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2013 Documentation/Coding Wellness 
Pediatric EM Morsels
OCTOBER 27, 2023
Taking care of a critically ill child can be nerve-racking to say the least, and downright petrifying for those who don’t do it frequently, even if they are well-trained and brilliant clinicians. Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Broselow does not.
271 
Northwestern EM Blog
MARCH 1, 2025
In this study, they found that prone positioning resulted in significant improvement in oxygenation, as well as a 50% decrease in mortality at 28 days (Guerin et. Position arms in a comfortable position, avoiding any position that could cause a brachial plexus injury, and ensure they are well-supported to avoid pressure ulcers.
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EMDocs
AUGUST 22, 2024
13 Interventions may include: Ascertaining a patient’s preferred language early in the clinical encounter (during registration, for instance), and clearly documenting this preference in a place that is visible to all providers. Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors.
Mind The Bleep
OCTOBER 29, 2024
Alkali burns result in liquefaction necrosis, allowing for deeper tissue injury as well as vascular injury that can lead to both local and systemic toxicity [1]. These systemic effects can include central nervous system (agitation, seizures , and coma), as well as cardiac ( hypotension and dysrhythmias) [10, 11]. 2013 May;74(5):1363-6.
52 
Pediatric EM Morsels
AUGUST 18, 2023
None of the patients were documented to have joint disease at follow up. Etminan 2019) In Belgium between 2010 – 2013, of the 262 children treated with fluroquinolones while hospitalized, only 17% were used for labelled indications. There were 2523 children included. 451 pediatric patients were included.
130 
The Skeptics' Guide to EM
MAY 8, 2021
He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR […] The post SGEM#329: Will Corticosteroids Help if…I Will Survive a Cardiac Arrest? He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR Safety Team. first appeared on The Skeptics Guide to Emergency Medicine.
52 
The Skeptics' Guide to EM
OCTOBER 28, 2017
Case: A 12-day old girl presents with fever and is otherwise well. That rant relied upon a Cochrane SRMA by Stevens B et al 2013 and a randomized clinical trail published in Pediatrics by Gray L et al 2015. Anthony is also the creator of SketchyEBM. You wonder whether there is a way to mitigate the painful experience for the child.
52 
Taming the SRU
FEBRUARY 5, 2024
(1) However, it wasn’t until the 1890s that purposeful, successful, and safe attempts to access this fluid were documented (2). The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). (And Clin Infect Dis. 2018;66(3):321-328. doi:10.1093/cid/cix806 5.
The Injectable Orange
JUNE 20, 2017
While well evaluated, you see the residents go back to the shop floor and struggle to apply any of the lessons that the group agreed had been take homes from the previous sim session. How do they do it so well?” doi: 10.1136/bmjopen-2013-003525 Lorello, G, Hicks, C et al. 2013 Dec;26(6):699-706. Well done”…….
SheMD
OCTOBER 8, 2023
In 2013, a large survey with 7,028 respondents found that 64.8% Actually, I wanted to ask what supports the program has in place for parents (male and female) as well as people increasing their families, be it biologically or through adoption?” Their well-being should be considered. Thank you for this question !
105 
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. This has been studied in children as well, and an elevated lactate in children – typically above 4 – was a predictor of prolonged ICU course and mortality in septic patients. 2013; 29:715-719.
52 
Advanced Emergency Nursing from AENJ
NOVEMBER 20, 2014
It is critically important to document the physical findings in a plain-seeing, plain-speaking, non-judgmental manner that will not color or taint future investigations. Accurate time entries are important to document. If you think your patient is the perpetrator, he may well be an innocent, or even an off-duty or undercover officer.
40 
ACEP Now
AUGUST 1, 2023
Recent data published in Annals showed that between 2013 and 2019, the percentage of clinicians working in rural areas who were emergency physicians actually dropped slightly. A rural ED staffed by a well-trained EP is an essential resource in small communities that may be otherwise lacking in readily available healthcare resources.
PulmCCM
FEBRUARY 19, 2024
Well … no. At Shands (the level 1 trauma center admitting adults), the panel relates the impressive results that mortality fell by 58%, and unplanned codes by 47% “after the widespread implementation of patient/ family activated RRT/MET.” Family-Activated METs in Adults Halves Mortality?
52 
Pediatric Education
MARCH 10, 2024
She was doing well and but was having problems with her math and some reading. “She’s doing well socially and developing pretty normally, so that is good. They learn or do some things exceptionally well, but they also are exceptional in that they have problems learning too. Assouline, Nicholas Colangelo, 2013.
40 
Dr. Smith's ECG Blog
JUNE 30, 2023
Smith and Meyers containing thousands of tracings with documentation of cardiac catheterization results. Criterion #5: Chest leads with T-wave inversion often have some ST elevation ( This is especially well seen in leads V3,V4,V5 of ECG #1 ).
52 Advanced Emergency Nursing from AENJ
JULY 9, 2015
Pull out the manikins (or use a volunteer; BVM only) and run some awkward codes! Flexibility of mind and skill bodes well. Wiget, Urs & Torres, Eric. Video] Sep 15, 2013. Video] Nov 19, 2013. How versatile are your airway skills? Oh, sure, you can handle any supine situations! Gather everyone. Before} 19 May 01.
EB Medicine
JULY 8, 2019
Jeff: Well that’s kind worrisome. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in. Jeff: Do note, however that 2013 guidelines do not recommend one procedure over another and leave that decision up to local surgical expertise, patient specific risk factors, and treatment goals.
Dr. Smith's ECG Blog
NOVEMBER 19, 2016
Clinical Course The paramedic activated a “Code STEMI” alert and transported the patient nearly 50 miles to the closest tertiary medical center. 2 The astute paramedic recognized this possibility and announced a CODE STEMI. N Engl J Med 2003; 348:1756-1763, 5/1/2013. Look at the aortic outflow tract. What do you see?
40 
Dr. Smith's ECG Blog
NOVEMBER 28, 2022
This patient was reported to have distant heart sounds but was not hypotensive and did not have JVD according to documentation. 2013 Sep;26(9):965-1012.e15. There appears to be some ST elevation in leads II and aVF, as well as to a lesser extent in the lateral chest leads. J Am Soc Echocardiogr. doi: 10.1016/j.echo.2013.06.023.
40 
PulmCCM
APRIL 7, 2025
This is based partly on the Western ethical principle of autonomy: our family members know us well and (it’s generally agreed) can best ascertain what care we would agree to, or not. Families should be invited to be present during codes (CPR), with a dedicated staff member at their side. This is a well-established principle.
EB Medicine
AUGUST 6, 2019
Nachi: Well, I’m sure more of those studies are still coming. Nachi: Well that was a ton of information and background on the DOACs. Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. Show More v Jeff: Fair enough, we’ll take what we can get.
EMDocs
JULY 25, 2024
The nurse completes the Columbia-Suicide Severity Rating Scale (C-SSRS) and documents that the patient’s recent thoughts of killing himself and his detailed plan makes him “High Risk” for suicide. There is no documented handoff to the on-coming emergency physician (EP) who assumes care. Blogpost, June 2013. Oct 04, 2012.
RebelEM
MAY 15, 2024
The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.
EMDocs
SEPTEMBER 23, 2023
Physical exam reveals a well-appearing female in no acute distress. HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes: document endorsed by HRS, EHRA, and APHRS in May 2013 and by ACCF, AHA, PACES, and AEPC in June 2013. Heart Rhythm.
105 
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.
52 
ACEP Now
OCTOBER 9, 2023
percent) do not speak English as a primary language, and 25 million of those speak English less than well (known as “limited English proficiency” or LEP); many indicators show this number will only continue to grow. Physicians should document the interpreter’s name and identification number if available in the patient’s chart.
Ziqitza HealthCare Ltd
JULY 14, 2023
Of these, about 7 lahks, or 30 per cent, were reported under Section 498A of the Indian Penal Code (IPC), the report says. These dedicated numbers are operational 24X7, are toll-free and available to women promptly, and have integrated call centres that operate round-the-clock for providing legal or police aid as well as medical services.
ACEP Now
DECEMBER 10, 2023
Although cases of human milkweed exposure are rare, a 2013 case reported a 42-year-old man experiencing cardiac symptoms and nausea after consuming fried milkweed pods from a recipe he found online. In the ED, he was found to have a heart rate in the 40s, and a digoxin level of 1.0 ng/mL (cross reactivity of the assay) and a potassium of 4.2
52 
RebelEM
AUGUST 12, 2024
Thus further adding to the well known safety of amino acid infusions The lack of a diversified patient population in combination with having used only one type of amino acid formulary greatly limits this study’s generalizability. Contemp Clin Trials. Epub 2022 Aug 28. PMID: 36038001 Levi TM, et al. Rev Bras Ter Intensiva.
81 
Northwestern EM Blog
SEPTEMBER 12, 2022
It is well known that most hospitals in large population centers already operate at or near full capacity [4]. Other things listed on tags can be a patient’s name, bar code, MRN or other tracking criteria. This makes it even more challenging when presented with an acute influx of patients in a short period of time. EPM , 5 Apr.
Dr. Smith's ECG Blog
JULY 22, 2023
The patient did well and was ultimately discharged home. Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. As for our patient, on discharge, her EKG had completed returned to her baseline morphology and she has been doing well in follow-up.
92 
Don't Forget the Bubbles
MARCH 11, 2024
There are many causes, and it is less well understood than plagiocephaly. Recommendations for sudden infant death syndrome prevention: a discussion document. Craniosynostosis Craniosynostosis is rare. It is due to the premature closure of the sutures rather than positional changes to an otherwise normal skull. Vollman, A. Hatfield, J.,
59 
Northwestern EM Blog
MAY 16, 2022
The above study was well summarized and bears repeating that, in this multicenter randomized study assessing CT vs POCUS vs radiology performed US in patients with suspected renal colic in the ED setting, initial US reduced radiation exposure without adversely affecting patient-centered outcomes. References Fwu, C. Eggers, P. Kimmel, P.
52 
Dr. Smith's ECG Blog
MAY 8, 2023
Code STEMI was activated by the ED physician based on the diagnostic ECG for LAD OMI in ventricular paced rhythm. There is concordant ST elevation in I, aVL with reciprocal concordant STD in inferior leads, as well as excessively discordant TE in V2-V4. This is a huge anterolateral OMI. I cannot be anything else.
52 
Dr. Smith's ECG Blog
JANUARY 30, 2019
I remember Allie well from her days in the Research volunteer program at Hennepin. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. A repeat EKG was performed at that time and showed this: The STE had almost completed resolved and the STE depression is improved as well. F (rectal).
Advanced Emergency Nursing from AENJ
MAY 3, 2014
Although told several times, the story of the development by Henning Ruben of the prototypical modern manual resuscitator, the self-refilling bag with unidirectional non-rebreathing valves which now dominate the world of resuscitation, is still not well-known. Documents improvements in BVMs previously investigated and found deficient in FIO2.
Advanced Emergency Nursing from AENJ
FEBRUARY 29, 2016
A natural one, and especially suited for increasing capability without regard to physician residency program output of graduates, and in less-well-served rural areas. 10/20/2013. EMS in America: The Foundation Documents. 1950s & 1960s Resuscitation Research. There is also FOANed for Nursing. How the BVM began.
EB Medicine
MAY 3, 2019
The PSS-3 assesses for depression/hopelessness and suicidal ideations in the past 2 weeks as well as lifetime history of suicide attempt. Next, schedule a follow up appointment, ideally within a week of discharge, and lastly, document the patient’s preferred follow up resources and steps taken to get them there. Reference book) 15.
EMDocs
FEBRUARY 12, 2024
ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). While ABGs and VBGs usually correlate well, there are a few situations where this correlation is disturbed.
RebelEM
DECEMBER 23, 2024
saline (NS) solutions are both isotonic crystalloids widely used for intravenous fluid resuscitation across many contexts and disease states ( Myburgh 2013 ). Lactated Ringer (LR) and 0.9% This introduces the risk that data may be less accurate than with prospective enrollment, access to medication administration records, etc.
EB Medicine
JANUARY 2, 2019
This corresponds nicely to a 2013 retrospective study demonstrating a bHCG threshold for the fetal pole to be just below 1400. For a completed abortion, you would expect a closed OS with no IUP on ultrasound with a previously documented IUP. Generally 1500 is used as the cutoff. Jeff: Let’s move on to disposition.
40 
Pediatric EM Morsels
FEBRUARY 2, 2024
In one ED study, ALL cases of missed travel-related illness did not have a documented travel history in their ED note , whereas 90% of the identified travel-related illnesses had a provider documented travel history (Greenky 2022) Those who are visiting friends and relatives (VFR) are typically at highest risk.
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