NIOSH Science Blog

JUNE 18, 2020

Yet, surgical smoke is still inhaled daily by nurses in the operating room. In a 2016 study, NIOSH surveyed health care personnel who were exposed to surgical smoke. Since the 1990s the Association of Perioperative Registered Nurses (AORN) has recommended the evacuation of all surgical smoke.

Operations 81

Operations 81

Pediatric EM Morsels

NOVEMBER 17, 2023

2016 Feb;30(1):3-11. 0.41), p < 0.001. Anaesthesia. 2019 Sep;74(9):1186-1190. doi: 10.1111/anae.14787. Epub 2019 Jul 16. PMID: 31313280. Shi F, Xiao Y, Xiong W, Zhou Q, Huang X. Cuffed versus uncuffed endotracheal tubes in children: a meta-analysis. doi: 10.1007/s00540-015-2062-4. Epub 2015 Aug 22. PMID: 26296534.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. Date: August 30, 2023 Reference: Griffey et al. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta.

Diabetic Emergencies 110

Diabetic Emergencies Operations Hospitals Research 110

Mount Sinai EM

DECEMBER 27, 2022

Lisfranc injury x-rays Management Depends on the severity of injury, so consult with your orthopedic surgeon to determine operative vs nonoperative management. Print publication year: 2016 Print Publication year: 2022 Sports Medicine for the Emergency Physician A Practical Handbook , pp. 273 – 310. DOI: [link] in a new window].

Dislocations 130

Dislocations Fractures Operations Radiology 130

EMDocs

DECEMBER 6, 2024

5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. McGraw Hill; 2016. 9 Typical dose: Polyethylene glycol (Go-Lytely ) 25 mL/kg/hr in small children and 1.5-2 2 L/hr in adults. Hernandez SH, Nelson LS. & Rangan, C. doi: 10.1097/PEC.0b013e3182302604.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

The Trauma Pro

OCTOBER 4, 2024

years from 2013 to 2016. A pediatric multi-center study of study on adherence to activity restrictions was published last year. Ten Level I pediatric trauma centers in the US tabulated their experience with solid organ injuries over 3.75

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

Pediatric Education

MARCH 16, 2025

A 15 year review of the Consumer Product Safety Commission’s National Electronic Injury Surveillance System was conducted in 2016 of consumer products that children ingested or aspirated and were reported. Regulations have made many of these products safer. This did not include organic items such as food.

Pediatrics 59

Pediatrics Radiology Radiology Operations 59

Don't Forget the Bubbles

JUNE 30, 2023

A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016. These procedures require an experienced operator. These procedures require an experienced operator. These procedures require an experienced operator. Injury 2016; 47: 797– 804. Really, in a 14-year-old? You are not sure.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

PulmCCM

SEPTEMBER 4, 2024

OP is operating point, the operating point defines the cardiac output on the y-axis and Pra on the x-axis; Rcardiac is cardiac resistance (i.e., OP1 is operating point 1 at baseline. With tamponade, operating point 2 (OP2) is formed. Pmsa and Pra do not correlate (inset, upper right). cardiac function).

Ultrasounds 84

Ultrasounds Operations Research Outcomes 84

The Skeptics' Guide to EM

JUNE 4, 2017

Lancet August 2016. Lancet August 2016. Lancet August 2016. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial.

Radiology 52

Radiology Radiology CPR Hospitals 52

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. Resuscitation.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Don't Forget the Bubbles

JANUARY 17, 2024

Forrester reported data from the Texas Poison Centers surrounding 110 cases of superabsorbent polymer bead ingestions between 2011 and 2016. They passed away a few days after a second operation. Children will swallow almost anything. Why should Orbeez be an exception? Unfortunately, the anastomosis broke down. It’s beads, too!

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

Advanced Medical Reviews

SEPTEMBER 15, 2017

A 2016 RAND Corporation study published in Health Affairs looked at a group of Aetna enrollees and discovered a correlation between greater use of retail clinics and higher plan utilization. Responding to millennial influence on healthcare technology and operations. Their overall convenience has tradeoffs, though.

Operations 56

Operations Research Wellness Hospitals 56

ALiEM

SEPTEMBER 9, 2024

General surgery and neurosurgery should be consulted emergently for further operative interventions. 2016 Dec 28;7(Suppl 44):S1150-S1153. Imaging should be obtained to confirm diagnosis, and broad-spectrum antibiotics with CNS coverage should be started early. References Paff, M, Alexandru-Abrams, D, Muhonen, M, Loudon, W.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

The Skeptics' Guide to EM

JULY 30, 2022

Background: Somewhere between two and four percent of patients presenting to US EDs with abdominal pain have a small bowel obstruction (SBO) – those who are managed operatively (who are only 20-30%) account for 60,000 hospitalizations and 565,000 inpatient care days per year. Also joining us is Dr. Andrew Goldsmith.

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

RebelEM

NOVEMBER 6, 2023

Methylene Blue for Vasoplegic Syndrome After Cardiac Operation: Early Administration Improves Survival. to 1mg/kg/hr) Information regarding the vasopressors used in the study is as follows: Norepinephrine equivalents = norepinephrine mcg/kg/min + (phenylephrine mcg/kg/min/10) + epinephrine mcg/kg/min + (vasopressin units/min x2.5)

Shock 71

Shock Administration Academics Hospitals 71

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). This is an example of why things in evidence-based medicine can be “complicated” ( SGEM#115 and SGEM#180 Clinical Question: Operative treatment or non-operative treatment of acute Grade 1 (uncomplicated) appendicitis?

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

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. Accessed 07/30/2016. Accessed 07/30/2016. Accessed 07/30/2016. Accessed 07/25/2016. April 6, 2016. Accessed 07/25/2016.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Farrington] Rebuilding of outdated hospitals put emergency rooms on ground level with nearby X-ray service, and, ideally, sometimes closer to the Blood Bank and the Operating Rooms. Accessed 2/29/2016. No Author, No Date ©2016] American Association of Emergency Medicine. Accessed 2/29/2016. Accessed 2/2/2016.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Taming the SRU

JANUARY 29, 2024

Variations in sensitivity are thought to be related to operator technique, patient habitus, and difficulty evaluating the subclavian vein beneath the clavicle. [12] 2016 Feb;50(2):98-101. Epub 2016 Feb 11. Greenberg J, Troutman DA, Shubinets V, Dougherty MJ, Calligaro KD. Vasc Endovascular Surg. Bolitho DG, Elwood ET, Roberts F.

Emergency Department 94

Emergency Department Fractures Hospitals Operations 94

ALiEM

MAY 13, 2024

63M with an Erythematous Abdomen Limitations of POCUS As with all ultrasound applications, soft tissue POCUS is operator dependent. Acad Emerg Med 2016 [7] 800 Systematic review of adult and pediatric (patients from birth – 21yrs) studies 97% (94-98%) 83% (75-88%) POCUS may assist physicians in distinguishing cellulitis versus abscess.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Don't Forget the Bubbles

MAY 10, 2023

Then the patient is rapidly moved to the operating theatre. 2016; 24(135): 1-10.DOI: The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre. Communication is closed-loop. with a shared collective mindset. DOI: [link] Gundrosen, S., Andenæs, E., 2009;18(2):109.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

EMDocs

SEPTEMBER 25, 2023

Improved Visualization: Video laryngoscopes allow for the use of standard or hyperangulated geometry, essentially allowing the operator to “look around the corner” on an anterior airway. Operators can manipulate the blade with less force to optimize the view, making it easier to identify and navigate the endotracheal tube into the trachea.

Emergency Department 93

Emergency Department Soft Tissue Injuries Airway Management Operations 93

The Skeptics' Guide to EM

MAY 28, 2017

This is called Non Operative Treatment of Appendicitis (N.O.T.A). David Talan ( Ann Emerg Med 2016 ). Clinical Question: Is non-operative treatment (N.O.T.) There is a small but increasing number of publications in the adult literature proposing management of the problem using simply intravenous antibiotics.

Pediatrics 40

Pediatrics Operations Emergency Department Ultrasounds 40

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

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. Published December 16, 2016. 2 Information blocking is any practice that is “likely to interfere with access, exchange, or use of [EHI].”

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

Unfortunately, we do not have those images for review, but the operators described a ruptured LAD plaque and they stented this area, which ensures the stability of the plaque. Fortunately, that is exactly what happened. The patient did well afterward without any recurrence of symptoms. There are no further EKGs or troponin measurements. .

EKG/ECG 127

EKG/ECG EMS Wellness Operations 127

Taming the SRU

JUNE 11, 2023

Utilized in the pre-hospital setting, ICU and the Operating Room, it is a non-invasive measurement that reflects a patient’s current state of metabolism, circulation and ventilation. Enrollment period was from February 2016 to August 2018. EtCO2 is a valuable tool in many medical specialties.

Hospitals 88

Hospitals Emergency Department EMS Outcomes 88

Northwestern EM Blog

MAY 2, 2022

Additionally, many chambers are not operated on nights and weekends, and of those available at off hours, many are unable to accommodate intubated patients. The benefit is thought to be highest when the treatment is performed early (ideally within six hours of exposure), which adds to the logistical burden.

Burns 52

Burns Poisoning EKG/ECG Operations 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 Fontan circulation was an operation initially developed around 50 years ago to treat tricuspid atresia.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

ACEP Now

MARCH 14, 2024

In our case, the patient had a CT of the head, cervical spine, and chest, abdomen, and pelvis with intravenous contrast demonstrated a C2, C7 compression fracture with significant bowel edema (Figure 4), and was taken to the operating room for left arm disarticulation, left below knee amputation and right above knee amputation.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Taming the SRU

MAY 27, 2024

This often is seen in trauma, cancer, post-operatively, and end-stage metabolic conditions with excessive colloid or protein leak. 13, issue 3, March 2016, p 305-450. If the volume of fluid is anticipated to re-accumulate quickly, a drain should be placed. Acute Hypoxemic Respiratory Failure after Large-Volume Thoracentesis.

Emergency Department 87

Emergency Department Ultrasounds Radiology Radiology 87

Advanced Medical Reviews

MAY 15, 2018

In 2016, a surgeon at Royal London hospital conducted a procedure streamed to 360-degree video and available via an online feed or a dedicated app designed for VR headsets capable of holstering compatible smartphones. Ultimately, they might be able to return to work sooner and require less extensive long-term care and WC benefits.

Telemedicine 45

Telemedicine Hospitals Operations Ultrasounds 45

ALiEM

AUGUST 9, 2023

The lung POCUS is also operator-dependent, and it has a steep learning curve. 2016 Jul;150(1):131-8. Limitations Lung pathology may be missed without a complete lung POCUS scanning protocol, as you will only see pathology located directly under the probe. PMID: 31211896 Jones BP, Tay ET, Elikashvili I, et al. J Ultrasound Med.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Intensive Blog

FEBRUARY 7, 2023

Figure 1: The development of LV Distension syndrome on VA ECMO (adapted from Amarelli et al (2016) 15 Q5. Insertion can be performed in the operating theatre, cardiac lab, or bedside in ICU – particularly attractive for a patient who is critically unstable on VA-ECMO The additional flow provided by the Impella may facilitate ECMO weaning.

Shock 52

Shock Operations Hospitals Outcomes 52

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. 2016 Feb 4;65:242-51. Any report of trauma should prompt evaluation with imaging. Osteopathic Family Physician.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

Don't Forget the Bubbles

MARCH 4, 2024

This study retrospectively identified 1,414 children, presenting to 15 UK EDs (2016 -2017), who had been screened for malaria. Participants were randomised to enhanced suctioning with a battery-operated device or minimal suction with a bulb device for 72 hours before all feeds. Paediatr Int Child Health. 2024 Jan 11:1-7.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78