Emergency Medicine Journal

MARCH 21, 2024

’ –Audre Lorde It has been over 4 years since 14 November 2019 when the first documented case of COVID-19 emerged. This has exposed deep-seated racial inequalities that persist in disease burden, healthcare access and outcomes in patients and healthcare professionals alike.

Documentation/Coding 52

Documentation/Coding Outcomes 52

SheMD

MAY 11, 2023

In medical emergencies, provider qualities which lead to greater performance and patient outcomes include leadership and teamwork. Transcripts were coded to sort data into “leadership occurrences” or “unrelated to leadership” as well as critical treatment decisions. 2019; 47(1): e8- e13. [link] ,Why is this article important?

Leadership 52

Leadership Documentation/Coding Teamwork CPR 52

The Skeptics' Guide to EM

MAY 11, 2019

Date: May 6th, 2019 Reference: Sceats et al. Date: May 6th, 2019 Reference: Sceats et al. Background: The first documented appendectomy was done by Claudius Amyand in 1735. Exclusion: Patients with co-occurring diagnosis or procedure codes consistent with complicated appendicitis and patients lacking appendectomy codes.

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

RebelEM

AUGUST 12, 2024

PMID: 36038001 Clinical Question: In patients undergoing cardiac surgery with cardiopulmonary bypass, does the administration of intravenous amino acid therapy lead to lower occurrence of postoperative AKI when compared to placebo?

Outcomes 81

Outcomes Hospitals Operations Shock 81

The Skeptics' Guide to EM

MAY 2, 2020

July 2019 Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. July 2019 Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. The crew then asks if you want them to transport your father Code 3 with full lights and sirens.

Documentation/Coding 40

Documentation/Coding EMS EKG/ECG Outcomes 40

The Skeptics' Guide to EM

FEBRUARY 23, 2019

Date: February 22nd, 2019 Reference: Lane et al. Date: February 22nd, 2019 Reference: Lane et al. The study by Alam et al took adult patients with a diagnosis of suspected infection and randomized them to ceftriaxone 2g IV started pre-hospital or usual care with a primary outcome of all-cause mortality at 28 days.

Sepsis 52

Sepsis Administration Documentation/Coding Hospitals 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

EMDocs

AUGUST 8, 2023

Bimodal age of distribution: at birth and 12-18 years 14% of cases occur in adults; older patients have worse outcomes Bell clapper deformity – bilateral in 80% of patients Prior episode of torsion Family history Trauma (can be minor) Clinical Presentation: Sudden/severe testicular pain Often unilateral, may radiate.

Ultrasounds 79

Ultrasounds Documentation/Coding Outcomes Emergency Department 79

Taming the SRU

APRIL 22, 2023

For treatment, the American Heart Association’s 2019 guidelines recommend limiting use of non-dihydropyridiine CCB due to potential for negative inotropic effects. There were similar lengths of say overall and no significant difference in safety outcomes. There was no difference in safety outcomes.

Outcomes 52

Outcomes Stroke Documentation/Coding Fractures 52

PulmCCM

JANUARY 16, 2024

You can read the document for all the caveats. Their effects on meaningful patient outcomes are unclear, though, and their appropriate use continues to be debated. Neither document commented on treating ARDS patients with statins, which seemed very likely to have benefited some patients with hyperinflammatory ARDS in past trials.

Research 87

Research Documentation/Coding Outcomes Fractures 87

Dr. Smith's ECG Blog

JULY 7, 2024

But because Code STEMI was cancelled on arrival and the patient had delayed angiography, the discharge diagnosis was 'non-STEMI' despite having the exact same pathology. The patient also had a 100% proximal LAD occlusion, with a peak troponin of 100,000 ng/L.

EKG/ECG 69

EKG/ECG Documentation/Coding EMS Wellness 69

Don't Forget the Bubbles

JULY 26, 2023

Cardiac testing and outcomes in infants after an ALTE, Hoki et al, Archives of Disease in Childhood 2012 showed significant cardiac disease was present in <1% of patients presenting with ALTE (although cardiac abnormalities were found in 4% overall). A 12 year old girl was heard to be coughing in the middle of the night.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

PulmCCM

JANUARY 6, 2025

A cluster randomized trial using all-cause mortality as an outcome was always needed to determine whether EMR alerts improve outcomes for suspected severe infection. This led the authors to speculate that qSOFA parameters were being documented more diligently on the wards randomized to screening.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

The Skeptics' Guide to EM

APRIL 24, 2021

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. Exclusions: Prisoners or those in police custody, pregnant or breast-feeding, or with documented allergy to any study medications.

Emergency Department 40

Emergency Department Research Outcomes Documentation/Coding 40

Don't Forget the Bubbles

FEBRUARY 26, 2024

Outcomes of paediatric critical care asthma patients. uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2019. Changes in the use of invasive and noninvasive mechanical ventilation in pediatric asthma: 2009–2019. Rampersad N, Wilkins B, Egan JR. Journal of Paediatrics and Child Health. Scotland HI.

Pediatrics 72

Pediatrics Research Documentation/Coding Outcomes 72

Mind The Bleep

OCTOBER 29, 2024

Provide detailed documentation of the initial assessment, treatment provided, and the patient’s response to interventions. Proper stabilization and detailed communication with the burns centre are essential for optimal patient outcomes. 2019 Nov;34(4):276-281. Epub 2019 Nov 29. J Med Toxicol. 2015 Jun;11(2):227-31.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

Taming the SRU

NOVEMBER 14, 2023

Complications of auricular hematoma drainage include pain, paresthesia, bleeding, infection, poor cosmetic outcome, scar formation, and re-accumulation of hematoma after the procedure. Oxford Medical Case Reports, Volume 2019, Issue 9, September 2019, omz091. How to Remove a Foreign Body from the External Ear.

Emergency Department 93

Emergency Department Pediatrics Wellness Documentation/Coding 93

Downeast Emergency Medicine

APRIL 26, 2021

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Lancet 2019; Vol 394, Iss 10210, P 1713-1723[ Full Text ]. There were no differences found in the secondary outcomes.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. 2019 Aug; PMID: 30954692 Clinical Question: What is the impact of system factors in the implementation of standard-of-care LPV in critically ill ED patients admitted to the ICU? Paper: Owyang CG, et al.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Northwestern EM Blog

SEPTEMBER 26, 2022

It is well-documented that ED physicians have historically high rates of burnout compared to other specialties as well as a high incidence of post-traumatic stress disorder (PTSD) compared to the general population. The hot debrief allowed for concrete actions to be taken about these issues and for a dedicated plan of action for correction.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

RebelEM

DECEMBER 28, 2022

Conducted at 2 US Veterans Affairs medical centers from 2012–2019. No difference in exploratory outcomes. Low rates of missing data allowed other exploratory outcomes Included a diverse and potentially high-risk group, including patients with indwelling catheters and intermittent catheter use.

Outcomes 52

Outcomes Documentation/Coding Hospitals EMS 52

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? However, with ultrasonography becoming more prevalent in EDs, it may be possible that initial imaging may avoid this radiation risk and still have similar outcomes for patients. Would you be satisfied with only US and no follow-up CT?

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

RebelEM

SEPTEMBER 26, 2022

Randomized study design Blind adjudication of transfusion reaction outcomes Follow-up was complete. The primary outcome was disease-oriented The enrolled cohort appears to be a convenience sample Sealed envelopes are a weak type of allocation and prone to error and manipulation. Hayes-Larson 2019).

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

PHEM Cast

APRIL 21, 2021

Guidance documents College of Paramedics Statement on Intubation, available here. The Effect of Paramedic Rapid Sequence Intubation on Outcome in Patients with Severe Traumatic Brain Injury. AAGBI Safer Prehospital Anaesthesia 2017, available here. Tracheal intubation. Anaesthesia & Intensive Care Medicine. 20(12);681-686.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

Dr. Smith's ECG Blog

MAY 16, 2023

Other outcome information is not available. An additional criterion that has sometimes been cited as helpful for making the diagnosis of acute Pericarditis — is the ST/T Wave Ratio in Lead V6 ( Please see My Comment at the BOTTOM of the page in the December 13, 2019 post of Dr. Smith's ECG Blog ). No angiogram was performed.

EKG/ECG 52

EKG/ECG Stroke Documentation/Coding Outcomes 52

RebelEM

NOVEMBER 30, 2023

Outcomes: Primary Outcome: In-hospital mortality. Secondary Outcomes: Delayed hypotension, increased ICU stay, and other relevant outcomes. There was no specified time-frame for the primary outcome, potentially affecting the precision of the findings. May 1, 2019 , A5999-A5999. 2.89, p = 0.01. Hamdon, M.

Sepsis 116

Sepsis Fluid Resuscitation Resuscitation Administration 116

Don't Forget the Bubbles

MAY 10, 2023

Then you hear the words coming out of the speaker, “ Paediatric code black. Paediatric code black ”. You’ve heard the phrase code black before – it’s a traumatic cardiac arrest. You know a paediatric code black means paediatric traumatic cardiac arrest. You’re just about aware of the tannoy in the background. Emerg Med J.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

Don't Forget the Bubbles

MAY 31, 2023

What outcomes did they look at? Was the outcome accurately measured to minimise bias? The inability to test for SARS-CoV-2 antibodies may have led to an underestimation of the impact of the virus on the reported outcomes. All ED visits that met the criteria for ‘new onset diabetes’ or DKA (‘decompensation’) were included.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

EM Updates

JUNE 15, 2021

Every patient admitted to the EDAT was followed to the conclusion of their hospital course; the development of this unit and patient outcomes resulting from its execution are presented here. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

Don't Forget the Bubbles

JULY 5, 2023

Furthermore, educating both patients and their families is important in order to achieve good treatment compliance and better clinical outcomes. Incentive spirometry has also demonstrated to improve outcomes in SCD without respiratory symptoms and with back pain. 2019, 3 rd edition.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

EMDocs

JULY 3, 2023

Introduction SAH has the potential for rapid progression and devastating outcomes. This neurological evaluation should include assessment and documentation of the GCS, the presence of any neurologic deficits, and an NIHSS. Short- and long-term outcome of patients with aneurysmal subarachnoid hemorrhage. 2019 Mar;123:184-187.

Seizures 95

Seizures Stroke Outcomes EMS 95

ACEP Now

AUGUST 1, 2023

Recent data published in Annals showed that between 2013 and 2019, the percentage of clinicians working in rural areas who were emergency physicians actually dropped slightly. emergency department deserves access to an emergency physician no matter their zip code. It is critical for our specialty to work on our rural pipeline.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Cook County EM Blog

MARCH 20, 2023

Further document handedness, occupation, site of injury, and thorough review of systems to evaluate for potential complications ○ Complications as distant as pneumomediastinum following air injection of the hand have been reported5,6. ➢ 2019 Nov 16;8(11):2000. Latex paint-gun injuries of the hand: are the outcomes better?

Documentation/Coding 52

Documentation/Coding Fractures Operations Research 52

The Skeptics' Guide to EM

MARCH 22, 2019

Date: March 20th, 2019 Guest Skeptic: Dr.Katie Walker is an emergency physician in Melbourne, Australia. Date: March 20th, 2019 Guest Skeptic: Dr.Katie Walker is an emergency physician in Melbourne, Australia. She is a clinical researcher at Cabrini Hospital and an Adjunct Clinical Associate Professor at Monash University.

Emergency Department 52

Emergency Department Documentation/Coding Dislocations Research 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

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. Vitamin D, B12, Calcium, foate, iron, and thiamine deficiencies are all well documented complications. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

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). Journal of Trauma and Injury 2019; 32(4): 238-242. Epub 2019 Dec 30. Resuscitation from a pH of 6.5:

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98