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Background The EmergencyDepartment(ED) team need to make sense of an ever-changing dynamic environment. Methods Non-random purposive sampling was used to recruit doctors and nurses from EDs in five hospitals in Cape Town. Data collection took place over 8 weeks between June and August 2018.
Trauma season is at hand and like all other pediatric emergencydepartments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. 2018;Volume 00(00):DOI:10.1097/BPO.0000000000001169. Hospital versus home management of children with buckle fractures of the distal radius.
Darnall Army Medical Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, (@long_brit) Disclaimer: The views expressed in this post are those of the authors and do not reflect the official policy or position of the Department of the Army, DoD, or the US Government.
The Centers for Disease Control and Prevention (CDC) estimates of emergencydepartment (ED) visits for 2022 were recently released. ED visit estimates and utilization rates for 2018 to 2022 are shown in Figure 1. The ED is clearly perceived as serving the needs of patients and as the front door to the hospital.
A young woman, 13 days post-tonsillectomy, comes into your rural emergencydepartment (ED) coughing up blood. Dr. Helman is an emergency physician at North York General Hospital in Toronto. Published August 6, 2018. and youre three hours from the nearest tertiary care center. Paediatr Anaesth. 2010;20(11):982-986.
Diagnosis of Acute Aortic Syndrome in the EmergencyDepartment (DAShED) study: an observational cohort study of people attending the emergencydepartment with symptoms consistent with acute aortic syndrome. first appeared on The Skeptics Guide to Emergency Medicine. EMJ Nov 2023. EMJ Nov 2023. per 100,000. [4-8]
Stercoral colitis in the emergencydepartment: a review of the literature. International journal of emergency medicine, 17(1), 3. Stercoral Colitis in the EmergencyDepartment: A Retrospective Review of Presentation, Management, and Outcomes. Annals of emergency medicine, 82(1), 3746. Stercoral Colitis.
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 emergencydepartment. Ann Emerg Med. 2018 Jun;128(6):1612-1620. Journal of veterinary emergency and critical care (San Antonio, Tex.
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 emergencydepartment. 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.
End-tidal carbon dioxide measured at emergencydepartment 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.
Physicians, nurses, and staff in emergencydepartments (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.
Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. The preliminary results of the 2022 EmergencyDepartment Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding.
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 emergencydepartment.
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.
Emergencydepartments (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.
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.
Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the EmergencyDepartment (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergencydepartment. Am J Emerg Med. Am J Emerg Med. 2, 2018, pp.
Patients with severe agitation are frequently encountered in the emergencydepartment (ED) setting. Emergencydepartments 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 emergencydepartment.
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.
Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergencydepartments (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.
Patients often seek care in the emergencydepartment (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.
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.
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 EmergencyDepartment Fracture, Dislocation, and Overuse. Most Important References * Ponce BA, Kundukulam JA, Pflugner R, et al.
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 emergencydepartment setting. Anesthesiology 2018; 128 : 38–43. [v] Medicine 2018; 97 : e13661.
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%
The patient was rushed to the nearest emergencydepartment (non-PCI facility) for stabilization. On arrival in the emergencydepartment, 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.
Are you using phenobarbital instead of benzodiazepines as the first-line monotherapy for patients in alcohol withdrawal in the EmergencyDepartment (ED)? More rigorous studies are needed determine dose thresholds that warrant hospital admission. The Journal of Emergency Medicine. The Journal of Emergency Medicine.
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.
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].
[display_podcast] Date: April 25th, 2018 Reference: Stern A et al, Corticosteroids for pneumonia (Review). Case: A 72-year-old gentleman presents to your emergencydepartment. display_podcast] Date: April 25th, 2018 Reference: Stern A et al, Corticosteroids for pneumonia (Review). Cochrane Database of Systematic Reviews.
Neck lumps are a common presenting complaint to the paediatric emergencydepartment 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.
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.
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 emergencydepartment (ED).
[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.
[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.
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
89% agree that violence in the emergencydepartment 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
[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 emergencydepartment. Dr. Rachel Littlefield is a PGY2 in Emergency Medicine at the University of […] The post SGEM#202: Lidocaine for Renal Colic?
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 emergencydepartment with a 68-year-old man post cardiac arrest patient. JAMA 2018 * Population: Adults who had a non-traumatic OCHA.
[display_podcast] Date: January 25th, 2018 Reference: Hawkins et al. Peripheral Intravenous Cannula Insertion and Use in the EmergencyDepartment: 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.
Single-dose dexamethasone is not inferior to 2 doses in mild to moderate pediatric asthma exacerbations in the emergencydepartment. 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.
[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.
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.
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 emergencydepartment (ED) with acute onset shortness of breath. October 19, 2018. Which one do you select? J Am Heart Assoc.
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