Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. West J Emerg Med.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

ACEP Now

JUNE 7, 2023

The preliminary results of the 2022 Emergency Department Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding. Preliminary results of the survey are being released to help emergency physicians understand that current challenges are occurring nationwide.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

ACEP Now

DECEMBER 11, 2023

The Emergency Department Benchmarking Alliance (EDBA) is a membership organization composed of high-performance emergency departments (EDs) that share a commitment to quality. EMS arrivals increased; many of those patients (35 percent) were admitted. percent in 2019. percent in 2019, to 2.7

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Emerg Radiol. 2013 Aug;20(4):337-9.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

Dr. Smith's ECG Blog

JUNE 21, 2023

EMS was called, and they recorded the following ECG on scene at 13:16: What do you think? In this medical system, the EMS provider can then be routed to the ED or to a type of urgent care facility that is open 24 hrs/day and staffed by a primary care provider. In this case, the EMS provider was routed to the urgent care facility.

Urgent Care 98

Urgent Care EKG/ECG EMS Emergency Department 98

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. Paper: Owyang CG, et al. J Crit Care. N Engl J Med. 2000 May 4; PMID: 10793162 Harvey CE, et al.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Broome Docs

OCTOBER 6, 2024

Mols EM, Haak H, Holland M, Schouten B, Ibsen S, Merten H, Christensen EF, Nanayakkara PWB, Nickel CH, Weichert I, Kellett J, Subbe CP, Kremers MNT; Safer@Home Research Consortium. Emergency Medicine Journal Published Online First: 12 September 2024. 2019 Nov 5;322(17):1722. Can patients predict the future? Epub ahead of print.

Emergency Department 102

Emergency Department EMS Research Outcomes 102

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? An implementation science approach improves language access in the emergency department. April 2019. Department of Health and Human Services. Annals of Emergency Medicine. Annals of Emergency Medicine. Pediatric Emergency Care.

Documentation/Coding 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

EMDocs

DECEMBER 6, 2024

Goldfrank’s Toxicologic Emergencies, 11e. McGraw Hill; 2019. A partner at bedside reports recent depressed mood, abdominal pain, and vomiting yesterday. Indications for treatment with deferoxamine: serum concentration greater than 500 g/dL, metabolic acidosis, persistent GI symptoms, altered mental status, and GI hemorrhage.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

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. 2022 Sep 7.

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

EMDocs

JUNE 2, 2023

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. 2019 Mar;20(2):409-418. Epub 2019 Feb 19.

Psychiatric 93

Psychiatric Pediatrics Emergency Department Administration 93

Taming the SRU

JULY 22, 2024

INDICATIONS Arthrocentesis is a common procedure performed in the Emergency Department, in which a needle is inserted into a joint to withdraw fluid from the joint capsule. 2019, April 30). emDOCs.net - Emergency Medicine Education. Emergency Medicine Procedures, 2e. 2023, October 9). 2022, February 25).

Ultrasounds 96

Ultrasounds Emergency Department EMS 96

EMDocs

JANUARY 3, 2024

Case Conclusion Your patient is given an IV dose of furosemide and improves after diuresis over the next few hours in the emergency department. 2019 Apr;6(2):308-18. 2019 Dec;21(Suppl M):M50-M53. Epub 2019 Dec 31. Published 2019 Jul 27. ESC heart failure. Eur Heart J Suppl. doi: 10.1093/eurheartj/suz265.

Allergic Reactions 113

Allergic Reactions Hospitals EMS Emergency Department 113

RebelEM

FEBRUARY 24, 2025

RESUS SCENARIO Picture this: you just arrived at your shift at the local emergency department. Jan 2019; PMID: 30138573. For more than just the correctness of terminology, the distensibility index should then be calculated. Youre barely logged in, coffee still in hand, when you get sign out on your soon-to-be newest patient.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Identifying means to optimise trainee retention and recruitment is an Emergency Medicine (EM) research priority. This study aimed to understand how increasingly crowded Emergency Departments (EDs) are impacting EM training in the United Kingdom. Abstract 2061 Figure 1

Emergency Department 40

Emergency Department EMS Research 40

The Skeptics' Guide to EM

FEBRUARY 8, 2020

Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. He also has this amazing #FOAMed blog called EM Nerd. He also has this amazing #FOAMed blog called EM Nerd. Reference: Perry et al.

Emergency Department 52

Emergency Department Stroke EMS Academics 52

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

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

OCTOBER 30, 2023

Pillai, MBBS (@sspillai01, EM Resident Physician, University of Kentucky) and Christopher N. 2 In response to the constrained availability of contrast media, emergency medicine (EM) and radiology departments were compelled to enact modifications in their imaging techniques. West J Emerg Med. Authors: Saran S.

Radiology 99

Radiology Radiology Emergency Department Hospitals 99

RebelEM

JUNE 5, 2023

from 2019 to 2021 (from 48,000 to 81,400 annual deaths), which includes prescription opioids (natural and semi-synthetic opioids and methadone), heroin, and synthetic opioids other than methadone including fentanyl (1). Microdosing and standard‐dosing take‐home buprenorphine from the Emergency Department: A feasibility study.

Emergency Department 97

Emergency Department Hospitals Outcomes EMS 97

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch. N Engl J Med.

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

The Skeptics' Guide to EM

SEPTEMBER 14, 2019

Date: September 10th, 2019 Reference: Fournier et al. Emergency Medicine Journal 2019. Guest Skeptics: Dr. Sarah Berg is a PGY-3 resident in Emergency Medicine at Washington University School of Medicine in St. Date: September 10th, 2019 Reference: Fournier et al. Emergency Medicine Journal 2019.

Head Injuries 52

Head Injuries Emergency Department Seizures EMS 52

EMDocs

JANUARY 29, 2024

Authors: Sameer Desai, MD (EM Attending Physician, University of Kentucky); Omar Abbas Ahmed Malik, MBBS (Patients’ Aid Foundation, Jinnah Postgraduate Medical Center) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University School of Medicine in St. Stroke 2019; 50:e344. 2019 Aug;50(8):2023-2029.

Stroke 99

Stroke Outcomes EMS Seizures 99

The Skeptics' Guide to EM

FEBRUARY 18, 2023

Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019. AEM Feb 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and Assistant Professor at the University of Calgary. Date: February 17, 2023 Reference: Gettel et al.

Emergency Department 52

Emergency Department EMS Administration 52

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

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. With EMS, patient had a GCS of 3 and was saturating 60% on room air. Vital signs were within normal limits on arrival to the Emergency Department. or basilar ischemia.

EKG/ECG 116

EKG/ECG Documentation/Coding Emergency Department COPD 116

EMDocs

FEBRUARY 15, 2024

8 However, it is not considered first line in treatment of anticholinergic toxicity and is not available in all emergency departments. Goldfrank’s Toxicologic Emergencies, 11e. McGraw Hill; 2019. World J Emerg Med. Goldfrank’s Toxicologic Emergencies, 11e. McGraw-Hill Education; 2019.

Hyperthermia / Hypothermia 111

Hyperthermia / Hypothermia Poisoning Seizures COPD 111

RebelEM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

EMDocs

SEPTEMBER 7, 2023

2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergency department. “Diethylene Glycol” in Goldfrank’s Toxicologic Emergencies , 11e Eds. McGraw Hill, 2019. McGraw Hill, 2019. Schier, Capt. Nelson, et al.

Poisoning 92

Poisoning CDC Administration Emergency Department 92

RebelEM

FEBRUARY 21, 2024

Surgical Patients Quereshi 2019 Double-blind RCT IM diclofenac 75 mg vs PO diclofenac 100 mg Small difference favoring IM in terms of speed to pain relief Authors conclude PO superior due to time to prepare injection The data looks fairly clear in terms of analgesic efficacy but, don’t some patients simply prefer to receive a shot?

Administration 63

Administration Emergency Department EMS Research 63

Taming the SRU

NOVEMBER 27, 2023

These patients may be discharged with close outpatient follow-up, and should be instructed to return to the Emergency Department if they develop worsening and/or spreading pain and swelling, as this may be indicative of an infectious process. Antibiotics are not indicated [7, 8].

Soft Tissue Injuries 95

Soft Tissue Injuries Emergency Department EMS Fractures 95

The Skeptics' Guide to EM

OCTOBER 14, 2019

Date: October 14th, 2019 Reference: CRASH-3 Trial Collaborators. The Lancet October 2019 Guest Skeptic: Dr. Salim Rezaie currently works as a community emergency physician at Greater San Antonio Emergency Physicians […] The post SGEM#270: CRASH-3 TXA for Traumatic Head Bleeds?

Stroke 52

Stroke EMS Emergency Department Outcomes 52

The Skeptics' Guide to EM

JANUARY 11, 2020

NEJM 2019 Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at St. He is also the managing editor of EM:RAP and associate editor at REBEL EM. NEJM 2019 Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at St. Joseph’s Hospital in Paterson, NJ.

Emergency Department 52

Emergency Department EMS Hospitals 52

The Skeptics' Guide to EM

JANUARY 25, 2020

NEJM February 2019 Guest Skeptic: Andrew Merelman is a critical care paramedic and second year medical student at Rocky Vista University in Colorado. Case: A 60-year-old male is […] The post SGEM#281: EM Docs Got an AmbuBag – The PreVent Trial first appeared on The Skeptics Guide to Emergency Medicine. Reference: Casey et al.

EMS 40

EMS Airway Management Administration Resuscitation 40

ACEP Now

OCTOBER 3, 2023

The last few years have been a tumultuous time for the emergency medicine (EM) specialty, especially as it pertains to our workforce. Per Medscape, emergency physicians have the highest burnout rate—65 percent—among all surveyed specialties. The EM job market could be improved in all four of those dimensions.

Emergency Department 52

Emergency Department EMS Wellness 52

ACEP Now

SEPTEMBER 28, 2023

In August 2021, an article published in the Annals of Emergency Medicine projected a surplus of more than 7,800 emergency physicians in 2030 based on multiple scenarios, including patterns of supply and demand for emergency physicians at that time. percent of graduates in 2019.

Academics 98

Academics Emergency Department EMS 98

EMDocs

SEPTEMBER 25, 2023

Personal take: While discussing this approach with many EM physicians whom we respect, one recurring critique was “We fought so hard to get the right to use paralytics in the ED, why would you want to go backwards.” actors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92