EMDocs

JULY 9, 2024

Insurance companies paying more attention to addressing social needs Medicaid: 1115 Demonstration Waivers, CalAIM in California ICD-10 code modifiers to acknowledge – and compensate—for the added complexity of social needs Additional resources/further reading: Liberman DB, Pham PK, Semple-Hess JE. Epub 2016 Nov 7. PMID: 27599265. Pediatrics.

Pediatrics 75

Pediatrics Emergency Department Research Burns 75

ACEP Now

JUNE 14, 2024

And the Board approved a new clinical policy, “Critical Issues in the Management of Adult Patients Presenting to the ED with Seizures,” rescinding the 2014 clinical policy with same title. There were some ACEP business decisions at the April Board meeting, as well. 17-23, 2025 in Orlando, Florida.

Sexual Assault 52

Sexual Assault Seizures Documentation/Coding EMS 52

American Medical Compliance

DECEMBER 6, 2023

Holistic care aims to increase their independence in everyday life activities while also enhancing their health and well-being to promote healthy aging. Integrative nursing principles are a branch of holistic philosophy that can help health workers improve the health of individuals, families, and communities.

Documentation/Coding 52

Documentation/Coding Wellness 52

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Cardiology consult note written around that time documents that "Pain improved with NTG, morphine in ED but still present." The note also says "slight lateral ST elevations noted, likely early repolarization since unchanged compared to 2014." This patient was not one of the lucky 6.4%

EKG/ECG 131

EKG/ECG Documentation/Coding Wellness Emergency Department 131

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.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Don't Forget the Bubbles

MARCH 19, 2024

In 2014, 71% (397) of emergency removals of children by police occurred out-of-hours or at weekends. Just 20% of a person’s health and general well-being is related to access to care and the quality of services. Key messages Consider social determinants of health and document these in a child’s clinical notes. Caitlin, A.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

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.

Resuscitation 40

Resuscitation Military Operations Emergency Nursing 40

Advanced Emergency Nursing from AENJ

MAY 27, 2014

This is a cased kit of a Sparklet Resuscitator (J size), with pressure chamber, regulator, tubing, reservoir bag, flow stopcock, and funnel mask, with associated documents. 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.

Resuscitation 40

Resuscitation Poisoning Research Administration 40

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.

EKG/ECG 92

EKG/ECG Hyperthermia / Hypothermia Documentation/Coding Wellness 92

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

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. link] Mitchell, E.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

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. Erratum in Mouth-to-Airway [adjunct] 4/22/2014. EMS in America: The Foundation Documents. Reviewed and revised 4 December 2014. Trimble, Tom, RN CEN.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

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. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease. What do you see?

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

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, 2014. Mar 27, 2014. Video] Feb 11, 2014. How versatile are your airway skills? Oh, sure, you can handle any supine situations! YouTube.com.

Airway Management 40

Airway Management Pediatrics Resuscitation Emergency Nursing 40

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. 2014; 14:83.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Dr. Smith's ECG Blog

JULY 3, 2018

After admission he undergoes another ECG, though it is unclear from documentation whether there was a change in his chest pain. He reports nausea as well. Documentation strongly suggests that this finding was what ultimately convinced the cardiologists that this was not pericarditis. The ejection fraction was 54% at that time.

EKG/ECG 52

EKG/ECG Documentation/Coding Administration Outcomes 52

Northwestern EM Blog

MAY 16, 2022

This is a great summary of the landmark randomized trial published in NEJM in 2014 assessing CT vs two types of US for patients with suspected renal colic in the ED setting. Please ensure that you document and discuss with the patient accordingly. ACR Appropriateness Criteria® acute onset flank pain–suspicion of stone disease.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

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?

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

ACEP Now

FEBRUARY 11, 2024

4 It is believed that substantial gastrointestinal loss causes chloride and potassium depletion, as well as hypovolemia, acute kidney injury, and renal potassium loss. There have been documented cases of overdose, and of note, there is no known antidote. Deerfield, Illinois: Takeda Pharmaceuticals America Inc; 2014. Steatorrhea.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

EB Medicine

JULY 8, 2019

Jeff: Well that’s kind worrisome. Jeff: A 2014 study even showed an up to 80% reduction in the likelihood of developing DM2 postoperatively at the 7-year mark. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in. While it was < 15% in 1990, by 2016 it reached 40%.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Pediatric Education

NOVEMBER 12, 2023

weeks was seen for well-care. No specific documentation regarding the duration of the car seat testing could be identified in the medical records. 2014-3527 Davis NL, Shah N. Patient Presentation A former 35 week, appropriate for gestational age male, now 37.5 The pertinent physical exam showed the patient was now 3.34

Pediatrics 40

Pediatrics Poisoning Hospitals Documentation/Coding 40

Don't Forget the Bubbles

JUNE 10, 2024

Baby A, a preterm infant, appears to be faring well for the moment—requiring minimal respiratory support, on full feeds, without IV access, and generally in an okay condition. The history of necrotising enterocolitis The earliest documented cases resembling Necrotising enterocolitis (NEC) date back to the late 19th and early 20th centuries.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

PulmCCM

FEBRUARY 17, 2025

But the range was broad: 25% were coded for less than 13 minutes, and 25% for more than 30 minutes. Health professionals who repeatedly perform CPR perceived as excessive or futile may experience reduced job satisfaction and well-being. 2014 Dec;3(6):e001044. who died) was 21 minutes. J Am Heart Assoc. doi: 10.1161/JAHA.114.001044.

CPR 112

CPR Hospitals Resuscitation Documentation/Coding 112

EB Medicine

OCTOBER 1, 2018

Jeff : So as well all know Sepsis is bread and butter emergency medicine, but, what is sepsis? In 2014, the Society of Critical Care Medicine and the European Society of Intensive Care Medicine started a task force, and by 2016, updated definitions were out again! Meaning, you’ve tried everything else, so you might as well try.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

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.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

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.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

Dr. Smith's ECG Blog

JULY 19, 2024

of very high risk NSTEMI patients underwent angiography in less than 2 hours in accordance with the 2014 ACC/AHA guidelines. In fact, in the one study I'm aware of in which it has been studied, only 6.4% Lupu et al. Clinical Cardiology.

EKG/ECG 115

EKG/ECG Documentation/Coding Outcomes Wellness 115

Downeast Emergency Medicine

OCTOBER 21, 2021

Applications were coded as “consistent” with Federation of State Medical Boards (FSBM) if they inquired only about current impairment from a mental health condition or did not ask about mental health conditions. All other applications were coded as “not consistent.” The New England Journal of Medicine March 23, 2017, 376; 12.[

Documentation/Coding 52

Documentation/Coding Emergency Department Shock Research 52

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

It was extremely well-liked by field personnel, but virtually unknown in hospitals. However, they could be used easily and well with the assist of head-straps which were never sold as part of the complete “kit” but only as an uncataloged “spare part.” Accessed July 28, 2014 **Quoting original documents of fascinating history.

Resuscitation 40

Resuscitation CPR Documentation/Coding EMS 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. 2014 Dec;31(6):678-87.

Infectious Diseases 164

Infectious Diseases Pediatrics Sepsis Documentation/Coding 164

RebelEM

NOVEMBER 11, 2024

What They Did: Investigators performed a retrospective cohort study in the Emergency Department at the University of Michigan between July 1, 2014 through December 31, 2018. Learning to recognize a strong instrumental variable, as well as the inherent limitations, will likely become increasingly high yield.

Sepsis 113

Sepsis Outcomes Administration Shock 113

Sensible Medicine

MARCH 11, 2025

A 2014 follow-up study by de Jonge analyzed 743,070 low-risk planned home and hospital births and found no significant difference in perinatal or neonatal mortality. analyzing about 500,000 planned low-risk home births in well-resourced countries, found no difference in perinatal or neonatal outcomes compared to planned hospital births.

Outcomes 86

Outcomes Hospitals Wellness Documentation/Coding 86

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Recent studies have shown that low-dose ketamine can reduce pain in acute painful crises of sickle cell patients as well as being an opioid-sparing drug.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Dr. Smith's ECG Blog

MARCH 8, 2025

It is now well recognized that acute MI can precipitate takotsubo. International expert consensus document on takotsubo syndrome (part I): Clinical characteristics, diagnostic criteria, and pathophysiology. In my opinion, the ECG changes and hemodynamic collapse seem out of proportion to the observed/suspected coronary pathology.

EKG/ECG 75

EKG/ECG CPR Resuscitation Wellness 75

EB Medicine

DECEMBER 1, 2018

Antigen drift refers to small point mutations to the viral genes that code for H and N. Jeff: Of note, EMS providers should use face masks themselves and place them on patients as well. Jeff: Viral culture and RT-PCR remain the gold standard, but both require more time and money, as well as a specialized lab. Nachi: Amazing.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Expiratory airway obstruction may well have been frequently misdiagnosed as it can produce breath-stacking and ball-valve obstruction that impedes any airflow with mask ventilation if neither a nasal nor an oral airway is used and the lips have closed under the mask. Lubricate well. Gerkin] Priceless. Always be gentle! Deshmukh, S.

Resuscitation 40

Resuscitation Airway Management EMS CPR 40

Mind The Bleep

SEPTEMBER 17, 2024

Document clearly: The location of all wounds Medical photography or drawn labelled diagrams can aid in explaining the exact location. Always consider an ATLS approach to the assessment. Feel for any swelling/collection/abscess. Move: Assess the range of motion of the surrounding joints to help determine the involvement of adjacent structures.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52