ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (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. J Emerg Nurs. Dr. Santamaria is a current second year medical student at A.T

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Providers should respect and utilize this mode of communication, as well as document the patient’s request for a non-certified interpreter.

Documentation/Coding 104

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

The Skeptics' Guide to EM

AUGUST 17, 2019

Date: August 9th, 2019 Reference: Daoust et al. Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain. AEM August 2019 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Volkow et al.

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Emergency Department Academics Fractures Outcomes 52

Northwestern EM Blog

MARCH 1, 2025

In this study, they found that prone positioning resulted in significant improvement in oxygenation, as well as a 50% decrease in mortality at 28 days (Guerin et. Position arms in a comfortable position, avoiding any position that could cause a brachial plexus injury, and ensure they are well-supported to avoid pressure ulcers.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 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.

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Emergency Department Research Documentation/Coding Outcomes 135

The Skeptics' Guide to EM

APRIL 11, 2020

Justin Morgenstern is an emergency physician and the creator of the excellent #FOAMed project called First10EM.com Case: It has been a hard shift. You wish you […] The post SGEM#289: I Want a Dog to Relieve My Stress in the Emergency Department first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 52

Emergency Department Resuscitation Wellness 52

EMDocs

JUNE 2, 2023

You should always follow your local practice guidelines and recommendations as well as adhere to approved medications in your facility. Document what you gave and why, as well as the impact. West J Emerg Med. 2019 Mar;20(2):409-418. If a patient has a PRN on their med list do that! doi: 10.5811/westjem.2019.1.41344.

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Psychiatric Pediatrics Emergency Department Administration 93

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

The Trauma Pro

OCTOBER 4, 2024

Clinical outcomes assessed at 60 days included an unplanned return to the emergency department (ED), re-admission, complications, and development of new bleeding confirmed by surgery, ultrasound, or computed tomography (CT) at 60 days post-injury. J Ped Surg 54:335-339, 2019. ” This means they probably did not.

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Pediatrics Outcomes Operations Emergency Department 113

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!

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EKG/ECG Shock Emergency Department Ambulance Services 128

EMDocs

DECEMBER 6, 2024

5 Severe metabolic acidosis persists Multi-system organ failure The endpoints of deferoxamine are less well defined but it can be weaned off as the patient is clinically improving, the anion gap resolves, and down-trending serum iron concentration. Goldfrank’s Toxicologic Emergencies, 11e. McGraw Hill; 2019. Tenenbein M.

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Poisoning Fluid Resuscitation Seizures Resuscitation 98

The Skeptics' Guide to EM

FEBRUARY 22, 2020

Maia Dorsett is an Emergency and EMS Physician at the University of Rochester Medical Center. Date: January 27th, 2020 Guest Skeptics: Dr. Bringing value, balance and humanity to the emergency department: The Right Care Top 10 for emergency medicine. ” Where does emergency medicine fit into the RCA initiative?

Wellness 52

Wellness Emergency Department EMS 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.

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Emergency Department Resuscitation Documentation/Coding Best Practices 98

ACEP Now

JULY 11, 2024

Deaths from drinking increased 25 percent from 2019 to 2020 and another 10 percent in 2021. 2 Although the opiate epidemic is certainly worthy of attention, it accounts for only about half of the number of deaths annually and only around a quarter of the number of emergency department visits annually relative to alcohol use.

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Emergency Department Psychiatric Outcomes Wellness 98

ACEP Now

DECEMBER 6, 2024

Morhaim spent more than two decades in the Maryland House of Delegates, fighting for legislation to protect health care workers and patients before his final legislative term ended in 2019. Dr. Morhaim has been assigned to a state commission to address emergency department wait times. Click to enlarge.)

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Emergency Department Hospitals Wellness 98

ACEP Now

MARCH 11, 2025

Many patients with PE can be discharged directly from the emergency department (ED). The pervasive maxim quick on, quick off for UFH doesnt hold up as well as touted. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS).

Hospitals 52

Hospitals Administration Outcomes Stroke 52

EMDocs

AUGUST 22, 2023

Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. J Emerg Med. Capnography for the nonintubated patient in the emergency setting. Ann Emerg Med. Predictive value of capnography for suspected diabetic ketoacidosis in the emergency department. West J Emerg Med.

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Emergency Department Blood Transfusions Resuscitation Sepsis 94

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

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. Respiratory and cardiovascular exams are normal. BMP : Na 136, K 4.3,

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Ultrasounds Emergency Department Wellness Operations 98

ALiEM

APRIL 12, 2023

The thin alcohol layer serves to eliminate any air bubbles under the adhesive cover as well as minimizes residual adhesive material sticking to the probe when removing the cover. Egan, Pharmacology and Physiology for Anesthesia (Second Edition), Elsevier, 2019, Pages 390-411, ISBN 9780323481106. Hemmings, Talmage D.

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Ultrasounds Emergency Department Resuscitation Wellness 103

EMDocs

OCTOBER 8, 2024

Tachycardia may be present both from many medications or drugs, as well as withdrawal. Let’s use the example of the well appearing patient, without significant comorbidities. Disposition of sinus tachycardia depends on many factors, however the well-appearing asymptomatic patient does not require admission for tachycardia alone.

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Shock Emergency Department Pediatrics EKG/ECG 105

Don't Forget the Bubbles

JULY 19, 2023

Olivia, a previously well 13-year-old girl, is referred to the paediatric ED from the Ophthalmology ED. Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation. 2019 Dec 1;54(6):653–8. Clin Ophthalmol.

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Pediatrics Emergency Department Outcomes Wellness 98

Sensible Medicine

JULY 29, 2024

Their primary endpoint was emergency department visits. The primary outcome was positive but there were caveats. “We can rule out even very small improvements in physical health and the effect that would be implied by the cross-sectional correlation between income and health lies well outside our confidence intervals.”

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Outcomes Research Sepsis Emergency Department 118

RebelEM

FEBRUARY 24, 2025

RESUS SCENARIO Picture this: you just arrived at your shift at the local emergency department. Well, the established cutoff for the distensibility index is 18%. Jan 2019; PMID: 30138573. For more than just the correctness of terminology, the distensibility index should then be calculated. Why does it matter?

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. Am J Emerg Med.

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EKG/ECG Documentation/Coding Emergency Department Outcomes 119

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.

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Administration Emergency Department Outcomes Documentation/Coding 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 74

Pediatrics Emergency Department Research Burns 74

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 94

Emergency Department Pediatrics Wellness Fractures 94

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

Dr. Smith's ECG Blog

AUGUST 4, 2024

Context: a man in his 40s presented to the emergency department with 1 day of sudden onset chest pain. The patient did well. == MY Comment , by K EN G RAUER, MD ( 8/4 /2024 ): == I thought today's case by Dr. Meyers is an important one for emergency providers for a number of reasons. Pericarditis maybe."

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EKG/ECG Wellness Operations Emergency Department 117

EMDocs

SEPTEMBER 7, 2023

DGA concentrates in the kidney tissue and causes nephrotoxicity, as well as neurotoxicity. Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. “Diethylene Glycol” in Goldfrank’s Toxicologic Emergencies , 11e Eds. McGraw Hill, 2019.

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Poisoning CDC Administration Emergency Department 92

EMDocs

JUNE 8, 2024

Post septal (retrobulbar) is higher risk to vision and requires CT imaging to diagnose as well as thorough exam to check for proptosis, afferent pupillary defect, increased intraocular pressure [7]. A 32-year-old man presents to the emergency department with eye pain. Overview of Eye Injuries in the Emergency Department.”

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EMS Allergic Reactions Poisoning Emergency Department 98

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

EMDocs

JULY 25, 2024

Do them well and document the process, preferably at the bedside. Literature-based Recommendations for Suicide Assessment in the Emergency Department: A Review. Medscape, January 08, 2019. EP Monthly, Apr 4, 2019. Assure and document the patient’s resources and safety net if discharged. Ronquillo L et al.

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Documentation/Coding Hospitals Patient Safety Emergency Department 104

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

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.

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Emergency Department Best Practices Radiology Radiology 90

EMDocs

JANUARY 3, 2024

10 This procedure has well-described rare complications including infection, blood loss, allergic reaction, arrhythmia, pneumothorax if approaching via the internal jugular vein, embolization of the device, and pulmonary artery perforation or dissection. 2019 Apr;6(2):308-18. 2019 Dec;21(Suppl M):M50-M53. Epub 2019 Dec 31.

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Allergic Reactions Hospitals EMS Emergency Department 113