PEMBlog

JUNE 14, 2023

Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. West J Emerg Med. 2019 Jul 22;20(5):690-695. Mental Health Revisits at US Pediatric Emergency Departments. Children’s Mental Health Emergency Department Visits: 2007-2016.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

Emergency Medicine Journal

JULY 22, 2024

The year 2019 had the highest number of incidents. Guanajuato State, located in central Mexico, is among the states most affected by the wave of violence, especially active shooter events.

Emergency Department 52

Emergency Department Documentation/Coding Hospitals 52

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Arch Dis Child.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

ACEP Now

NOVEMBER 14, 2023

The emergency department (ED) at UVA was rebuilt in 2019 and the department had not fully optimized its operations when COVID-19 hit. They also developed standard work documents for each role. The post Re-Engineering Flow in an Academic Emergency Department appeared first on ACEP Now.

Academics 52

Academics Emergency Department Leadership Operations 52

RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. Unfortunately, its not clear whether the documentation came from RTs or ED providers.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

EMDocs

JULY 25, 2024

The nurse completes the Columbia-Suicide Severity Rating Scale (C-SSRS) and documents that the patient’s recent thoughts of killing himself and his detailed plan makes him “High Risk” for suicide. There is no documented handoff to the on-coming emergency physician (EP) who assumes care. Medscape, January 08, 2019.

Documentation/Coding 82

Documentation/Coding Hospitals Patient Safety Emergency Department 82

PulmCCM

JUNE 12, 2023

Temperature management (or fever avoidance) should begin immediately after cardiac arrest (ideally in the emergency department, for out-of-hospital arrests) and continued for at least 72 hours. Elsevier boasted a 40% profit margin in 2019. Use code PULMCCM15 and get 15% off when you register online.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

RebelEM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. Epub 2019 Jul 3. Am J Emerg Med. J Med Toxicol.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

EMDocs

JUNE 2, 2023

Document what you gave and why, as well as the impact. Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry. West J Emerg Med. 2019 Mar;20(2):409-418. West J Emerg Med.

Psychiatric 66

Psychiatric Pediatrics Emergency Department Administration 66

EMDocs

SEPTEMBER 30, 2024

Inhaled Corticosteroids Rarely Prescribed at Emergency Department Discharge Despite Low Rates of Follow-Up Care. J Emerg Med. Among patients with a primary provider documented in the chart, 30-day outpatient follow-up rate was 21.3% (n = 313). Study: Kligler SK, Vargas-Torres C, Abbott EE, Lin MP. 2023 May;64(5):555-563.

Outcomes 83

Outcomes Documentation/Coding Academics Administration 83

Dr. Smith's ECG Blog

OCTOBER 12, 2024

A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. Vital signs were within normal limits on arrival to the Emergency Department. Written by Bobby Nicholson What do you think of this “STEMI”? Blood glucose was not low at 162 mg/dL.

EKG/ECG 94

EKG/ECG Documentation/Coding Emergency Department COPD 94

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 Fractures 92

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 55

Pediatrics Emergency Department Research Burns 55

EB Medicine

JULY 8, 2019

I’m Jeff Nusbaum and I’m back with Nachi Gupta for the 30 th episode of EMplify and the first Post-Ponte Vedra Episode of 2019. This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EMDocs

JUNE 16, 2023

And now we’re here at our destination, the place we know and love, the emergency room to talk about what we should be doing for the growing volume of children with mental health problems boarding in the emergency department. McEnany, Olutosin Ojugbele, Julie R. Doherty, Jennifer L. McLaren, JoAnna K. 10.1542/peds.2020-1174

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

Northwestern EM Blog

SEPTEMBER 26, 2022

Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The Emergency Department is a challenging work environment for a variety of reasons. Promoting hot debriefing in an emergency department. 2021, August 16).

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

ACEP Now

DECEMBER 10, 2023

In the program, Medicare patients who visit a participating emergency department (ED) with specific diagnoses will have their 14-day total cost of care measured across all settings by the state regulatory agency, also known as the Health Services Cost Review Commission (HSCRC). Ann Emerg Med. Am J Emerg Med.

Emergency Department 52

Emergency Department Hospitals Documentation/Coding 52

The Skeptics' Guide to EM

NOVEMBER 16, 2019

Date: November 6th, 2019 Reference: Lascarrou et al. NEJM Oct 2019 Guest Skeptic: Dr. Laura Melville (@lmelville535) is an emergency physician in Brooklyn, New York, is a part of the New York ACEP Research Committee, ALL NYC EM, and is the NYP-Brooklyn Methodist Resident Research Director. Do you continue with the ICE Code?

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia EMS Research Documentation/Coding 40

The Skeptics' Guide to EM

APRIL 24, 2021

Randomized Double-blind Trial Intramuscular Droperidol, Ziprasidone and Lorazepam for Acute Undifferentiated Agitation in the Emergency Department. Unfortunately, an FDA Black Box warning and supply issues meant that droperidol effectively vanished from the US armamentarium from 2013-2019 and other agents were used and investigated.

Emergency Department 40

Emergency Department Research Outcomes Documentation/Coding 40

Cook County EM Blog

MARCH 28, 2023

The Case: The patient is a 61-year-old male with non-insulin dependent diabetes, hypertension, coronary artery disease status post CABG in 2019 who presented with blurry vision of the left eye after being hit on the face with a blunt object by his roommate approximately ten days prior to presentation.

Dislocations 52

Dislocations Ultrasounds Fractures Radiology 52

EMDocs

AUGUST 8, 2023

Document consideration of torsion in males with abdominal pain. Just the facts: assessment and management of testicular torsion in the emergency department. Pediatr Emerg Care. 2019 Dec;35(12):821-825. Missed diagnosis often due to: atypical presentation, torsion not considered, or no testicular exam was done.

Ultrasounds 68

Ultrasounds Outcomes Documentation/Coding Emergency Department 68

Don't Forget the Bubbles

MARCH 19, 2024

In 2019, 14% of all child and adolescent mental health patients were treated in approved adult hospitals. Becasue paediatric emergency departments are accessible out-of-hours they become the de facto place of safety with access to immediate support. pdf Health Service Executive (HSE), 2019. What can clinicians do?

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

Dr. Smith's ECG Blog

JANUARY 9, 2024

She presented to the emergency department after a couple of days of chest discomfort. the most commonly overlooked arrhythmia ( See My Comment at the bottom of the page in the May 1, 2023 — and the November 12, 2019 post , among others ). The last echocardiography 12 months ago showed HFmrEF. The ECG below was recorded.

EKG/ECG 97

EKG/ECG Stroke Hospitals Documentation/Coding 97

PHEM Cast

APRIL 21, 2021

Guidance documents College of Paramedics Statement on Intubation, available here. Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Association Between Repeated Intubation Attempts and Adverse Events in Emergency Departments: An Analysis of a Multicenter Prospective Observational Study.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Don't Forget the Bubbles

DECEMBER 16, 2024

Similarly, the global vaccine coverage of children who received a first dose of measles vaccine was 83% in 2023, compared to pre-pandemic levels of 86% in 2019. A review of child deaths in England and Wales from 2019 to 2022 revealed that delayed or missed vaccinations were a contributing factor in 3% of cases. 2010;375(9716):2134-45.

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59

EMDocs

JULY 11, 2023

PMID: 7382250 MASAC Document 257 – Guidelines for Emergency Department Management of Individuals with Hemophilia and Other Bleeding Disorders. Published 2019. The post emDOCs Podcast – Episode 81: Hemophilia appeared first on emDOCs.net - Emergency Medicine Education. Kitchens CS. Occult hemophilia.

Head Injuries 62

Head Injuries Pediatrics Dislocations CDC 62

Northwestern EM Blog

MAY 16, 2022

1 Low-dose non-contrast abdominal CT has become the gold standard for diagnosis as it has become readily available in emergency departments nationwide, with some studies touting sensitivity and specificity of 97% and 95%, respectively.2 Please ensure that you document and discuss with the patient accordingly. J Urol 2019.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

A Rising Troponin That afternoon, he complained of increased shortness of breath and was noted to have oxygen saturations in the 70s, prompting a mini code to be called. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19). By the next day, the hs-cTnI was up to 1827 ng/L.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

Don't Forget the Bubbles

JULY 5, 2023

A 6-year-old girl from Saudi Arabia was referred by her General Practitioner to the local emergency department. However, there are documented adverse events such as haemorrhagic cerebrovascular accidents or recurrence of VOC after drug withdrawal, which represent a drawback in its regular use. 2019, 3 rd edition.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). Int J Emerg Med. The role of venous blood gas in the emergency department: a systematic review and meta-analysis.

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

ACEP Now

AUGUST 1, 2023

How does that apply to the role of the board certified emergency physician? Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. When those same fundamentals done right achieve great success, they aren’t little at all.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Don't Forget the Bubbles

JANUARY 22, 2024

Choosing Wisely in Paediatric Car e A trainee-led project in a UK tertiary paediatric emergency department looked at the usefulness of blood tests in 101 children. You receive a referral for a 7-year-old Josh, who presented to the emergency department (ED) with a 5-day history of fever, cough, and borderline oxygen saturation.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

The Skeptics' Guide to EM

MARCH 22, 2019

Date: March 20th, 2019 Guest Skeptic: Dr.Katie Walker is an emergency physician in Melbourne, Australia. Case: The emergency department is backing up. Your medical team is great, but you […] The post SGEM#250: Scribes – I Want to Break Free (from the EMR) first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 52

Emergency Department Documentation/Coding Dislocations Research 52

Dr. Smith's ECG Blog

JANUARY 17, 2024

This case was one of the 4% of true positive Code STEMI with an initial ECG labeled ‘normal’ by computer interpretation,[2] and there are dozens more such cases detailed here. Here you will sign up for the Queen of Hearts on the Telegram app: [link] Or, you can get the PM Cardio app with Queen of Hearts function through this QR code.

EKG/ECG 96

EKG/ECG Documentation/Coding Wellness Emergency Department 96

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. 2019 Mar;123:184-187.

Seizures 86

Seizures Stroke Outcomes EMS 86