52

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.

Airway Management 40

Airway Management Resuscitation EMS CPR 40

PulmCCM

MARCH 7, 2025

Any self-respecting surgeon or anesthesiologist will tell you that patients undergoing surgery before the weekend receive just as high a quality of care as those operated on earlier in the week. Among almost 3 million patients at 28 hospitals in the U.S., Is it true? For elective surgeries at most U.S.

Outcomes 116

Outcomes Hospitals Operations Radiology 116