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. Unionization of healthcare providers can create opportunities to improve staff’s financial and general well-being, but may also facilitate future strikes.

Hospitals 77

Hospitals Research Patient Safety Wellness 77

RebelEM

JANUARY 25, 2023

Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

The Skeptics' Guide to EM

DECEMBER 12, 2020

She is systemically well and there is no sign of tracking, so you decide to perform incision and drainage in the ED. Way back in 2012 we looked at packing after incision and drainage (I&D) on SGEM#13 and concluded routine packing might not be necessary. Kirsty is also the creator of the wonderful infographics called #PaperinaPic.

Operations 52

Operations Outcomes Research Academics 52

EMDocs

JANUARY 11, 2025

Well keep it short, while you keep that EM brain sharp. Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. 2012 May-Jun;13(3):283-289. Avoid medications that induce constipation. Korean J Radiol. link] Sacerdote, M.,

EMS 72

EMS Sepsis Shock Fluid Resuscitation 72

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 110

EKG/ECG Emergency Department Academics Operations 110

ACEP Now

MARCH 13, 2024

Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. Conclusion/Recommendation ED crowding is a national patient safety issue driven by hospitals routinely operating over capacity. 2012): 2470-2478. ED crowding impairs this mission.

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 6, 2024

5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Published 2012 Jul 1. 2012 Aug;39(8):719-24. 9 Typical dose: Polyethylene glycol (Go-Lytely ) 25 mL/kg/hr in small children and 1.5-2 2 L/hr in adults. Arch Pediatr Adolesc Med.

Poisoning 76

Poisoning Fluid Resuscitation Seizures Resuscitation 76

Don't Forget the Bubbles

OCTOBER 10, 2024

Ten thousand children in the UK are operated on a year for fingertip injuries, and 96% of surgeons currently report replacing the nail plate intra-operatively. Adopting this approach would reduce time in surgery for the child as well as the financial cost of nail bed repair. 2012 Aug 15;(8):CD004872. PMID: 22895944.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

mEq/L for Mg++ ) — given that ECF levels of these cations comprise only ~1-2% of total body stores ( Jahnen-Dechent and Ketteler — Clin Kidney J 5(Suppl 1):i3-i14, 2012 — and — Udensi and Tchounwou — Int J Clin Exp Physiol 4(3): 111-122, 2017 ). mEq/L for K+ and 1.76 Nossen — results of genetic testing for LQTS are pending.

Seizures 104

Seizures EKG/ECG EMS Stroke 104

Pediatric Emergency Playbook

JUNE 1, 2017

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Mind The Bleep

OCTOBER 22, 2024

Cardiology applications typically open around November, and since 2012, there has been no Round 2 for Cardiology. Late applications are not accepted, so checking the dates for the application year and applying well in advance is essential. All applications to Cardiology are made nationally via the Oriel Application System.

Evidence-Based Practice 52

Evidence-Based Practice Academics Operations Hospitals 52

Don't Forget the Bubbles

MARCH 11, 2024

There are many causes, and it is less well understood than plagiocephaly. Craniosynostosis needs urgent referral and is usually corrected operatively before a child’s first birthday. Craniosynostosis Craniosynostosis is rare. It is due to the premature closure of the sutures rather than positional changes to an otherwise normal skull.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

Don't Forget the Bubbles

JULY 26, 2023

A cardiac family history should of course be sought, but think a little outside the box as well. On arrival at hospital the child was well with normal observations. The Fontan circulation was an operation initially developed around 50 years ago to treat tricuspid atresia. Family history. What are the important investigations?

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Advanced Emergency Nursing from AENJ

JULY 9, 2015

They may be entrapped; have limited access; may be midway in an operating position that can’t be changed; may need to be sitting due to pulmonary edema, morbid obesity, aspiration prevention or for awake intubation. Flexibility of mind and skill bodes well. Wiget, Urs & Torres, Eric. Video] Oct 30, 2012. Wackett, A.,

Airway Management 40

Airway Management Pediatrics Resuscitation Documentation/Coding 40

EMDocs

SEPTEMBER 9, 2023

Answer : Extensor tendon laceration Epidemiology: Hand extensor injuries make up >25% of orthopedic soft tissue injuries 2, 3 Common in young men in manual labor Dominant hand more likely to be injured 4 2012 study on 86 patients reported 83% men with a mean age of 34.2 Plast Reconstr Surg Glob Open. 2020;8(12):e3278. doi:10.1097/GOX.0000000000003278

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

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. 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.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Farrington] Rebuilding of outdated hospitals put emergency rooms on ground level with nearby X-ray service, and, ideally, sometimes closer to the Blood Bank and the Operating Rooms. We applied to "The Golden Hour" the attitudes and abilities that led to a man on the moon. 1950s & 1960s Resuscitation Research. Touchstone, Mike.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Northwestern EM Blog

MAY 16, 2022

Follow up CT should depend on the patient and ultrasound operator. Lastly the POCUS operators were ED physicians with training “recommended by ACEP.” In this study, 40.7% of those in the POCUS group and 27% in the formal ultrasound group underwent subsequent CT. Kidney international , 83 (3), 479-486. Coursey, C. Casalino, D.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

EB Medicine

MARCH 1, 2019

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. But don’t be reassured by normal vitals, especially in the young, who may be compensating well despite being quite ill. Nachi: Definitely. for pericardial effusion. Jeff: Exactly.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

ETM Course

MAY 3, 2017

Simple windlass-style tourniquets are relatively inexpensive, easy to apply and easy to operate. Ft Detrick, Maryland: Borden Institute; 2012. Studies comparing different commercially available tourniquets have produced mixed results so no single device can be recommended over another. References: Kragh J, Kirby J, Ficke J.

Military 52

Military Shock Hospitals Operations 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. Weingart, S.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

Taming the SRU

MARCH 14, 2023

He appears well and is triaged to an ESI 4. Ultimately, definitive management is in the operating room with revision or replacement of the VP shunt. She was doing well, but recently has had the “stomach flu” with a couple weeks of abdominal pain, nausea and vomiting. More on this below as we work through a few cases….

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. This finding was not significantly different among operators with different levels of experience, or between adults and children. Raised inflammatory markers BMJ 2012; 344 :e454 doi:10.1136/bmj.e454 Gabay C, Kushner I. Oncotarget.

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

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 ). Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

PEMBlog

JUNE 5, 2024

2012 Jan 13;61(RR-1):1-20. Infants can get a cervical spine injury during breech delivery or, unfortunately, during non accidental trauma as well. That’s a spine or neurosurgery operation. Hopefully they will find it helpful as well. MMWR Recomm Rep. PMID: 22237112. Now moving on to disposition.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Advanced Emergency Nursing from AENJ

MAY 27, 2014

Henderson , it would seem, was an enthusiast, well-convinced of his opinions, with missionary zeal, who would firmly argue his positions and tirelessly campaign them. The Therapeutic Use of Carbon Dioxid After Anesthesia and Operation. In 1920, he put forward his paper on CO2. Journal of the American Medical Association, 67(1), 1-5.

Resuscitation 40

Resuscitation Poisoning Research Administration 40

EMDocs

OCTOBER 23, 2023

She had been feeling well until yesterday when she had a follow-up with her surgeon, at which time she reported that they performed an internal exam and inserted a ‘medication disk’ into her vagina. The patient is noted to be mildly tachycardic as well as febrile. difficile infection, and post-operative hemorrhage.

OB/GYN 67

OB/GYN Operations EMS Ultrasounds 67

Ziqitza HealthCare Ltd

JULY 14, 2023

For starters, several states have launched and currently operate the 181 and 112 emergency helpline numbers to provide relief to women in distress, whether it is in a public place, at home or even at their workplace. Ziqitza Healthcare Limited has also operated 181 Police Helpline in Punjab to provide timely assistance to the caller in need.

Domestic Violence 52

Domestic Violence Documentation/Coding Operations Ambulance Services 52

Advanced Emergency Nursing from AENJ

FEBRUARY 27, 2015

There are increasingly many writings upon the health of our Presidents either factual or speculative, and even in contention whether the office is inherently detrimental to wellness and longevity of its occupants. President Eisenhower's Operation for Regional Enteritis A Footnote to History. Franklin D. September 2003. Dallek, Matthew.

Stroke 40

Stroke COPD Emergency Nursing Sepsis 40

Advanced Emergency Nursing from AENJ

MAY 27, 2015

If mere criminality was the only matter, there’s some cash, personal electronics, appliances, and business machines; if not merely criminal, and well-studied beforehand, there are to be had radioactive materials, drugs, toxins, chemicals, and many who would pay a ransom for the loved ones within. Emergency Preparedness. Vernon , August. (No

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40

EB Medicine

AUGUST 1, 2018

Jeff: Because the current DEA controlled substances schedule designations are based on original chemical names, synthetics have gained popularity as manufacturers are able to produce newer compounds and circumvent DEA designation as well as routine urine drug screening tests. Jeff: And the etiology of CHS is not well understood.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EB Medicine

JANUARY 2, 2019

Jeff: Perhaps most importantly, no history or physical alone can rule in or out an ectopic pregnancy, for that you’ll need testing and imaging or operative findings. It’s noteworthy that a 2012 Cochrane review failed to find clear superiority for one strategy over another. Jeff: Up first is the urine pregnancy test.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

EMDocs

NOVEMBER 13, 2023

2019) argue against a minimum NIHSS score to trigger the use of CTA, instead purporting that clinical suspicion of acute ischemic stroke presenting within 24 hours of the last known well was sufficient evidence to order the study. Lancet Neurol 2012, 11 (4), 307-314. 8 The data in Mayer et al. positivity rate on CTA for BCVI.

Stroke 87

Stroke Radiology Radiology Emergency Department 87

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. Lubricate well. Open Journal of Anesthesiology, 2012, 2, 38-43 doi: 10.4236/ojanes.2012.22010 Gerkin] Priceless.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40

SheMD

APRIL 23, 2023

Today Dr. Sabrina Gerkowicz, a reproductive endocrinologist (aka fertility doctor) shares with us some very important findings and statistics about #physicianinfertility as well as what a fertility workup looks like, who should have one, and 5 things you MUST know! Aghajanova et al. So when and why should I have a fertility work up?

Ultrasounds 52

Ultrasounds Wellness Operations 52