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. Utilizing certified interpreters and documenting their use. Educating patients on their rights.

Documentation/Coding 104

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

Don't Forget the Bubbles

AUGUST 23, 2023

2016) “Implementation of a Post-Code Pause: Extending Post-Event Debriefing to Include Silence”. 2012) “Implementation of a Rapid Post-Code Debrief Quality Improvement Project in a Community Emergency Department Setting”. Be kind and care for yourself and those around you. Selected References Copeland, A. & & Liska, H.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

Dr. Smith's ECG Blog

OCTOBER 12, 2024

The providers documented concern for ST elevation in the precordial and lateral leads as well as a concern for hyperkalemic T waves in the setting of succinylcholine administration. Preliminary findings documented in the cath lab were “Anterior STEMI and no significant coronary artery disease.” (!!!) 2016 Nov;34(11):2182-2185.

EKG/ECG 116

EKG/ECG Documentation/Coding Emergency Department COPD 116

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. 2016 Nov 7;170(11):e162521.

Pediatrics 74

Pediatrics Emergency Department Research Burns 74

EMDocs

FEBRUARY 12, 2025

In 2016, about 3.05 Additionally, senescent keratinocytes release pro-inflammatory signals, activating immune cells and recruiting neutrophils, which exacerbate tissue injury. 5 Reactive oxygen species (ROS) generated by radiation amplify cellular damage, targeting lipids, proteins, and DNA. This figure is expected to rise to 4.17 9 Figure 1.

Best Practices 56

Best Practices Documentation/Coding Radiology Radiology 56

Dr. Smith's ECG Blog

MAY 27, 2024

Since the ECG now meets STEMI criteria, a code STEMI was activated. Am J Emerg Med 2016 5. There was a 99% mid RCA occlusion, and peak troponin was greater than 25,000ng/L (upper limit of assay). Kontos et al. J Am Coll Cardiol 2022 4. Bischof et al. Meyers et al.

EKG/ECG 123

EKG/ECG Documentation/Coding Emergency Department 123

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

All efforts to identify the decedent by hospital staff, law enforcement agencies or social service agencies should be well documented in the medical records. Accessed 07/30/2016. Accessed 07/30/2016. Accessed 07/30/2016. Based upon California Health and Safety Code 102850 and Government Code 27491.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Northwestern EM Blog

MARCH 1, 2025

Document thorough skin assessment every nursing shift, and inspect weight-bearing ventral surfaces. Proning makes the heart rest against the sternum, and the diaphragm is displaced inferiorly. This change in positioning of mediastinal structures allows for increased distention of the posterior lung (Koulouras et. 2020; Koulouras et.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

RebelEM

NOVEMBER 30, 2023

Studies without IRB approval Studies older than 2016 Intervention: Administration of <30 mL/kg IV crystalloid fluids within three hours of sepsis identification. Limitations: The investigators excluded studies published before 2016, non-English studies, and non-published studies, potentially missing valuable data.

Sepsis 121

Sepsis Fluid Resuscitation Resuscitation Administration 121

PEMBlog

JUNE 14, 2023

Boarding of Mentally Ill Patients in Emergency Departments: American Psychiatric Association Resource Document. Children’s Mental Health Emergency Department Visits: 2007-2016. Pediatrics March 2023; 151 (3): e2022057383. 10.1542/peds.2022-057383 2022-057383 Nordstrom K, Berlin JS, Nash SS, Shah SB, Schmelzer NA, Worley LLM.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

Don't Forget the Bubbles

MAY 10, 2023

Then you hear the words coming out of the speaker, “ Paediatric code black. Paediatric code black ”. You’ve heard the phrase code black before – it’s a traumatic cardiac arrest. You know a paediatric code black means paediatric traumatic cardiac arrest. 2016; 24(135): 1-10.DOI: You actually run down the corridor.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

Total Medical ComplianceHIPAA

NOVEMBER 7, 2022

In its 2016-2017 HIPAA Audits Industry Report, the Office for Civil Rights (OCR) provided a few examples of what a prominent location on a website might be: Through a drop-down menu on the home page. The OCR’s report made it clear that the NPP and general privacy documents should not be combined.

Documentation/Coding 72

Documentation/Coding Wellness 72

ACEP Now

NOVEMBER 7, 2023

1 In 2016, the 21st Century Cures Act (Cures Act) took additional steps to authorize the Secretary of Health and Human Services to identify and define information blocking and associated exceptions. Training opportunities for documentation best practices should be employed. Published December 16, 2016. HealthIT.gov website.

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

The Skeptics' Guide to EM

MAY 11, 2019

Case: An 18-year-old woman presents with a Grade 1 appendicitis (Tominaga et al J Trauma Acute Care Surg 2016). Background: The first documented appendectomy was done by Claudius Amyand in 1735. His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation.

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

Don't Forget the Bubbles

JANUARY 22, 2024

The campaign started in the United States in 2012, in Canada two years later, and in the United Kingdom in 2016. Choosing Wisely UK was launched in 2016 by the Academy of Medical Royal Colleges to identify tests, treatments, and procedures of questionable value. 2016 ;50(13):826-8. Br J Sports Med. Regan W, Hothi D, Jones K.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

Emergency Medicine Journal

JANUARY 22, 2024

This is an Institutional Review Board-exempt retrospective review of de-identified ED data available for the state of Maryland through the Healthcare Cost and Utilization Project (HCUP) database from 2016 to 2018.

Outcomes 40

Outcomes Emergency Department Poisoning Documentation/Coding 40

PHEM Cast

JANUARY 5, 2016

This is the Step 1,2,3 tool described: For more information on the toxidromes associated with various chemicals, biological agents and radiation sources have a look at this document (admittedly it’s a few years old but the content is still good, especially the flow chart which is pasted below): [link] What is an anti-muscarinic chemical?

Mass Casualty Incidents 52

Mass Casualty Incidents Documentation/Coding 52

The Injectable Orange

JUNE 20, 2017

This is met with resistance, “we’re too busy theirs not enough staff or time”, “the staff have done mock codes before, they really disrupt things and they hated them”. 2016 Mar;18(2):136-42. Debrief2Learn Sept 2016. link] Brazil, Spurr and Eppich, Simulcast Episode 2, August 2016 – Eppich Debriefing [link] Cheng, A.,

Head Injuries 52

Head Injuries Documentation/Coding Wellness Resuscitation 52

The Skeptics' Guide to EM

MAY 2, 2020

The crew then asks if you want them to transport your father Code 3 with full lights and sirens. July 2019 * Population: All dispatches of a transport-capable ground EMS vehicle to a 911 emergency scene from the 2016 National EMS Information System, both the response to the scene and the transport from the scene.

Documentation/Coding 40

Documentation/Coding EMS EKG/ECG Outcomes 40

Don't Forget the Bubbles

DECEMBER 16, 2024

Despite the clear benefits, pertussis vaccination coverage during pregnancy has declined from 75% in 2016 to just 58.6% Manual for the laboratory diagnosis of measles and rubella infection Geneva: WHO Documents Production Services, 2007 Available from: [link] [Accessed 4 Oct 2024] Government of the United Kingdom. in 20232024.

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59

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). C., & ESCMID Study Group for Infections of the Brain (ESGIB) (2016). Glennie, L., Gaillemin, O., Wyncoll, D., Kaczmarski, E., Thwaites, G., Davies, N. C., & Solomon, T. Mourvillier, B., Ostergaard, C.,

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

RebelEM

JUNE 8, 2023

2016; PMID: 27720568 Guest Post By: Courney Knieriem, MD PGY-1, Emergency Medicine Resident RWJBH Community Medical Center, Toms River, NJ Courtneyknieriem.md@rutgers.edu 2015;10(3):e0119331. PMID: 25789927 Schwartz MB, et al. The impact of push-dose phenylephrine use on subsequent preload expansion in the ED setting. Am J Emerg Med.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Triage documented a complaint of left shoulder pain. The neighbor recorded a systolic blood pressure again above 200 mm Hg and advised her to come to the ED to address her symptoms. The patient presented to triage at around 10 PM. The patient said, "I just don't feel good." Circulation , 130 (25). link] Bischof, J. Worrall, C., Thompson, P.,

EKG/ECG 123

EKG/ECG Outcomes Academics Documentation/Coding 123

EMDocs

AUGUST 8, 2023

2016 validation study 0 points for low risk, 1-5 for intermediate risk and 6-7 for high risk. Document consideration of torsion in males with abdominal pain. 2022 meta-analysis 0-2 as low risk and ≥5 or higher as high risk = AUC of 0.924. 0 as low risk, 1-5 points as intermediate risk and ≥6 points as high risk = 99.5%

Ultrasounds 94

Ultrasounds Documentation/Coding Outcomes Emergency Department 94

The Skeptics' Guide to EM

FEBRUARY 23, 2019

The Surviving Sepsis Campaign makes a number of recommendations in their 2016 guideline. JAMA 2018 * Population: Patients with sepsis identified using the international Statistical Classification of Disease and Related Health Problems, Tenth Revision (ICD-10CA) coding that was modified to be consisten.

Sepsis 52

Sepsis Administration Documentation/Coding Hospitals 52

RebelEM

JANUARY 29, 2024

Thrombolysis Compared with Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials. PMID: 15262836 Sharifi M et al. Pulseless Electrical Activity in Pulmonary Embolism Treated with Thrombolysis (from the “PEAPETT” Study). PMID: 27422214 Wang C et al.

Stroke 136

Stroke Outcomes Hospitals Administration 136

The Skeptics' Guide to EM

JULY 30, 2022

Somewhat surprisingly, we’ve never covered SBO on the SGEM, although Ped EM Superhero, Dr Anthony Crocco shared his views on the (lack of) utility of abdominal X-rays in paediatric constipation back in 2016 ( SGEM Xtra: RANThony#4 ).

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

The Skeptics' Guide to EM

OCTOBER 28, 2017

Stevens and colleagues updated their review in 2016 and concluded “sucrose is effective for reducing procedural pain” and “no serious side effects or harms have been documented with this intervention”. Clinical Question: 1) What is the current evidence for the use of sucrose in neonatal infants undergoing painful procedures?

Pediatrics 52

Pediatrics Documentation/Coding Emergency Department Hospitals 52

The Skeptics' Guide to EM

OCTOBER 1, 2022

It is not well documented, whether gaps in pain assessment and treatment exist in conditions in which opioids are not indicated, such as migraine headaches. Some groups of patients who are at greater risk than others ( elderly , women , mentally ill , certain ethnic groups, and insurance status ). Brown et al , Selbst and Clark ).

Pediatrics 52

Pediatrics Emergency Department Documentation/Coding Research 52

ACEP Now

OCTOBER 26, 2023

In this case, reasonable would mean that the person requesting PHI confirms that they are the patient’s clinician and that any transmitted documents will have secure receipt, e.g., to the department’s fax machine at the clerk’s desk, away from any general access. Published January 2016. HHS website. Accessed October 9, 2023.

Infectious Diseases 52

Infectious Diseases Documentation/Coding Hospitals Emergency Department 52

Don't Forget the Bubbles

JULY 26, 2023

Stredder et al, Archives of Disease in Childhood 2016 we see that 58% were not asked about triggers, 30% were not asked about duration and, importantly for risk stratification, 59% were not asked for a family history of cardiac disease. The presence of these pathways is documented inutero and they usually regress by around 20 weeks gestation.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Don't Forget the Bubbles

DECEMBER 13, 2023

Failure to thrive’ has many definitions We use standardized charts to document infant growth. 2016 Apr;175(4):573-9. Infants who are slow to gain weight require early treatment as they are at risk for having a short stature, behavioural and emotional problems, and developmental delays. Eur J Pediatr. doi: 10.1007/s00431-015-2676-4.

Dehydration 98

Dehydration CDC Hospitals Wellness 98

Don't Forget the Bubbles

FEBRUARY 26, 2024

2016 Sep 1;20:24-31. uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2019. Cochrane Database of Systematic Reviews. Mayordomo‐Colunga J, Medina A, Rey C, Concha A, Menéndez S, Arcos ML, Vivanco‐Allende A. Non‐invasive ventilation in pediatric status asthmaticus: a prospective observational study. Scotland HI.

Pediatrics 72

Pediatrics Research Documentation/Coding Outcomes 72

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

EMS in America: The Foundation Documents. Accessed 2/29/2016. No Author, No Date ©2016] American Association of Emergency Medicine. Accessed 2/29/2016. Accessed 2/2/2016. Accessed 2/29/2016. January 29, 2016. Accessed 2/29/2016. Accessed 2/29/2016. Touchstone, Mike. Sakran, J.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

The Skeptics' Guide to EM

DECEMBER 2, 2017

Case: You are working a regular shift in the emergency department when you hear a code blue called. The American Heart Association ( AHA ) reports that were 209,000 IHCA arrests in 2016. DISCLAIMER: The views and opinions of this podcast do not represent the United States Government or the US Air Force.

Hospitals 40

Hospitals CPR Resuscitation Documentation/Coding 40

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. As always, document clinical sobriety before discharge. 2016 Feb 4;65:242-51. Osteopathic Family Physician.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

Don't Forget the Bubbles

JULY 3, 2023

This data relies heavily on the coding, which we know is not standardized across healthcare sites- and, therefore may not be truly reflective. Four hundred data sets were included, 54% belonging to female patients. Discharge home from ED was the primary. Why does it matter?

Emergency Department 105

Emergency Department Hospitals Domestic Violence Pediatrics 105