Don't Forget the Bubbles

DECEMBER 2, 2024

This single-centre prospective study focused on a quality improvement (QI) project to reduce the overuse of chest X-rays (CXR) in paediatric patients with acute asthma exacerbations (AAE) arriving at the emergency department (ED ). The interventions were based on GINA guidelines 2018 and performed over a 5-month period.

Documentation/Coding 98

Documentation/Coding Pediatrics Emergency Department Fractures 98

Taming the SRU

MAY 22, 2023

Ankle fractures are the third most common fracture in the ED [2] and more than 20,000 patients are seen in the ED for ankle sprains each day [3]. traumatic axial loading with calcaneal fractures, pilons, and vertebral compression fractures) [5]. Gross deformities often suggest fracture or dislocation [Image 2].

Fractures 76

Fractures Dislocations Operations Radiology 76

Taming the SRU

JANUARY 10, 2024

89% agree that violence in the emergency department has harmed patient care. Additionally, ED boarding is a now a larger factor than in 2018. None of the physicians in the study believe that the rate of violence has decreased at all.

EKG/ECG 92

EKG/ECG Shock Fractures Emergency Department 92

The Skeptics' Guide to EM

OCTOBER 6, 2018

[display_podcast] Date: October 5th , 2018 Reference: Stiell et al. A Multicenter Program to Implement the Canadian C-Spine Rule by Emergency Department Triage Nurses. display_podcast] Date: October 5th , 2018 Reference: Stiell et al. She is worried she may have a serious injury to her neck. Reference: Stiell et al.

Emergency Department 52

Emergency Department EMS Fractures 52

Taming the SRU

FEBRUARY 5, 2024

Traumatic brain injury (TBI) accounts for millions of Emergency Department visits annually. While moderate and severe TBI is often managed on an inpatient basis, patients presenting with mild TBI, or concussion, are often managed solely by Emergency physicians.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

The Skeptics' Guide to EM

JULY 17, 2018

[display_podcast] Date: July 16th, 2018 Reference: Gupta M et al. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. display_podcast] Date: July 16th, 2018 Reference: Gupta M et al. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Pediatrics 52

Pediatrics Head Injuries Academics Emergency Department 52

EMDocs

OCTOBER 9, 2023

Yoo, MD (Assistant Professor/Core Faculty, San Antonio, TX) // Reviewed by Brit Long, MD (@long_brit) Case An 18-year-old man with a history of asthma and medication noncompliance presents to the emergency department (ED) with acute onset shortness of breath. October 19, 2018. Which one do you select? Published 2017 Oct 12.

Basic Life Support 81

Basic Life Support CPR Fractures Emergency Department 81

Taming the SRU

NOVEMBER 14, 2023

Chief complaints involving the ear are a common occurrence in Emergency Departments across the US and include presenting symptoms such as ear pain or fullness, hearing loss, redness, trauma, vertigo, and foreign bodies. A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6

Emergency Department 92

Emergency Department Pediatrics Wellness Documentation/Coding 92

Taming the SRU

NOVEMBER 27, 2023

These patients may be discharged with close outpatient follow-up, and should be instructed to return to the Emergency Department if they develop worsening and/or spreading pain and swelling, as this may be indicative of an infectious process. Antibiotics are not indicated [7, 8].

Soft Tissue Injuries 93

Soft Tissue Injuries Emergency Department EMS Fractures 93

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. Trauma CTs showed a "mildly displaced sternal fracture and a small retrosternal hematoma." He was intubated for altered mental status.

EKG/ECG 112

EKG/ECG Wellness Fractures Emergency Department 112

EB Medicine

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. In total, they pulled references from 1966 until 2018. Jeff: Let’s move on to evaluation in the emergency department.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Taming the SRU

FEBRUARY 12, 2024

HISTORY OF PRESENT ILLNESS A female in her 30s arrives to the emergency department via emergency medical services. She arrives in the emergency department agitated and unable to answer questions appropriately. The patient is agitated on a backboard with C-collar in place. BMC Pharmacol Toxicol. May 2; 19(1): 19.

Administration 78

Administration Fractures Anaphylaxis Head Injuries 78

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. I sent this to the Queen of Hearts So the ECG is both STEMI negative and has no subtle diagnostic signs of occlusion.

EKG/ECG 121

EKG/ECG Documentation/Coding Fractures Emergency Department 121

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. 2018 Aug 1;10(8):a028456. Evaluation of fever in the emergency department. ng/mL, 0.25-0.5

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

EMDocs

JUNE 3, 2023

How should pelvic fractures be identified in unstable trauma patients? Pelvic fractures can involve disruptions in any of the bony or ligamentous structures of the pelvic ring. Due to the round shape of the pelvic ring, multiple fractures typically occur concurrently. 2 Vertical shear fractures are also unstable.

Fractures 54

Fractures Resuscitation Operations EMS 54

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Klein 2018) Despite the high risk of pathology and decompensation, many patients with presumed alcohol intoxication can be evaluated and discharged without any labs or imaging. Annals of Emergency Medicine.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

Taming the SRU

OCTOBER 28, 2024

Potential causes include: -Trauma: Blunt or penetrating thoracic injuries, rib fractures, esophageal rupture (Boerhaave syndrome). When should I get a consultant involved in the emergency department? She is a graduate from the UC EM residency, class of 2018. West J Emerg Med. References 1. StatPearls [Internet].

COPD 77

COPD Pediatrics Emergency Department Ultrasounds 77

Mind The Bleep

SEPTEMBER 17, 2024

Introduction Patients regularly present to the emergency department with animal bites. Feel: Palpate the area of the bite to feel for areas of tenderness as this could indicate a fracture or infection. There should be a minimum of 2 views in the plain film, or 3 in the hands if there is a suspicion of a fracture.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

EMDocs

NOVEMBER 6, 2024

He denies any past medical history other than polysubstance abuse and depression. tetani infection is also indicated. tetani infection is also indicated.

Poisoning 76

Poisoning Airway Management Dislocations Forensics 76

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. Electrical injuries in the emergency department: an evidence-based review. Emerg Med Pract.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Don't Forget the Bubbles

JULY 22, 2024

The 2018 PREVIEW trial reported a significant reduction in length of stay (LOS) in children given prednisolone in Australia (24-71 months, mean 41 months) compared to placebo. There is an increased risk of pneumonia and sepsis in the 31-90 days after prescription and an increased risk of fractures, GI bleeds and sub-optimal growth.

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

PEMBlog

JUNE 5, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

The Skeptics' Guide to EM

APRIL 20, 2019

The article was called “A lexicon for gender bias in academia and medicine: Mansplaining is the tip of the iceberg” It was published in the December 2018 edition of the BMJ. Case: A 52-year-old man presents to the emergency department via EMS after a motor vehicle collision while driving home from the city.

Emergency Nursing 40

Emergency Nursing Sepsis EMS Fractures 40

EB Medicine

JUNE 6, 2019

Jeff: Abdominal pain is the one of most frequent complaint in US emergency departments, representing 8% of all adult ED visits, with admission rates for all patients with abdominal pain ranging between 18-42% and reaching as high as 60% for the elderly. Check out the August 2018 EMP or EMplify for more details if you’re curious.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EMDocs

NOVEMBER 16, 2024

6 Periprosthetic fracture Occurs at an estimated rate of 3.5-4.1%. 5 CT if concern for occult fracture. Periprosthetic Fractures Pain prior to injury may point toward underlying pathology like infection, implant loosening, etc. Unified classification system used to describe periprosthetic hip fractures. 10% of patients.

EMS 75

EMS Dislocations Fractures Operations 75

The Skeptics' Guide to EM

MARCH 25, 2018

[display_podcast] Date: March 20th, 2018 Reference: Sawa et al. CJEM March 2018 Guest Skeptic: Dr. Christina Shenvi is an Emergency Physician at University of North Carolina. She is fellowship trained in Geriatric Emergency Medicine and has a podcast called GEMCAST. However, they were both unrestrained.

Outcomes 40

Outcomes Geriatric Emergencies Emergency Department COPD 40

Don't Forget the Bubbles

AUGUST 10, 2023

This is partly because the hands (including fingers) of children & young people have a tendency to fracture without as much compressive force being applied to the bones when compared with adult hands. We will focus on the most important structures when assessing paediatric hands in the emergency department.

Fractures 52

Fractures Soft Tissue Injuries Emergency Department Operations 52

The Skeptics' Guide to EM

JANUARY 26, 2019

JAMA Pediatrics December 2018 Guest Skeptic: Dr. Samina Ali is a pediatric emergency physician, clinician-scientist, and Professor of Pediatrics & Emergency Medicine at the University of Alberta in Edmonton. Case: A 10-year-old girl presents to your emergency department (ED) after falling off a zipline at the playground.

Pediatrics 52

Pediatrics Fractures Research Emergency Department 52

EMDocs

JULY 3, 2023

Louis); Alex Koyfman, MD (@EMHighAK); Marina Boushra, MD (EM-CCM Attending, Cleveland Clinic Foundation) Case A 62-year-old male with past medical history of hypertension (HTN), hyperlipidemia (HLD), and prior cerebrovascular accident (CVA) presents to the emergency department (ED) via ambulance. 2018 Mar 5;6:17. Neurocrit Care.

Seizures 84

Seizures Stroke Outcomes EMS 84

EMDocs

NOVEMBER 4, 2024

Costochondritis, rib fractures, and pericarditis are common causes of chest pain that can be treated with multimodal regimens. 7 Rib and Sternal Fractures: Rib fractures are often caused by blunt chest trauma. Up to two-thirds of rib fractures are missed on initial chest radiographs. J Emerg Med. Acad Emerg Med.

Emergency Department 97

Emergency Department Fractures Burns EMS 97

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. 23 Blunt vertebral artery injury has been found to be associated with older age, female sex, lower GCS, presence of neck pain, cervical spine fracture, and blunt carotid injury.

Stroke 85

Stroke Radiology Radiology Emergency Department 85