Pediatric EM Morsels

JULY 21, 2023

cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! Interrater reliability of Glasgow Coma Scale scores in the emergency department. Ann Emerg Med. 2018 Jun;128(6):1612-1620. Journal of veterinary emergency and critical care (San Antonio, Tex.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

The Trauma Pro

OCTOBER 18, 2024

Bottom line: I have visited a number of hospitals that successfully use the Nelson score to assist with admission service decision-making while the patient is still in the emergency department. Journal of Trauma Nursing, 25 (3), 192-195, 2018. The only gray zone is the score of 4 or 5. Am Surg, 88(7), 1537-1540, 2022.

Documentation/Coding 147

Documentation/Coding Emergency Department Hospitals 147

Taming the SRU

JUNE 11, 2023

End-tidal carbon dioxide measured at emergency department triage outperforms standard triage vital signs in predicting in-hospital mortality and intensive care unit admission. Acad Emerg Med 2023; 10.1111/acem.14703 Acad Emerg Med 2023; 10.1111/acem.14703 Enrollment period was from February 2016 to August 2018.

Hospitals 88

Hospitals Emergency Department EMS Outcomes 88

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. are caused by a behavioral crisis.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

ACEP Now

JUNE 7, 2023

Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. The preliminary results of the 2022 Emergency Department Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

ACEP Now

MAY 9, 2024

1,2 You’ll also find the story of Sheila Powell, a woman who suffered a pneumothorax during her 2018 Miami BBL and whose 16-year-old daughter worried that in “just a blink of the eye, I could have lost my mom.” Familiarity with post-op restrictions for gluteal AFT patients will also improve their care in the emergency department.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Emergency Medicine Journal

JULY 22, 2024

The rate of violent events in Mexico, especially in hospital settings, has increased since 2006, but has become more evident in 2018. Guanajuato State, located in central Mexico, is among the states most affected by the wave of violence, especially active shooter events. The year 2019 had the highest number of incidents.

Emergency Department 52

Emergency Department Documentation/Coding Hospitals 52

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. 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.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

EMDocs

SEPTEMBER 26, 2024

An attorney is consulted and a lawsuit filed against the hospital, the first ED physician, the EM group, and the PCP. Even if we don’t know who the second EP was, he was an agent of the hospital, so the hospital is also liable. Defense : Cardiomegaly is a chronic problem, not an emergency. Baccei SJ et al. Tyler W et al.

Radiology 95

Radiology Radiology EKG/ECG Documentation/Coding 95

RebelEM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2, 2018, pp.

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

ACEP Now

DECEMBER 11, 2023

Patients with severe agitation are frequently encountered in the emergency department (ED) setting. Emergency departments can be crowded and chaotic, further exacerbating mental health issues. A 2018 study by Klein et al., ACEP Policy statement: Use of droperidol in the emergency department.

Emergency Department 52

Emergency Department Pediatrics Research Hospitals 52

EMDocs

DECEMBER 11, 2023

As we all know, a critical concern for emergency physicians is identifying patients with heart tissue-threatening ischemia that could benefit from percutaneous catheterization via stent deployment by an interventional cardiologist. Fourth Universal Definition of Myocardial Infarction (2018). 2018 Oct 30;72(18):2231-2264.

EKG/ECG 119

EKG/ECG Emergency Department Academics Operations 119

ACEP Now

JULY 7, 2023

Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Heart disease and stroke statistics—2018 update: A report from the American Heart Association. Benjamin EJ, et al. Circulation.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

ACEP Now

MAY 10, 2024

Patients often seek care in the emergency department (ED) setting when flares of pain affect their ability to ambulate, climb stairs, or even stand up from sitting. Stegeman is an Ultrasound Fellow at Alameda Health System / Highland Hospital. Dr. Mikell is an Ultrasound Fellow at Alameda Health System / Highland Hospital.

Ultrasounds 92

Ultrasounds Emergency Department Hospitals Wellness 92

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.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

EB Medicine

JUNE 1, 2018

Join hosts Jeff Nusbaum, MD, and Nachi Gupta, MD on this episode of EMplify as they take you through the June 2018 issue of Emergency Medicine Practice: Managing Shoulder Injuries in the Emergency Department Fracture, Dislocation, and Overuse. Most Important References * Ponce BA, Kundukulam JA, Pflugner R, et al.

Dislocations 40

Dislocations Emergency Department Fractures Research 40

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The cohort of patients that require this intervention in the pre-hospital setting are likely to be the most critically unwell patients we encounter. It is currently the subject of future research and publication in the emergency department setting. Anesthesiology 2018; 128 : 38–43. [v] Medicine 2018; 97 : e13661.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

EMDocs

JUNE 1, 2023

Take Aways: The data do not suggest that targeted hypothermia improves neurological function, reduces death, or reduces hospital length of stay as compared to normothermia. 2018; 320(21):2211-2220. Bradycardia: 18.8% Average ventilator days (8.3 Bradycardia: 18.8% Average ventilator days (8.3 Bradycardia: 18.8% Bradycardia: 18.8%

Hyperthermia / Hypothermia 79

Hyperthermia / Hypothermia Outcomes Hospitals Emergency Department 79

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization. On arrival in the emergency department, invasive blood pressure was 35/15mmHg and the patient was in profound cardiogenic shock with severe confusion secondary to brain hypoperfusion. Long term follow up is not available.

EKG/ECG 129

EKG/ECG Shock Emergency Department Ambulance Services 129

ALiEM

JUNE 1, 2023

Are you using phenobarbital instead of benzodiazepines as the first-line monotherapy for patients in alcohol withdrawal in the Emergency Department (ED)? More rigorous studies are needed determine dose thresholds that warrant hospital admission. The Journal of Emergency Medicine. The Journal of Emergency Medicine.

Administration 98

Administration Emergency Department Seizures Hospitals 98

Taming the SRU

MAY 13, 2024

Acute stump appendicitis without evidence of perforation or abscess (Figure 1) HOSPITAL Course Acute Care Surgery was consulted from the ED and recommended admission for operative resection of a 3 cm remnant of the appendix. The patient was discharged on hospital day 5. World J Emerg Surg 13, 22 (2018). Clin Case Rep.

Ultrasounds 98

Ultrasounds Emergency Department Wellness Operations 98

RebelEM

JANUARY 25, 2024

A 2018 systematic review and meta-analysis of 25 studies focusing on the accuracy of emergency lung ultrasound showed sensitivity of 85-95% and specificity of 75-90% for pneumonia, sensitivity of 78% and specificity of 94% for COPD/asthma, and sensitivity of 75-90% and specificity of 80-90% for acute heart failure [4].

Ultrasounds 125

Ultrasounds Outcomes COPD Hospitals 125

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. Physician Assistant Clinics.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

The Skeptics' Guide to EM

APRIL 28, 2018

[display_podcast] Date: April 25th, 2018 Reference: Stern A et al, Corticosteroids for pneumonia (Review). Case: A 72-year-old gentleman presents to your emergency department. display_podcast] Date: April 25th, 2018 Reference: Stern A et al, Corticosteroids for pneumonia (Review). Cochrane Database of Systematic Reviews.

Hospitals 40

Hospitals Emergency Department Outcomes Shock 40

The Skeptics' Guide to EM

DECEMBER 30, 2018

Date: December 30th, 2018 Happy New Years to all the SGEMers out there in the #FOAMed world. It is time to reflect upon 2018 and look forward to 2019. Last year we named 2017 the year of FeminEM and celebrated 15 amazing women in emergency medicine. It is time to reflect upon 2018 and look forward to 2019.

Emergency Department 52

Emergency Department Academics EMS Hospitals 52

Emergency Medicine Journal

MAY 23, 2023

Background Upper gastrointestinal bleeding (UGIB) is a medical emergency with an approximate mortality of 10%, which results in a high hospitalisation rate. The Glasgow-Blatchford score (GBS) is recommended to identify low-risk patients who can be discharged from the emergency department (ED).

Emergency Department 40

Emergency Department Blood Transfusions Hospitals Wellness 40

The Skeptics' Guide to EM

FEBRUARY 17, 2018

[display_podcast] Date: February 14th, 2018 Reference: Alam N et al. Case: EMS is dispatched to a retirement […] The post SGEM#207: Ahh (Don’t) Push It – Pre-Hospital IV Antibiotics for Sepsis. first appeared on The Skeptics Guide to Emergency Medicine. display_podcast] Date: February 14th, 2018 Reference: Alam N et al.

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

The Skeptics' Guide to EM

APRIL 1, 2018

[display_podcast] Date: March 30th, 2018 Reference: Bronzetti et al. Upside-down position for the out of hospital management of children with supraventricular tachycardia. February 2018. Guest Skeptic: Dr. Robert Edmonds is an Emergency physician in the US Air Force. February 2018. February 2018.

Pediatrics 52

Pediatrics Emergency Department EKG/ECG Hospitals 52

Taming the SRU

MARCH 12, 2024

ED visits per 1000 adults with diabetes based on 2018 data resulting in over 500,000 annual hospital days. This amounts to annual hospital costs of $5.1 DKA accounts for approximately 223,000 ED visits annually or 8.9

Operations 97

Operations Hospitals Best Practices Wellness 97

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. Current bills in progress: US H.R.2663 2663 & S.1176 2584 & S.2768

EKG/ECG 93

EKG/ECG Shock Fractures Emergency Department 93

The Skeptics' Guide to EM

JANUARY 14, 2018

[display_podcast] Date: January 9th, 2018 Reference: Soleimanpour H et al. Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department. Dr. Rachel Littlefield is a PGY2 in Emergency Medicine at the University of […] The post SGEM#202: Lidocaine for Renal Colic?

Emergency Department 52

Emergency Department Ultrasounds Hospitals 52

The Skeptics' Guide to EM

MARCH 2, 2019

Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. Case: EMS arrive to your emergency department with a 68-year-old man post cardiac arrest patient. JAMA 2018 * Population: Adults who had a non-traumatic OCHA.

Airway Management 52

Airway Management CPR Hyperthermia / Hypothermia Outcomes 52

The Skeptics' Guide to EM

JANUARY 27, 2018

[display_podcast] Date: January 25th, 2018 Reference: Hawkins et al. Peripheral Intravenous Cannula Insertion and Use in the Emergency Department: An Intervention Study. AEM Jan 2018 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency.

Emergency Department 40

Emergency Department Academics Outcomes Research 40

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.

Pediatrics 52

Pediatrics Emergency Department Urgent Care Hospitals 52

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? J Am Heart Assoc.

Basic Life Support 103

Basic Life Support CPR Fractures Emergency Department 103

The Skeptics' Guide to EM

JANUARY 19, 2019

Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study. Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study. Date: January 17th , 2019 Reference: Clemency et al. Date: January 17th , 2019 Reference: Clemency et al.

EMS 52

EMS CDC Emergency Department Hospitals 52