RebelEM

JANUARY 25, 2024

Point-of-care ultrasound (PoCUS) is inherently operator-dependent, which may have led to inconsistencies in the quality and findings of the ultrasound exams across different operators. Additionally, the serial US group had higher hospital readmission rates on days 0-7 and 8-30 without improving hospital or 30-day mortality.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

PulmCCM

JANUARY 6, 2025

Their spread has coincided with the Centers for Medicare and Medicaid’s “sepsis bundle quality measure” (SEP-1) going live in 2015. With financial penalties coming for noncompliance with the new rule, hospital administrators rapidly deployed the alerts to fire on all eligible inpatients. And have they fired.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

EMDocs

NOVEMBER 1, 2023

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

Operations 93

Operations Radiology Radiology Fluid Resuscitation 93

RebelEM

APRIL 17, 2023

While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage. 2015 May;204(5):1064-8. Additionally, potential increases in resource utilization, healthcare expense, and ED length of stay are also essential considerations. Ultrasound has become an extended part of our physical exam.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

Don't Forget the Bubbles

JUNE 30, 2023

However, patients in the 1:1 group had the lowest 24-hour mortality ( 14% vs 18% vs 22% vs 24% ; p = 0.01), and in-hospital mortality ( 32% vs 36% vs 40% vs 44% ; p = 0.01). These procedures require an experienced operator. These procedures require an experienced operator. These procedures require an experienced operator.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Don't Forget the Bubbles

JUNE 17, 2024

Riskin (2015) showed that rudeness accounted for a 12% reduction in diagnostic and procedural performance in a simulated resuscitation. Creating a culture of safety and respect through professional accountability: case study of the Ethos program across eight Australian hospitals. 2015 May;30:656-74. 2015 Sep 1;136(3):487-95.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Taming the SRU

OCTOBER 23, 2023

At this point, the patient is taken to the operating room for a diagnostic laparoscopy. After a short period of recovery in the hospital, she is discharged home in stable condition with follow-up with OBGYN. She was taken to the operating room and found to have a right tubal ectopic pregnancy with a pseudogestational sac.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

Don't Forget the Bubbles

JANUARY 8, 2024

Dr Elyssia Bourke, based at Ballarat Base Hospital, is actively engaged in this area through her ongoing PhD research. As we are not used to sedating children in this way, choosing drugs and doses can be difficult. In paediatric emergency care, addressing the challenge of adolescent agitation is a complex and evolving task. Mulraney, M.,

Research 105

Research Emergency Department Psychiatric Academics 105

ACEP Now

MARCH 13, 2024

1 Hospital boarding is the main driver of ED crowding, with patients nearly always awaiting transfer to inpatient beds and now more commonly, to other hospitals. When considering inter-hospital transfer, the patient’s goals of care should be paramount in guiding the process.

Ethical Issues 52

Ethical Issues Emergency Department Operations 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]. This finding was not significantly different among operators with different levels of experience, or between adults and children.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

The Skeptics' Guide to EM

NOVEMBER 20, 2021

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). Background: We looked at geriatric falls on an SGEM Xtra in 2015. Date: November 16th, 2021 Reference: Hammouda et al.

Geriatric Emergencies 52

Geriatric Emergencies Elder Abuse Research Academics 52

Emergency Medicine Journal

MAY 23, 2023

Methods In this retrospective study, we included all adult patients who visited the ED of a single urban academic tertiary-care university hospital in South Korea for five consecutive years (1 January 2015 to 31 December 2019). The data set was randomly split into train and test sets (1:1) for internal validation.

Outcomes 40

Outcomes Emergency Department Academics Operations 40

The Skeptics' Guide to EM

NOVEMBER 28, 2020

Date: November 25th, 2020 Guest Skeptic: Dr. Joe Vipond has worked as an emergency physician for twenty years, currently at the Rockyview General Hospital. Date: November 25th, 2020 Guest Skeptic: Dr. Joe Vipond has worked as an emergency physician for twenty years, currently at the Rockyview General Hospital.

Infectious Diseases 52

Infectious Diseases Operations Outcomes Wellness 52

Don't Forget the Bubbles

JULY 26, 2023

REVERT trial (adults); Appelboam et al, Lancet 2015 showed that by modifying the traditional valsalva manoeuvre to be done semi-recumbent with a passive leg raise immediately afterwards increased the success from 17% cardioversion to 43%. This has been trialled (out of hospital) in known children with SVT. www.cats.nhs.uk/wp-content/uploads/guideline-intubation.pdf

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

PulmCCM

OCTOBER 16, 2024

Animal studies have suggested that the body could be prepped or trained to better withstand ischemic-reperfusion injury, by inducing mild ischemia in another tissue bed before the operation. The mechanism is unclear. The surgery is then performed. Several randomized trials have tested this maneuver, called remote ischemic preconditioning.

Outcomes 52

Outcomes Operations Research Hospitals 52

Advanced Medical Reviews

SEPTEMBER 15, 2017

FierceHealthPayer projected hundreds of thousands of dollars in savings from reduced ER/hospital admissions. But the study did not reach a clear conclusion about whether the uptick in utilization was ultimately good or bad; it could reduce physician or hospital visits in the long term, while costing payers more in the short term.

Operations 56

Operations Research Wellness Hospitals 56

33 Charts

OCTOBER 2, 2021

The fundamental problem: we turned on 24/7/365 access for patients (who of course like it) with no operational or business model to handle it. Why MyChart messages create a challenge for hospital systems So more contact and connection between doctors and patients seems like a good thing, right? Crucial that we fix this. Absolutely.

Leadership 75

Leadership Operations Administration Hospitals 75

RebelEM

MARCH 9, 2023

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. Suicide attempts in which alcohol is involved: a special group in general hospital emergency rooms. Epub 2015 Sep 14.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

AED Leader

SEPTEMBER 22, 2024

Portable defibrillators have become game-changers in saving lives during sudden cardiac arrest situations outside the hospital. With simple operation and minimal maintenance requirements, these AEDs are designed for ease of use – even for non-medical folks! Key features of portable AEDs Portable AEDs are a game-changer.

CPR 52

CPR Shock Operations Hospitals 52

ACEP Now

NOVEMBER 7, 2023

The 2015 Edition Cures Act sought to promote “transparency, modern standards, and enhanced health IT capabilities by fostering innovation in the health care technology ecosystem to deliver better information to patients, clinicians, and other users.” Dr. Bissmeyer is a senior resident at Orange Park Hospital in Jacksonville, Fla.

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

PulmCCM

APRIL 1, 2024

That could (and should) change if improved functional outcomes, persisting for months after hospital discharge, are ever confirmed in large, well-conducted trials. Authors included 130 studies published 2015-2023, “to ensure that included studies were representative of current medical practices, including ultrasonography guidance.”

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

ETM Course

MAY 3, 2017

Simple windlass-style tourniquets are relatively inexpensive, easy to apply and easy to operate. If there will be a delay of more than an hour to definitive surgical care (for example, delayed retrieval or prolonged transport time), all efforts should be made to obtain vascular haemorrhage control by a surgeon in the referring hospital.

Military 52

Military Shock Hospitals Operations 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Still, except for the public hospital, other hospitals did little emergency work and would have unattended first aid or treatment room in which one could meet one's physician or have an intern provide care in the meanwhile. ." Rebuilding of EDs in proximity to Radiology, Blood Bank, OR, and ICU, becoming organic to the hospital.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Advanced Emergency Nursing from AENJ

JUNE 16, 2015

Ordinary hospital practice would be for admission orders to specify Isolation Cart, to ensure that the ward would have one delivered and restocked daily until no longer needed. That is to say, I would need a “Positive Air Pressure Respirator” [Powered Air-Purifying Respirator] or “PAPR.” They are costly, too.

PPE 40

PPE Infectious Diseases Emergency Nursing Operations 40

Pediatric Emergency Playbook

FEBRUARY 1, 2016

REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. 2015 Jan;50(1):177-81. Withholding or termination of resuscitation in pediatric out-of-hospital traumatic cardiopulmonary arrest.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

Northwestern EM Blog

DECEMBER 20, 2021

Management is orthopedic consultation for operative stabilization [12]. 2015 Nov 15;92(10):908-16. Terese Whipple, MD Assistant Professor Department of Emergency Medicine University of Iowa Hospitals and Clinics How To Cite This Post: [Peer-Reviewed, Web Publication] Ng, T. References Smith E, Anderson M, Foster H.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

" [Coroners Society] King Richard I (the Lionheart) needed vast sums of money for the Third Crusade, operation of the kingdom, and for his ransom fro m Duke Leopold of Austria. All efforts to identify the decedent by hospital staff, law enforcement agencies or social service agencies should be well documented in the medical records.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Taming the SRU

MARCH 14, 2023

After a several week NICU stay for prematurity, the infant has been generally healthy and this is his first trip back to the hospital since discharge. Ultimately, definitive management is in the operating room with revision or replacement of the VP shunt. He has a weak cry and you notice bulging fontanelles. Lancet Neurol.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Taming the SRU

FEBRUARY 19, 2024

Arterial lines require specialized monitoring and nursing resources which are not available in all hospital settings. 12) Axillary While axillary arterial line placement has been uncommon, in the age of facile ultrasound operators it may become a more advantageous and accessible site particularly in patients with high BMIs.

Shock 59

Shock Resuscitation Ultrasounds Research 59

PEMBlog

JUNE 5, 2024

2015 Apr;22(4):441-6. Epub 2015 Mar 16. Or patients with a substantial head or torso injury and substantial means that they’re going to require an intervention or observation in the hospital. Any patient with a cervical spine injury or a neurologic deficit They’re getting admitted to the hospital.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Pediatric Emergency Playbook

APRIL 1, 2017

16 found that of 142 patients evaluated at a single site university hospital, 61 had a foreign body. Steady the operating hand by placing your hypothenar eminence on the child’s zygoma or temporal scalp, to avoid jutting the instrument into the ear canal with sudden movement. link] Accessed February 20, 2015. Broncoscopy!

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

Prevention of torsade depointes in hospital settings: a scientific statement from the American HeartAssociation and the American College of Cardiology Foundation. In addition, the QT can be volatile especially in ill hospitalized patients and some recommend continuous monitoring of the QTc for those at high risk. Drew BJ, et al.

EKG/ECG 52

EKG/ECG Outcomes Wellness Hospitals 52

Advanced Emergency Nursing from AENJ

SEPTEMBER 13, 2016

It is a 11:39 minute film, by Walter Reid Army Institute of Research Production of experimental research done by Peter Safar, MD, and associates, at Baltimore City Hospital's Department of Anesthesiology. March 27, 2015. " established that exhaled air was a satisfactory gas for resuscitation. Early Modern Resuscitators.

Resuscitation 40

Resuscitation CPR Emergency Nursing Basic Life Support 40

EMDocs

NOVEMBER 16, 2024

4 Pain is the most common reason for presentation in the early post operative period. 5 Highest risk of dislocation early in the post operative course due to laxity of the soft tissue after surgery. 6 Hip flexion or adduction in the early post-operative period can cause atraumatic dislocations (typically avoided for 6 weeks post-op).

EMS 98

EMS Dislocations Fractures Operations 98

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. Make sure that the patient knows not to operate vehicles or heavy machinery under the influence of drugs. Acute effects of synthetic cannabinoids: update 2015. Subst Abus.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EB Medicine

JUNE 6, 2019

Taylor and Shaukat of Emory and Coney Island Hospital respectively for their efforts in peer reviewing this huge topic. Jeff: An interesting question for your abdominal pain patient is to ask about the ride to the hospital. Jeff: Before we dive into the meat and potatoes of this month’s issue, let me also recognize Drs.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Don't Forget the Bubbles

JANUARY 27, 2025

However, the limitation with MRI scanning is the logistics of obtaining one in a busy hospital especially if it is an out-of-hours presentation of torsion. 2015) Surgical problems in the paediatric patient, Clinical Gynaecology, 2 nd edition, p578-579. 2015 Aug;33(8):487-93. Epub 2015 Jun 29. How unstable is this patient?

Ultrasounds 76

Ultrasounds Emergency Department Pediatrics Dehydration 76