Pediatric EM Morsels

OCTOBER 27, 2023

Taking care of a critically ill child can be nerve-racking to say the least, and downright petrifying for those who don’t do it frequently, even if they are well-trained and brilliant clinicians. Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Prehosp Emerg Care.

Pediatrics 269

Pediatrics Resuscitation Documentation/Coding Wellness 269

The Skeptics' Guide to EM

FEBRUARY 15, 2020

Case: A 32-year-old woman with no previous medical history calls you while a passenger on a […] The post SGEM#284: Might as Well Jump, but We would Recommend a Parachute first appeared on The Skeptics Guide to Emergency Medicine. Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial.

Wellness 52

Wellness Outcomes Emergency Department Research 52

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. Definitive emotional support is critical to our emotional and psychological well-being. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. & Liska, H. 23 (2), pp.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

EMDocs

JULY 9, 2024

The emergency department takes care of some of the highest risk patients with the worst access to health care and social services Over the past 20 years, many researchers have created and validated social needs screeners Some examples: iHELP, WE CARE, SEEK, USDA 2-item food insecurity questionnaire Does screening make a difference?

Pediatrics 71

Pediatrics Emergency Department Research Burns 71

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

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. Interdisciplinary Neurosurgery, 13, 66-70.

Sepsis 60

Sepsis Academics Operations Wellness 60

ALiEM

MARCH 7, 2024

It is usually large, nodular, well-defined, homogeneous, and slightly hypoechoic (Figure 13) [6]. Facts and Literature Review Bladder volume estimation Measuring bladder volume via POCUS in pediatric patients has been studied, demonstrating a benefit on Emergency Department workflow and length of stay (Table 1). Dessie et al.,

Ultrasounds 70

Ultrasounds Pediatrics Radiology Radiology 70

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. In fact, it’s use is so ubiquitous that the newer generation of emergency physicians are largely inexperienced in the insertion of central lines as a blind technique. Anesthesiology 2018; 128 : 38–43. [v]

Ultrasounds 98

Ultrasounds Shock Research Operations 98

EMDocs

DECEMBER 11, 2023

In October 2022, the American College of Cardiology released an updated expert consensus decision regarding the evaluation of chest pain in the emergency department. This included the addition several new STEMI equivalents [4] on ECG that warrant “prompt evaluation for emergency coronary angiography.” J Am Coll Cardiol.

EKG/ECG 110

EKG/ECG Emergency Department Academics Operations 110

Taming the SRU

MAY 13, 2024

The patient is a well-appearing male who is awake, alert, and oriented. There is also a well-appearing, healed surgical scar. There is also a well-appearing, healed surgical scar. The skin is warm and well perfused with brisk capillary refill. World J Emerg Surg 13, 22 (2018). BMP : Na 136, K 4.3,

Ultrasounds 97

Ultrasounds Emergency Department Wellness Operations 97

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. We prefer an in-plane, superior to inferior approach, but an out-of-plane technique can be performed, as well. 2018 Jan;21(1):41-52. J Emerg Med.

Ultrasounds 92

Ultrasounds Emergency Department Hospitals Wellness 92

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

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. 97.4%) 85.4% (78.9-90.2%) Lam et al.,

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

RebelEM

FEBRUARY 12, 2024

There are greater than 2 million annual emergency department visits for suspected renal colic in the US, and Ct scanning is performed for more than 90% of patients who receive a diagnosis of kidney stone. ” The Journal of Urology 199.4S (2018): e683-e684. What Your Gut Says: We need a CT report to diagnose a kidney stone.

Radiology 85

Radiology Radiology Emergency Department Ultrasounds 85

ALiEM

DECEMBER 8, 2023

A 45-year-old male status-post right nephrectomy secondary to a renal mass presented to the emergency department with right-sided flank pain. Major risk factors for their development include prior abdominal surgeries that weaken the musculature as well as cardiovascular co-morbidities. 2018 Apr;22(2):353-361.

Academics 60

Academics Emergency Department Outcomes Wellness 60

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

ACEP Now

JULY 7, 2023

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. Adult cardiac arrest in the emergency department – A Swedish cohort study. Circulation. Circulation.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

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. There is now some flow in the LMCA!

EKG/ECG 125

EKG/ECG Shock Emergency Department Ambulance Services 125

EB Medicine

DECEMBER 1, 2018

Nachi: And just last year we saw the 2017-2018 influenza epidemic with record-breaking ED visits. The 2017-2018 vaccine was only 40% effective, but this still translates to 40% less severe cases and a subsequent decrease in hospitalizations and death. This was the deadliest season since 1976 with at least 80,000 deaths. Nachi: Amazing.

Emergency Department 40

Emergency Department CDC Infectious Diseases EMS 40

Taming the SRU

APRIL 14, 2024

You may place cold packs or ice packs to the hernia site to help reduce inflammation and swelling, as well as to assist in local analgesia. Symptoms include persistent tenderness in the area, as well as symptoms of obstruction including nausea, vomiting, and pain, despite reduction. (2) References Chen, Shyr-Chyr, et al. 7638, 31 Jan.

Ultrasounds 92

Ultrasounds Emergency Department Pediatrics Radiology 92

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

EB Medicine

SEPTEMBER 1, 2018

Jeff: Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the September 2018 issue of Emergency Medicine Practice - Emergency Department Management of North American Snake envenomations.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

The Skeptics' Guide to EM

JUNE 24, 2018

[display_podcast] Date: June 15th, 2018 Reference: Silva et al. Safety and Efficacy of Intravenous Lidocaine for Pain Management in the Emergency Department: A Systematic Review. Ann Emerg Med. first appeared on The Skeptics Guide to Emergency Medicine. display_podcast] Date: June 15th, 2018 Reference: Silva et al.

Emergency Department 52

Emergency Department Outcomes Administration Research 52

ACEP Now

AUGUST 15, 2023

Emergency physicians spend only 5 to 10 percent of their time for personal activities on shift. While there has been ample discussion of “the practice of mindfulness” in health care workers that improves mental well-being, when do we have this time? 13-15 Even the thought of gratitude can positively influence mental wellness.

Emergency Department 90

Emergency Department Military Wellness Resuscitation 90

The Skeptics' Guide to EM

DECEMBER 15, 2018

Date: December 13th , 2018 Reference: Murata et al. 2018 Guest Skeptic: Dr. Damian Roland is a Consultant at the University of Leicester NHS Trust and Honorary Associate Professor for the University of Leicester’s SAPPHIRE group. first appeared on The Skeptics Guide to Emergency Medicine. Pediatrics. Pediatrics.

Seizures 52

Seizures Pediatrics Emergency Department Administration 52

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)? Well not exactly. The Journal of Emergency Medicine. Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives. 2012.07.056.

Administration 98

Administration Emergency Department Seizures Hospitals 98

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

Ultrasounds 70

Ultrasounds Documentation/Coding Wellness EMS 70

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. as well as patients less than 18 years old were excluded from analysis. DKA accounts for approximately 223,000 ED visits annually or 8.9 This amounts to annual hospital costs of $5.1

Operations 96

Operations Hospitals Best Practices Wellness 96

The Skeptics' Guide to EM

MAY 14, 2022

Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergency department and specifically the use of ketamine. His twitter handle is @PainFreeED.

Emergency Department 52

Emergency Department Research Wellness 52

American Medical Compliance

DECEMBER 7, 2022

In 2018, that number dropped to just 34 percent. Sixty percent of nurses report being victims of sexual assault and less than half of emergency department doctors have been victims of physical violence. Centering trust in patient-doctor interactions will be key to improving safety and well-being for everyone.

Sexual Assault 52

Sexual Assault Emergency Department Research Hospitals 52

The Skeptics' Guide to EM

FEBRUARY 10, 2018

[display_podcast] Date: February 6th, 2018 Reference: Foster SJ et al. Lancet January 2018 Guest Skeptic: Dr. Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. display_podcast] Date: February 6th, 2018 Reference: Foster SJ et al.

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

RebelEM

JANUARY 23, 2023

Second-generation H1 antihistamines (cetirizine, loratadine, and fexofenadine) do not cross the blood-brain barrier as easily (Bernstein J 2018). Philadelphia: Wolters Kluwer Health; 2018. Multicenter study of emergency department visits for insect sting allergies. Patients were randomized in a 1:1 ratio. Antihistamines.

Allergic Reactions 52

Allergic Reactions Anaphylaxis Emergency Department Urgent Care 52

The Skeptics' Guide to EM

SEPTEMBER 12, 2020

I have discussed burnout and wellness a number […] The post SGEM Xtra: The Water is Wide first appeared on The Skeptics Guide to Emergency Medicine. in November of 2018, the sudden death of my “little” brother Scottie (The Moose) in February 2020 and the unexpected death our family dog Moxy (best dog every) this summer.

Emergency Department 52

Emergency Department Wellness 52

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. Systolic function normal by visual assessment only, unable to visualize well for further characterization. The patient did well and was discharged.

EKG/ECG 107

EKG/ECG Wellness Fractures Hospitals 107

Taming the SRU

MAY 5, 2023

doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. 2018, Kuttab, Lykins et al. Sixty centers participated during the years 2018-2022. N Engl J Med. 2023;388(6):499-510. N Engl J Med.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

ACEP Now

SEPTEMBER 13, 2023

But what if we could measure a patient’s spleen via ultrasound in the emergency department (ED) to guide specific patient care? A multi-institutional, randomized, double-blinded, placebo-controlled trial (the BABY HUG trial) evaluated spleen size as well as serum labs and splenic dye uptake of technetium-labeled sulfur colloid.

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Poisoning 52

EB Medicine

AUGUST 6, 2019

Nachi: Well, I’m sure more of those studies are still coming. Nachi: Well that was a ton of information and background on the DOACs. Nachi: While measuring thrombin time is not routinely recommended, the result of thrombin time or dilute thrombin time does correlate well with dabigatran concentrations across normal ranges.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40