Don't Forget the Bubbles

SEPTEMBER 30, 2024

In the UK, as in most developed countries, more patients are presenting to Emergency Departments (EDs) with minor illnesses or injuries. examined 977,907 first-time ED presentations by children aged 0-15 across thirteen acute hospital trusts (between April 2014 and March 2017), trying to figure out how many were non-urgent.

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Emergency Department Research Pediatrics Hospitals 89

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.

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Ultrasounds Outcomes COPD Hospitals 128

Northwestern EM Blog

MARCH 1, 2025

While a randomized control trial should be done to evaluate the effect of early proning in a controlled environment, these studies suggest that we should consider using this in our Emergency Department for patients who present with hypoxia and concern for mild to moderate ARDS without urgent need for intubation. Crit Care Med.

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Emergency Department Fractures EKG/ECG Wellness 52

Don't Forget the Bubbles

MARCH 19, 2024

This has coincided with a widespread shortage of specialist placements for children facing behavioural, psychiatric, and child protection challenges, leading to an over-reliance on the placement of these children in hospitals. A paediatric social admission is one where a child is admitted to the hospital but not for a medical reason.

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Hospitals Psychiatric Documentation/Coding Pediatrics 52

Don't Forget the Bubbles

JANUARY 22, 2024

Repeated GP and hospital attendance might stimulate increased testing and unnecessary prescriptions. 2015) highlighted that a poor understanding of statistics often results in a belief that screening is more beneficial than it actually is. 2015 ;24(2):167-74. Families and patients may drive over-investigation. Malhotra et al.

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Emergency Department Best Practices Radiology Radiology 90

RebelEM

FEBRUARY 5, 2024

Sites: Investigators recruited patients at 31 French emergency departments at university and nonuniversity hospitals Duration : June 1, 2009 to March 31, 2015. Funding: The Cardinal Health Laboratory provided Turkel thoracentesis kits to two hospitals Trial Registry: Clinicaltrials.gov: NCT01008228.

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Outcomes Hospitals Research Emergency Department 103

Don't Forget the Bubbles

NOVEMBER 20, 2023

Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. Royal Children’s Hospital. Royal Children’s Hospital, Melbourne. Thorough history taking and detailed examination can aid in diagnosis. DOI 10.1016/j.cpha.2017.12.003

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Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

Emergency Medicine Journal

DECEMBER 22, 2023

Methods Discrete event simulation was used to model a large urban teaching hospital in the UK, as a case study, with a colocated GP service. The Centre for Urgent and Emergency Care research database patient-level database (May 2015–April 2016), secondary literature and expert elicitation were used to inform the model.

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Emergency Department Research Outcomes Hospitals 52

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]. . + Procalcitonin (PCT) Etiology: PCT was first discovered in 1984. However, it was not until a 1993 study that its significance was realized.

Infectious Diseases 90

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 90

The Skeptics' Guide to EM

JUNE 15, 2018

Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.

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Emergency Department Fluid Resuscitation Sepsis Hospitals 52

Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). Riskin (2015) showed that rudeness accounted for a 12% reduction in diagnostic and procedural performance in a simulated resuscitation.

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Leadership Resuscitation Teamwork Patient Safety 105

The Skeptics' Guide to EM

SEPTEMBER 10, 2022

Single-dose dexamethasone is not inferior to 2 doses in mild to moderate pediatric asthma exacerbations in the emergency department. Pediatr Emerg Care. 2022 Guest Skeptic: Dr. Harrison Hayward is a Pediatric Emergency Medicine fellow at Children’s National Hospital. Pediatr Emerg Care. Pediatr Emerg Care.

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Pediatrics Emergency Department Urgent Care Hospitals 52

The Skeptics' Guide to EM

MAY 20, 2023

Guest Skeptic: Dr. Kat Priddis is a paediatric emergency medicine consultant and trauma director at Watford General Hospital. Kat Priddis is a paediatric emergency medicine consultant and trauma director at Watford General Hospital. Which hospital should you transfer the patient to? NEJM Evidence. N Engl J Med.

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Hyperthermia / Hypothermia Pediatrics CPR Hospitals 52

EMDocs

SEPTEMBER 27, 2023

This would be similar to how all other Medicare providers (long-term care facilities, hospital payments, etc.) The MIPS system was established in 2015 as part of an effort to combat the perverse incentive to provide more care in a traditional fee-for-service model. are already reimbursed (5).

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Emergency Department Research Outcomes Hospitals 86

Emergency Medicine Journal

DECEMBER 22, 2023

Using CPMs to identify patients, rather than prespecified criteria, accommodates for the dynamic hospital user population and for sufficient time to provide preventative support. However, it is unclear how this care model would negatively impact survival.

Emergency Department 52

Emergency Department Hospitals Outcomes 52

RebelEM

MARCH 23, 2023

REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal Click here for Direct Download of the Podcast Clinical question : Is a phenobarbital-based or lorazepam-based alcohol detoxification protocol associated with a lower hospital length of stay compared to Ativan for alcohol withdrawal? Paper : Hawa F et al.

Emergency Department 52

Emergency Department Burns Outcomes Hospitals 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. Between 81-95% of life-threatening ventricular dysrhythmias and acute cardiac failure occur within 24-48 hours of hospitalization. 2015, March 1).

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EKG/ECG Wellness Fractures Emergency Department 114

PHEM Cast

APRIL 10, 2016

One year mortality of patients treated with an emergency department based early goal directed therapy protocol for severe sepsis and septic shock: a before and after study. Severe Sepsis in Pre-Hospital Emergency Care. Am J Emerg Med. 2015 Aug 26;:1–31. Am J Emerg Med. 2015 Oct 17;:1–16.

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Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. After a short period of recovery in the hospital, she is discharged home in stable condition with follow-up with OBGYN. Am J Emerg Med.

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Ultrasounds Operations Radiology Radiology 99

EMDocs

OCTOBER 21, 2023

In hospital mortality estimated at 30-40%. 17 65-78% of survivors have significant disability one month after hospital discharge. 2015 Jul;5(3):142-50. Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department. 2015 Jan;46(1):102-7. link] January 24, 2007.

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EMS Stroke Outcomes Hospitals 97

The Skeptics' Guide to EM

SEPTEMBER 16, 2017

Guest Skeptic: Dr. Anand Swaninathan is an Assistant Professor of Emergency Medicine at NYU/Bellevue Hospital in the Department of Emergency Medicine. Guest Skeptic: Dr. Anand Swaninathan is an Assistant Professor of Emergency Medicine at NYU/Bellevue Hospital in the Department of Emergency Medicine.

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Anaphylaxis Administration EMS Emergency Department 52

EMDocs

JUNE 16, 2023

Episode 4 covered management of the agitated child in the pre-hospital environment. And now we’re here at our destination, the place we know and love, the emergency room to talk about what we should be doing for the growing volume of children with mental health problems boarding in the emergency department.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

Ultrasounds 95

Ultrasounds Documentation/Coding Wellness EMS 95

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. first appeared on The Skeptics Guide to Emergency Medicine. The TOMAHAWK Investigators.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. He was transitioned to cefdinir and fluconazole for a full 7-day course of antibiotics and discharged from the hospital on day three, with instructions to follow up with general surgery for an outpatient cholecystectomy.

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Ultrasounds Sepsis Radiology Radiology 80

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Case: You’re working a shift in a rural emergency department when a 68-year-old man presents with a two-day course of worsening cough, shortness of breath, and fever. This is Bob’s ninth visit to the SGEM. DISCLAIMER: THE VIEWS AND OPINIONS OF THIS PODCAST DO NOT REPRESENT THE UNITED STATES GOVERNMENT OR THE US AIR FORCE.

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Poisoning Administration Hospitals Sepsis 52

The Skeptics' Guide to EM

OCTOBER 28, 2017

Pediatrics 2017 Guest Skeptic: Dr. 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: […] The post SGEM#193: Stop, In the Name of Love first appeared on The Skeptics Guide to Emergency Medicine.

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Pediatrics Documentation/Coding Emergency Department Hospitals 52

ACEP Now

OCTOBER 15, 2023

1 The emergency department remains an important frontier for work in judicious prescribing, but opiate analgesia remains a valuable tool for the initial treatment of a variety of presentations. The treatment response for any six-week program is of limited relevance to the acute treatment provided in the emergency department.

Emergency Department 52

Emergency Department Outcomes CDC Research 52

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Barr 2016 , Trevejo-Nunez 2015) Patients are at high risk of bleeding from the GI tract due to clotting factor impairment or devastating hemorrhage from esophageal varices in the setting of portal hypertension.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

The Skeptics' Guide to EM

NOVEMBER 20, 2021

Moving the Needle on Fall Prevention: A Geriatric Emergency Care Applied Research (GEAR) Network Scoping Review and Consensus Statement. AEM November 2021 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).

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Geriatric Emergencies Elder Abuse Research Academics 52

Don't Forget the Bubbles

MAY 29, 2023

A qualitative study of 2,815 pre-hospital clinicians reported that nearly half of the respondents had experienced incivility from professional teams at least once a week. Bad manners in the Emergency Department: Incivility among doctors. Organizational Dynamics [Internet] 2015:44:4: 258-265. PLoS ONE [Internet].

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Leadership Patient Safety Academics Research 98

EMDocs

FEBRUARY 22, 2024

Authors: Katey DG Osborne, MD (EM Attending Physician: Tacoma, WA) and Rachel Bridwell, MD (EM Attending Physician: Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital); Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp! Ann Emerg Med.

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EMS Emergency Department Hospitals 97

The Skeptics' Guide to EM

JUNE 5, 2021

Garreth Debiegun is an emergency physician at Maine Medical Center in Portland, ME and clinical assistant professor with Tufts University School of Medicine. He also works at an urgent care and a rural critical access hospital. first appeared on The Skeptics Guide to Emergency Medicine.

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Stroke Urgent Care Critical Access Outcomes 52

EB Medicine

AUGUST 6, 2019

Jeff: Edoxaban is up next, approved by the FDA in 2015 for similar indications as the other Factor Xa inhibitors. Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. This can help with destination selection when relevant.

Emergency Department 40

Emergency Department Stroke Wellness Resuscitation 40

The Skeptics' Guide to EM

JANUARY 12, 2019

He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine. We haver reviewed papers on pain management in the emergency department for many years on the SGEM. However, these were not patients recruited from the emergency department.

Emergency Department 40

Emergency Department Research Outcomes Hospitals 40

PHEM Cast

APRIL 21, 2021

Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Association Between Repeated Intubation Attempts and Adverse Events in Emergency Departments: An Analysis of a Multicenter Prospective Observational Study. Annals of Emergency Medicine 2012; Volume 60, Issue 6, Pages 749–754.e2

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Airway Management Resuscitation EMS Hospitals 40

ACEP Now

OCTOBER 30, 2023

A notable achievement was ESEM’s co-organization of the International Federation of Emergency Medicine Trauma Update Symposium in 2015. These initiatives aim to equip physicians with an evidence-based approach and effective management strategies for common emergency-department scenarios.

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Leadership Emergency Department Ultrasounds CPR 52