Taming the SRU

OCTOBER 23, 2023

At this point, the patient is taken to the operating room for a diagnostic laparoscopy. She was taken to the operating room and found to have a right tubal ectopic pregnancy with a pseudogestational sac. 2007), Free Fluid in Morison's Pouch on Bedside Ultrasound Predicts Need for Operative Intervention in Suspected Ectopic Pregnancy.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

Sensible Medicine

DECEMBER 11, 2023

Standard meaning the operators spent time checking to make sure the vein was isolated. The Struggle to Publish The authors presented this data at the European Heart Rhythm Association meeting in 2019. The team from Imperial College London randomized about 300 patients with paroxysmal AF to one of three arms. One arm got AF drugs.

Operations 115

Operations Hospitals 115

Ken Grauer, MD

FEBRUARY 9, 2024

Awareness of this common association made me instantly suspect that some type of Wenckebach conduction is probably operative in today's rhythm — even though I admittedly do not see any pattern of consistent group beating, or any repetitive PR intervals that typically clue me in to Mobitz I conduction defects.

EKG/ECG 262

EKG/ECG Operations Wellness 262

Don't Forget the Bubbles

JUNE 17, 2024

Exposure to incivility hinders clinical performance in a simulated operative crisis. 2019 May 31:bmjqs-2019. 2019 May;27(4):758-64. BMJ Quality & Safety. Keller R, Allie T, Levine R. An evaluation of the “BE NICE Champion” programme: A bullying intervention programme for registered nurses.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Dr. Smith's ECG Blog

DECEMBER 19, 2023

Unfortunately, we do not have those images for review, but the operators described a ruptured LAD plaque and they stented this area, which ensures the stability of the plaque. From My Comment in the November 14, 2019 post in Dr. Smith's ECG Blog: A subject well worth periodic review — is the concept of Terminal QRS Distortion ( T-QRS-D ).

EKG/ECG 127

EKG/ECG EMS Wellness Operations 127

NIOSH Science Blog

MAY 14, 2020

This year has seen nurses all over the world step up and battle coronavirus disease 2019 (COVID-19) fearlessly, often while navigating evolving guidance and operating under difficult conditions with strained resources. None of us could have anticipated how prescient that would be.

Wellness 52

Wellness Operations 52

ACEP Now

JUNE 7, 2023

Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. After drops of about 14 percent in overall ED volumes in 2020 compared to 2019, many EDs are managing patients at volumes near those of 2019 again. percent in 2019. percent in 2022, compared to 2.7

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

Emergency Medicine Journal

JULY 22, 2024

Methods Adult patients transported to a single ED by ambulances and subsequently admitted to the hospital between 1 January 2019 and 18 April 2019 were eligible for inclusion. The discriminative ability of the EWS scores was assessed using the area under the receiver operating characteristic curve (AUROC). male, mean age 68.7±17.5

Ambulance Services 52

Ambulance Services Hospitals Operations Emergency Department 52

RebelEM

JANUARY 25, 2024

What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021. Point-of-care ultrasound (PoCUS) is inherently operator-dependent, which may have led to inconsistencies in the quality and findings of the ultrasound exams across different operators.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

RebelEM

FEBRUARY 1, 2024

What they Did : Investigator-initiated, Multicenter, Parallel-ground, Open-label, Registry-linked, Randomized, Controlled, Non-Inferiority trial 22 Canadian Primary and Comprehensive Stroke Centers from December 2019 to January 2022 Eligible ischemic stroke patients randomized 1:1 to receive intravenous tenecteplase (0.25 vs Alteplase 34.8%

Stroke 135

Stroke Blood Transfusions Outcomes EMS 135

Dr. Smith's ECG Blog

AUGUST 4, 2024

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 ).

EKG/ECG 116

EKG/ECG Wellness Operations Emergency Department 116

RebelEM

NOVEMBER 6, 2023

Methylene Blue for Vasoplegic Syndrome After Cardiac Operation: Early Administration Improves Survival. to 1mg/kg/hr) Information regarding the vasopressors used in the study is as follows: Norepinephrine equivalents = norepinephrine mcg/kg/min + (phenylephrine mcg/kg/min/10) + epinephrine mcg/kg/min + (vasopressin units/min x2.5)

Shock 71

Shock Administration Academics Hospitals 71

Taming the SRU

MAY 13, 2024

Acute stump appendicitis without evidence of perforation or abscess (Figure 1) HOSPITAL Course Acute Care Surgery was consulted from the ED and recommended admission for operative resection of a 3 cm remnant of the appendix. No free intraperitoneal air. Stump appendicitis, a rare but serious complication of appendectomy: A case report.

Ultrasounds 98

Ultrasounds Emergency Department Wellness Operations 98

SheMD

MAY 4, 2023

Women were more likely to be first appointed to educational rather than operational roles (52.6% The most common pathway to a departmental chair role was through an operations track, and male physicians were more likely to have an initial role in operations, while females were more likely to have an initial role in education.

Leadership 52

Leadership Academics Operations Emergency Department 52

The Skeptics' Guide to EM

FEBRUARY 16, 2019

Date: February 15th, 2019 Reference: Gottileb, Holladay and Peksa. AEM January 2019. Date: February 15th, 2019 Reference: Gottileb, Holladay and Peksa. AEM January 2019. In the hands of experienced operators, indirect ophthalmoscopy has an LR+ 44 and LR- of 0.23. Remember, you need a LR- of less than 0.01

Ultrasounds 52

Ultrasounds Operations Emergency Department 52

ACEP Now

NOVEMBER 14, 2023

In 1901, UVA opened its first hospital with 25 beds and three operating rooms. The emergency department (ED) at UVA was rebuilt in 2019 and the department had not fully optimized its operations when COVID-19 hit. She is a consultant with Quality Matters Consulting, and her expertise is in ED operations.

Academics 52

Academics Emergency Department Leadership Operations 52

Emergency Medicine Journal

OCTOBER 26, 2023

Methods We undertook a retrospective diagnostic cohort study involving adult emergency medical cases transported to Sheffield Teaching Hospitals ED by Yorkshire Ambulance Service in 2019. Results We linked 12 870/24 955 (51.6%) cases and identified 348/12 870 (2.7%) with a positive reference standard.

Sepsis 52

Sepsis Ambulance Services Operations Hospitals 52

RebelEM

JUNE 8, 2023

Epub 2019 Jul 3. Am J Emerg Med. 2022 2022 Sep 5. PMID: 36108346 Cole JB, et al. Human Errors and Adverse Hemodynamic Events Related to “Push Dose Pressors” in the Emergency Department. J Med Toxicol. PMID: 31270748 Maheshwari K, et al. Intensive Care Med. 2018;44(6):857–67. Am J Emerg Med.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

ACEP Now

DECEMBER 11, 2023

The overall length of stay for all ED patients increased to 211 minutes in 2022, up from 194 minutes in 2021, 184 minutes in 2020, and 182 minutes in 2019. Patients who require inpatient boarding remain a significant challenge to ed operations. percent in 2019. percent in 2019, to 2.7 percent in 2021, 2.8 percent in 2022.

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

PulmCCM

SEPTEMBER 20, 2024

This process can’t be trusted to operate in China. The first layer of protection against fabricated data comes from the nearby peers and colleagues at a researcher’s own institution or competing institutions. Second, the Chinese government ultimately controls research production there.

Academics 105

Academics Forensics Research Operations 105

PulmCCM

JANUARY 6, 2025

The SCREEN Trial SCREEN was a stepped-wedge cluster randomized trial of an EMR alert for organ failure, conducted at 45 wards of 5 hospitals in Saudi Arabia from 2019 to 2021. Instead of clinical micromanagement, in its new form it would incentivize continuous improvement in systemwide operational processes.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

Taming the SRU

NOVEMBER 3, 2023

Results 24 patients were eligible during the study period from January 2019 to June 2020 and 20 patients age 33-95 were ultimately enrolled by the 6 operators. Secondary outcomes were changes in pain scores at rest at 15 minutes, during incentive spirometry at both time points and then change in maximum vital capacity. SD 3.28) and 6.5,

Fractures 98

Fractures Ultrasounds Research Outcomes 98

Don't Forget the Bubbles

MAY 22, 2023

In 2019, there were 2,383 LTV patients in the UK. These can be operated and maintained by patients and their families at home. There has been a 2.5x increase in the use of LTV in children in the UK over the last 10 years. Advances in technology have also led to more portable ventilators.

Radiology 98

Radiology Radiology Hospitals Wellness 98

Mind The Bleep

JUNE 21, 2024

This will not be an issue if oil is used, though this will require another operation to be removed and gain full visual potential. Laser/cryotherapy is applied to seal the break intra-operatively. Note: vitrectomy is associated with a very rapid post-operative progression/development of a cataract which will then necessitate surgery.

Operations 52

Operations Emergency Department Ultrasounds 52

Taming the SRU

AUGUST 30, 2023

The 2019 Journal of Arthroplasty practice guidelines to screen for periprosthetic joint infections recommend using ESR at 30mm/hr and CRP at 10mg/L, citing pooled sensitivities and specificities ranging from 75%-86% and 70-72.3%, respectively, for ESR and 88% and 73-74%, respectively, for CRP [32]. 2019 Feb;34(2S):S187-S195.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

The Skeptics' Guide to EM

APRIL 16, 2022

An update was published by Fanaroff et al in JAMA 2019. Clinical Question: What is the effectiveness of common elective orthopaedic procedures compared with no treatment, placebo, or non-operative care? They found 53 guidelines with 7,196 recommendations. There were 26 guidelines with 2,930 recommendations. Reference: Blom et al.

Military 40

Military Operations Emergency Department Pediatrics 40

Emergency Medicine Journal

NOVEMBER 28, 2023

Method and Design We undertook a retrospective diagnostic cohort study involving adult medical cases transported to hospital by emergency ambulance in 2019. We aimed to determine the accuracy of early warning scores alongside paramedic diagnostic impression to identify sepsis requiring urgent treatment.

Sepsis 40

Sepsis Ambulance Services Operations Hospitals 40

PulmCCM

APRIL 24, 2024

Perc trachs do not require operating room time or a surgeon, and can significantly shorten ICU stays. It looks like this: FDA Clearance and Initial Adoption According to Dr. Tropello, the new system was FDA cleared in April 2019 based on animal testing and lab data.

Ultrasounds 52

Ultrasounds Hospitals Operations Outcomes 52

ACEP Now

NOVEMBER 16, 2023

Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. Published 2019. The 2019 model of the clinical practice of emergency medicine. government. Emergency medicine’s body of knowledge as reflected by the Model of the Clinical Practice of EM is ever-expanding.

Academics 52

Academics EMS Telemedicine Research 52

Emergency Medicine Journal

DECEMBER 22, 2023

This retrospective study included adult patients suspected of having BSI (defined by at least one BC collection) from two European ED between 1 January 2017 and 31 December 2019. The primary end point was the BSI rate in the validation cohort for patients with a negative Bacteremia Rule Out Criteria (BAROC) score.

Emergency Department 40

Emergency Department Operations 40

Emergency Medicine Journal

NOVEMBER 28, 2023

Method and Design This single-centre retrospective cohort study of people aged over 64 linked year 2019 ED attendance data to vital signs at hospital discharges within the previous eighteen months. Receiver operating characteristics were compared to NEWS2 models with and without incorporation of relative systolic pressure.

Operations 40

Operations Emergency Department Hospitals 40

RebelEM

NOVEMBER 30, 2022

Systematic review by Mellick demonstrates significant survival rates past 48 hours (Mellick 2019). 2019 Dec;35(12):821-82 References: Price DP. Epidemiology: Most common cause of acute scrotal pain in prepubertal boys Torsion present in 3.2% 10, (-) LR = 0.13 Louis, Mosby, Inc., 2014, (Ch) 99: p 1326-1356. Mellick LB et al.

Ultrasounds 52

Ultrasounds Pediatrics Operations EMS 52

ALiEM

AUGUST 9, 2023

The lung POCUS is also operator-dependent, and it has a steep learning curve. Acad Emerg Med 2019 25 studies; 3353 patients 94% 92% Significant difference in accuracy between novice and advanced sonographers. 2019 Sep;26(9):1074-1088. A lung consolidation needs to extend to the pleural surface to be visualized on lung POCUS.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Intensive Blog

MARCH 11, 2024

They are staffed by Ambulance attendants to help operate specialized bariatric equipment. Moving a patient on ECMO, a ventilator and 6 infusions brings it’s own challenges if you have nowhere to secure your equipment. CPAVs are a scarce resource scattered across the state.

Hospitals 69

Hospitals Radiology Radiology Sepsis 69

Intensive Blog

AUGUST 17, 2023

Diagnostic and Interventional Imaging, 2019, 100(6), 337-345, ISSN 2211-5684, [link]. The many causes of anaemia include: Decreased production Malnutrition Bone marrow suppression (e.g., Interventional treatment of bleeding complications due to percutaneous acannulation for peripheral extracorporeal membrane oxygenation.

Blood Transfusions 52

Blood Transfusions Operations Wellness 52

American Medical Compliance

JANUARY 15, 2024

dollars in global market value in 2019 to nearly 460 billion U.S. In recent years, telemedicine has surged in popularity, offering a convenient and efficient way for patients to access healthcare services remotely. According to Statista, the telemedicine market is forecasted to grow significantly, from 50 billion U.S. dollars by 2030.

Telemedicine 52

Telemedicine Operations Administration Hospitals 52

RebelEM

MARCH 27, 2023

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? More pertinent and relevant takeaway messages have to do with staffing and operations. Paper: Owyang CG, et al. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52