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 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

The Skeptics' Guide to EM

JULY 8, 2023

Case: A 57-year-old woman with hypertension, hyperlipidemia and type-2 diabetes mellitus presents to the emergency department (ED) with fever, cough, myalgias, headache and congestion. Managing editor of EM:RAP and Associate Editor at REBEL EM. It’s flu season and you’ve already seen 15 people with the same symptoms.

CDC 108

CDC Hospitals EMS Emergency Department 108

Taming the SRU

DECEMBER 11, 2023

1,2] Patients at risk for suicide often interact with emergency medical care. Suicide-related behavior (SRB) accounts for 1% of all Emergency Department (ED) visits; additionally, greater than 8% of patients visiting emergency departments are likely experiencing suicidal ideation at the time of the encounter.[3-5]

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

Taming the SRU

FEBRUARY 14, 2024

THE CASE A female in her 20’s presented to the emergency department with concern for oral swelling. She endorsed low grade fevers and chills as well as odynophagia, dysphagia, and some shortness of breath. The American Journal of Emergency Medicine. 2013; 31(1):267.e1-3. There was no trismus. 2018;158(2):280-286.

Ultrasounds 97

Ultrasounds Emergency Department Wellness 97

Don't Forget the Bubbles

AUGUST 7, 2023

This prospective cohort study included patients between 0-16 years old, who presented to one of four NHS hospital sites in Greater Manchester (a large metropolitan area in the North of England), consisting of an Urgent Care Centre and three Emergency Departments. 2013 Apr 1;131(4):e1150–7. Acad Emerg Med. Pediatrics.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

Taming the SRU

AUGUST 27, 2024

This differential is broad and reflects the clinical diversity of their presentations - in this post we will parse through the specifics of bullous lesions as well as what there is to do for them acutely. What can you do from the Emergency Department if suspected? What can you do from the Emergency Department if suspected?

Emergency Department 83

Emergency Department Dehydration Burns Sepsis 83

EMDocs

SEPTEMBER 25, 2023

These clinically challenging intubations prompted emergency clinicians to turn to a KOBI technique and forgoing the use of an NMBA, which are not without risk. Additionally, many if not most emergency physicians do not receive adequate training on topical awake intubations (TAI) (11). Resuscitation 2013; 84(11): 1500 – 4.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

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. ECGpedia , 22 May 2013, [link]. The patient states that this has never happened before. Heart Rhythm. 2013;10(12):1932-1963.

EMS 105

EMS EKG/ECG Documentation/Coding Emergency Department 105

Northwestern EM Blog

APRIL 15, 2024

While most of the immediate complications of tracheostomy will occur in the ICU, these patients still frequent our emergency department with and without tracheostomy related emergencies. ENT and airways in the emergency department: national survey of junior doctors’ knowledge and skills. Borrowed from: Morris, L.L.,

Emergency Department 98

Emergency Department Resuscitation Pediatrics Outcomes 98

Don't Forget the Bubbles

OCTOBER 2, 2023

This American single-centre retrospective review of 145 previously-well children referred to endocrinology to evaluate hypoglycaemia (<3.9 mmol/L) with acute illness between 2013 and 2018. Previously well children presenting with acute illness are often thought hypoglycaemic due to prolonged fasting. Why does it matter?

Outcomes 138

Outcomes Research Wellness Emergency Department 138

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. April 9, 2013. A 41-year-old male with no significant past medical history presents with a deep hand laceration. Medicine (Baltimore). J Ultrason.

EMS 95

EMS Fractures Operations Ultrasounds 95

ACEP Now

AUGUST 1, 2023

How does that apply to the role of the board certified emergency physician? Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. Coach John Wooden was famous for focusing on the fundamentals, sometimes called “little things.”

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. 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.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 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. Blogpost, June 2013. Assure and document the patient’s resources and safety net if discharged. Handoffs are a high-risk exchange. Applebaum PS.

Documentation/Coding 104

Documentation/Coding Hospitals Patient Safety Emergency Department 104

ALiEM

DECEMBER 18, 2023

A 19-year-old female with a past medical history of epilepsy presented to the emergency department for evaluation of rash and fever. 2013 Jun;6(6):31-7. Two days prior to presentation she began to experience fevers with a Tmax of 103°F. The patient endorsed associated pruritus and cervical lymphadenopathy with the rash.

Academics 70

Academics Emergency Department Wellness 70

Taming the SRU

SEPTEMBER 15, 2023

Limited availability of radiology-performed US services in certain hospitals, especially overnight Can avoid unnecessary anticoagulation in patients Reduce time in ED to disposition In terms of workflow, when there is suspicion for a DVT, you need to first calculate a Wells’ Score for a DVT If low/moderate risk, can start with a D-dimer prior to committing (..)

CPR 90

CPR Burns Airway Management Wellness 90

RebelEM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

EMDocs

OCTOBER 30, 2023

Background and Context Contrast-enhanced computed tomography (CECT) is of paramount importance in the emergency department (ED) due to its indispensable role in facilitating precise diagnostic outcomes. 3 A study of CT use trends in the ED has shown increasing use of CTs by almost 60% from 2005 to 2013. West J Emerg Med.

Radiology 99

Radiology Radiology Emergency Department Hospitals 99

The Skeptics' Guide to EM

DECEMBER 15, 2018

During winter periods a typical emergency department may well see a child a day presenting with a febrile seizure There was a SRMA by Rosenbloom et al. ( Eur J Paediatr Neurol 2013) that concluded antipyretics were ineffective in reducing the recurrence of febrile seizures in children.

Seizures 52

Seizures Pediatrics Emergency Department Administration 52

ACEP Now

OCTOBER 3, 2023

Kang, MD, FACEP, “ACEP supports the Commission’s proposal to categorically ban non-compete clauses, and we urge it to finalize the regulation as proposed to help address the current anti-competitive conditions faced by many emergency physicians that limit their right to freely practice medicine in their communities.” Ann Emerg Med.

Emergency Department 52

Emergency Department EMS Wellness 52

EB Medicine

MAY 3, 2019

This month, we’re moving into uncharted territories for the podcast… we’re talking psychiatry Nachi: Specifically, we’ll be discussing Depressed and Suicidal Patients in the emergency department. The PSS-3 assesses for depression/hopelessness and suicidal ideations in the past 2 weeks as well as lifetime history of suicide attempt.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

The Skeptics' Guide to EM

MAY 14, 2022

Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine. His twitter handle is @PainFreeED.

Emergency Department 52

Emergency Department Research Wellness 52

PEMBlog

OCTOBER 18, 2023

The night prior to presentation, mom noticed he was not feeding as well and seemed fussy. Initially in the emergency department he was generally well-appearing with normal vital signs. Infants with NTED generally remain well-appearing and do not meet toxic shock syndrome (TSS) criteria. No medication exposures.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

EM Curious

JULY 24, 2015

Identify the triangle shaped femoral nerve, lateral to the femoral artery, as well as the iliopsoas muscle and the fascia illiaca running over its surface. Get your tip as close as possible to the nerve, and under the fascia illiaca, then inject (well, after aspirating first, of course). Academic Emergency Medicine, 20(6), 584–591.

Fractures 52

Fractures Ultrasounds Emergency Department Dislocations 52

EMDocs

JANUARY 29, 2024

Introduction: Neurologic emergencies are common in the Emergency Department (ED), and blood pressure management is critical to immediate management. 2013 Jul;44(7):1846-51. Epub 2013 May 23. ATACH-2 Trial Investigators and the Neurological Emergency Treatment Trials Network. doi: 10.1161/STROKEAHA.113.001212.

Stroke 99

Stroke Outcomes EMS Seizures 99

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

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. Nachi: While measuring thrombin time is not routinely recommended, the result of thrombin time or dilute thrombin time does correlate well with dabigatran concentrations across normal ranges.

Emergency Department 40

Emergency Department Stroke Wellness Resuscitation 40

Don't Forget the Bubbles

OCTOBER 21, 2024

Olivia, 7, has been brought to the emergency department. She is otherwise completely well. Her mother has brought her to the emergency department because she is worried that Olivia is doing the movements more frequently and would like a brain scan. They only occur when she’s awake. What are tics? World Psychiatry.

Emergency Department 59

Emergency Department Research Hospitals Wellness 59

EMDocs

APRIL 13, 2024

If the hematoma is not drained it can cause disruption of blood supply to the cartilage and subsequent necrosis, as well as an increase in risk of infection. A 21-year-old man presents to the emergency department for pain and swelling in his ear beginning 3 days ago. Clin J Sport Med 2013; 23:321 Jones SE, Mahendran S.

EMS 104

EMS Emergency Department Pediatrics Wellness 104

The Skeptics' Guide to EM

OCTOBER 28, 2017

Anthony Crocco is a Pediatric Emergency Physician and is the Medical Director & Division Head of the Division of Pediatric Emergency at McMaster’s Children’s Hospital. Case: A 12-day old girl presents with fever and is otherwise well. Anthony is also the creator of SketchyEBM.

Pediatrics 52

Pediatrics Documentation/Coding Emergency Department Hospitals 52

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). As may be seen in the table below, there are several themes as well a range of stringency. WHO - Who Needs an LP in the ED? Patients with concern for infection (i.e., Clin Infect Dis.

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

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

ALiEM

MARCH 7, 2024

It is usually large, nodular, well-defined, homogeneous, and slightly hypoechoic (Figure 13) [6]. Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). Dessie et al.,

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

All went well. Feng, MD Management of Cord Prolapse & Shoulder Dystocia [ppt] Eliza Rivera-Mitu, RN, MSN Cord Prolapse - Perinatal Services British Columbia [pdf] Umbilical cord prolapse A plan for an ob emergency By Sharon T. Preeclampsia/ Eclampsia - Emergency Department Resources. {3 abstracts} Luckett-Gatopoulos, S.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

RebelEM

MARCH 23, 2023

The 30-day emergency department readmission rate and all-cause 30-day readmission were significantly lower only when adjusted for propensity scores. of symptom-triggered phenobarbital versus symptom-triggered lorazepam in the emergency department (n=44). A randomized, blinded clinical trial (Hendey et al.)

Emergency Department 52

Emergency Department Burns Outcomes Hospitals 52

Downeast Emergency Medicine

MAY 16, 2022

The following three journal club articles sought to investigate the potential clinical benefits for the use of phenobarbital in the emergency department (ED) for the treatment of AWS. The Journal of Emergency Medicine. 3, pp 592-598, 2013.[ Articles reviewed 1. Staidle, et al. Rosenson, et al. Volume 44, No.

Outcomes 52

Outcomes Emergency Department Hospitals Wellness 52

Dr. Smith's ECG Blog

JUNE 18, 2013

His ECG was repeated at this point: This shows a well developed anterior STEMI. Usefulness of automated serial 12-lead ECG monitoring during the initial emergency department evaluation of patients with chest pain. Ann Emerg Med 1998;31(1):3-11. Figure-1: I've labeled the initial ECG from this June 18, 2013 post.

EKG/ECG 52

EKG/ECG Outcomes Emergency Department Hospitals 52