PEMBlog

JUNE 14, 2023

Pediatrics October 2020; 146 (4): e20201174. 2020-1174 AAP-AACAP-CHA Declaration of a National Emergency in Child and Adolescent Mental Health Jennifer A. Boarding of Mentally Ill Patients in Emergency Departments: American Psychiatric Association Resource Document. 2020-030692 Lo CB, Bridge JA, Shi J, Ludwig L, Stanley RM.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

Don't Forget the Bubbles

MAY 31, 2023

Mintegi, S., & Country Leads (2020). Identified cases were then screened further by looking at the medical notes to confirm whether the presentation was eligible for inclusion. Bressan, S., Buonsenso, D., Farrugia, R., Oostenbrink, R., Titomanlio, L., Nijman, R. Maconochie, I., Da Dalt, L., Annals of emergency medicine, 76(6), 788–800.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

Dr. Smith's ECG Blog

APRIL 18, 2024

Emergent cath lab activation is also named after this test (code STEMI), so patients whose ECGs don’t meet STEMI criteria don’t get emergent angiograms, despite guidelines. And because there was no Code STEMI, the discharge diagnosis was “non-STEMI”, so this case will not be flagged as an opportunity for improvement. But only 6.4%

EKG/ECG 124

EKG/ECG Documentation/Coding Fractures Emergency Department 124

Board Bombs

DECEMBER 21, 2020

ICD-10 code above. Let's tackle a difficult, common ED topic to finish off 2020. ICD-10 code above. Let's tackle a difficult, common ED topic to finish off 2020. Arrives with acute low back pain that is reproducible. So much high yield info, so take a listen and curl up next to the fireplace.

Documentation/Coding 52

Documentation/Coding 52

Stop and Think

NOVEMBER 19, 2023

This was a 20-year survey in which the authors used 4 independent databases to document the incidence and causes of sudden cardiac death in NCAA athletes. Notably, the authors reported only one case of myocarditis-related death during the 2020-2022 period. They found 143 cases of sudden cardiac death over the 20 years.

Documentation/Coding 128

Documentation/Coding Wellness Resuscitation 128

EB Medicine

DECEMBER 8, 2020

Use code AMAZON20 Write us at emplify@ebmedicine.net. Don’t forget about the $50 Amazon card with any order over $300 through 12/31/20. Write us at emplify@ebmedicine.net (mailto:emplify@ebmedicine.net).Don’t Don’t forget about the $50 Amazon card with any order over $300 through 12/31/20.

Emergency Department 52

Emergency Department Documentation/Coding Hospitals 52

EMDocs

AUGUST 22, 2024

13 Interventions may include: Ascertaining a patient’s preferred language early in the clinical encounter (during registration, for instance), and clearly documenting this preference in a place that is visible to all providers. Utilizing certified interpreters and documenting their use. Educating patients on their rights.

Documentation/Coding 82

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 82

Pediatric EM Morsels

OCTOBER 6, 2023

Obasi 2020) Hepatic and splenic abscesses have been documented in children, and splenic rupture is particularly associated with cases of MDR typhoid fever. 2020 Jan-Mar; 10(1): 35–38. (Shah 2021) GI hemorrhage can be seen if there is erosion of the bowel walls, and further erosion can also lead to bowel perforation.

Pediatrics 161

Pediatrics CDC Seizures Documentation/Coding 161

PulmCCM

JUNE 12, 2023

In its 2020 updated guidelines , the American Heart Association recommended cooling to 32-36 °C after any cardiac arrest (shockable or non-shockable rhythms, in-hospital or out), but after TTM2, authors for the American College of Cardiology argued cooling patients below normothermia may no longer be necessary.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

RCEM Learning

MAY 20, 2022

Author: Govind Oliver / Code: / Published: 06/02/2020 In December 2019 the NIHR announced a themed call for applications in urgent and emergency care, injuries and accidents. The NIHR Academy fellowship scheme is included in this themed call.

Documentation/Coding 52

Documentation/Coding 52

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Macroscopic T-Wave Alternans: A Red Flag for Code Blue. In practice — It appears that electrical alternans is most often seen in association with regular SVT rhythms ( See the example in My Comment at the bottom of the page, in the September 7, 2020 post in Dr. Smith's ECG Blog ). J Am Coll Cardiol. 2006 Jan 17;47(2):269-81.

EKG/ECG 128

EKG/ECG Documentation/Coding Psychiatric EMS 128

ACEP Now

JUNE 7, 2023

The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. ED leaders worked to develop new physician documentation and coding guidelines that needed to be implemented at the beginning of 2023. Patient volume losses in 2020 reversed in 2021. percent.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

ALiEM

JANUARY 26, 2024

Ciprofloxacin has been documented as a cause of IgA vasculitis. Epub 2020 Dec 3. Case Question: What are common triggers for this diagnosis? Common triggers include infection, drugs, and autoimmune. Case Discussion Take-Home Points Consider IgA vasculitis, even in an older patient. Dermatol Ther. 2021 Jan;34(1):e14591. PMID: 33244823.

Documentation/Coding 73

Documentation/Coding Academics EMS Hospitals 73

Emergency Medicine Journal

MARCH 21, 2024

Methods This retrospective study included patients with code-red emergency medical communication centre (EMCC) stroke suspicion ambulance dispatch between August to December 2020. The study aim was to investigate the efficacy of the G-FAST criteria for LVO patient selection and direct transfer to a CSC.

Stroke 52

Stroke Documentation/Coding EMS Hospitals 52

RCEM Learning

MAY 20, 2022

Author: Rick Body / Editor: Govind Oliver / Code: / Published: 06/02/2020 In 2017 the National Institute for Health Research (NIHR) published its Training Review.

Academics 52

Academics Documentation/Coding Research Hospitals 52

Downeast Emergency Medicine

DECEMBER 1, 2021

ROSENBERG ET AL Northern New England and, in particular, Maine have been especially hard-hit by the opioid epidemic, with Maine experiencing its’ highest number of opioid deaths ever in 2020. All transcripts were then coded using a final code book and resultant codes were organized into themes and subthemes with supportive quotes.

Emergency Department 52

Emergency Department Documentation/Coding Leadership Hospitals 52

EMDocs

SEPTEMBER 30, 2024

Among patients with a primary provider documented in the chart, 30-day outpatient follow-up rate was 21.3% (n = 313). 2020 Feb;8(2):605-617.e6. For follow up, 13.98% of visits were followed by an outpatient visit within 30 days, and 3.77% of index visits were followed by an ED revisit within 30 days. J Allergy Clin Immunol Pract.

Outcomes 83

Outcomes Documentation/Coding Academics Administration 83

The Skeptics' Guide to EM

NOVEMBER 21, 2020

Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. AEM November 2020. Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. AEM November 2020. AEM November 2020. Reference: Pines et al. Reference: Pines et al.

Emergency Department 52

Emergency Department Telemedicine Academics Outcomes 52

EMDocs

DECEMBER 4, 2023

Document a risk and benefit discussion with the patient regarding empiric anticoagulation, perhaps even including the HAS-BLED score in the documentation [10]. A study in 2020 led to 624 patients with delayed US strategy started on rivaroxaban had 0% major bleed rate and eventual diagnosis of 119 DVTs [11]. mg/kg for 24 hours.

Ultrasounds 71

Ultrasounds Documentation/Coding Wellness EMS 71

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

I therefore feel it relevant to document ( in your dictation/on the medical chart ) when significant artifact potentially impairs the accuracy of your interpretation. P.S.: For another clinical example of how EASY-it-is to overlook a long QTc if one is not systematic in approach — Please check out the May 3, 2020 post in Dr. Smith's ECG Blog.

Seizures 111

Seizures EKG/ECG EMS Stroke 111

The Skeptics' Guide to EM

MAY 2, 2020

Date: April 24th, 2020 Reference: Watanabe et al. Date: April 24th, 2020 Reference: Watanabe et al. The crew then asks if you want them to transport your father Code 3 with full lights and sirens. Is Use of Warning Lights and Sirens Associated With Increased Risk of Ambulance Crashes? Annals of Emergency Medicine.

Documentation/Coding 40

Documentation/Coding EMS EKG/ECG Outcomes 40

Sensible Medicine

SEPTEMBER 26, 2023

adults say they have a great deal of confidence in medical scientists to act in the best interests of the public, down from 40% who said this in November 2020.” It would become much easier to document a journal’s track record of replicability, which could become a counterweight to the relentless pursuit of impact factors.”

Research 128

Research Hospitals Documentation/Coding Outcomes 128

American Medical Compliance

DECEMBER 26, 2023

On December 27, 2020, the United States Congress adopted the No Surprises Act (NSA) as part of the Consolidated Appropriations Act of 2021, which has various provisions to assist in protecting customers against unexpected costs beginning January 1, 2022. The following course highlights the NSA and how it impacts healthcare.

Ambulance Services 52

Ambulance Services Documentation/Coding 52

Dr. Smith's ECG Blog

JUNE 11, 2024

Emergency department Code STEMI patients with initial electrocardiogram labeled ‘normal’ by computer interpretation: a 7-year retrospective review. To add to this complexity ( as per My Comment in the August 22, 2020 post in Dr. Smith's ECG Blog ) — the ST-T wave appearance in repolarization variants may be dynamic !

EKG/ECG 116

EKG/ECG Documentation/Coding Emergency Department Wellness 116

ACEP Now

NOVEMBER 7, 2023

3 These regulations have led to widespread practices of EHI, such as test results and clinical documentation, being shared with patients in real time. Training opportunities for documentation best practices should be employed. Code of federal regulations eCFR website. Published May 1, 2020. Public law 114–255—Dec.

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

ACEP Now

NOVEMBER 6, 2024

emergency departments, according to research published in 2020 in Annals of Emergency Medicine. It was written like a diary, detailing what he did during a weekend shift: codes, traumas, you name it. Native American emergency physicians make up 0.1 percent of physicians in U.S. I thought, “That’s what I want to do.”

Military 98

Military Emergency Department Documentation/Coding Research 98

RebelEM

NOVEMBER 30, 2023

Published 2020 Aug 19. It is crucial for physicians to exercise clinical judgment and discretion when administering crystalloid fluids, avoiding indiscriminate fluid administration based on these nuanced considerations. Improvement in Mortality With Early Fluid Bolus in Sepsis Patients With a History of Congestive Heart Failure. Hamdon, M.

Sepsis 121

Sepsis Fluid Resuscitation Resuscitation Administration 121

Dr. Smith's ECG Blog

JULY 31, 2020

Meyers, Weingart and Smith published their OMI Manifesto — in which they extensively document the critically important concept that management of acute MI by separation into a “STEMI” vs “non-STEMI” classification is an irreversibly flawed approach. P.S.: Our September 3, 2020 post features Dr. Meyers' 17-minute summary of the OMI Manifesto.

EKG/ECG 52

EKG/ECG Documentation/Coding 52

The Skeptics' Guide to EM

JANUARY 30, 2021

2020 Case: A healthy 55-year-old woman was out for a walk and had a FOOSH (fall on outstretched hand) of her dominant arm. 2020 * Population: Adults (18 years and older) inpatient or outpatients with a diagnosis of certain long bone fractures (neck of femur/tibia/fibula/tibia and fibula/radius/ulna/humerus/clavicle) based on ICD-9 codes.

Fractures 52

Fractures Documentation/Coding Outcomes 52

The Skeptics' Guide to EM

OCTOBER 21, 2020

Date: October 21st, 2020 This is an SGEM Xtra episode. Date: October 21st, 2020 This is an SGEM Xtra episode. The rivalry between Newton and Hooke is well documented. I had the honour of presenting at the Department of Family Medicine’s Grand Rounds at the Schulich School of Medicine and Dentistry.

Documentation/Coding 52

Documentation/Coding Wellness 52

The Skeptics' Guide to EM

JANUARY 16, 2021

Annals of EM 2020 Guest Skeptic: Dr. Will Flanary is an ophthalmologist, writer, and comedian who moonlights in his free time as “Dr. Annals of EM 2020 Guest Skeptic: Dr. Will Flanary is an ophthalmologist, writer, and comedian who moonlights in his free time as “ Dr. Glaucomflecken ” on Twitter and TikTok.

EMS 52

EMS Documentation/Coding Emergency Department 52

EM Updates

JUNE 15, 2021

In the last week of March and first week of April 2020, hospitals across New York City were overwhelmed with critically ill COVID-19 patients, many of whom had unprecedented oxygen requirements. From April 6 to May 3, 2020, 90 patients were admitted to the EDAT. The study was approved by the MMC institutional review board.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

Don't Forget the Bubbles

JANUARY 1, 2024

During the COVID-19 pandemic (2020-2021), the incidence of IPD reached its lowest level in 20 years. Point-of-care brain ultrasound and transcranial doppler or color-coded doppler in critically ill neonates and children. Pediatrics. Shikha A, et al. Eur J Pediatr. 2023 Dec 27. Vinci F, et al. Eur J Pediatr. 2023 Dec 19.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

ACEP Now

NOVEMBER 13, 2023

5 Hospitals commonly activate a “code” in response to agitated patients, alerting security personnel to the location of that patient. From the law enforcement perspective, hospital policies regarding behavioral codes were “vague” and the same patients are often seen multiple times with similar behavioral crises, he noted in an interview.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

Dr. Smith's ECG Blog

JULY 21, 2024

In both tracings — an exceedingly fast PMVT is documented. As I review in My Comment in the January 16, 2020 post of Dr. Smith's ECG Blog ( and have reproduced in Figure-2 below ) — the ECG of patients with acute LMCA occlusion may be varied. That said — there is no evidence on ECG of re-occlusion of the infarct artery.

EKG/ECG 122

EKG/ECG Shock Hospitals Sepsis 122

ACEP Now

DECEMBER 6, 2024

This case report documents the first known instance of using NTG during an emergency department resuscitation to treat a patient in cardiac arrest due to severe coronary artery vasospasm. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented. N Engl J Med. 1992;326(22):1451-1455. Circulation.

Resuscitation 52

Resuscitation EKG/ECG Documentation/Coding COPD 52

ACEP Now

OCTOBER 30, 2023

This makes documentation and communication of the utmost importance for these patients for their health and safety. Published September 16, 2020. Communication between providers and nursing regarding indwelling devices, bed sores, cleanliness, or signs of neglect is important, as the thoroughness of each examination may vary.

Sexual Assault 98

Sexual Assault Teamwork Outcomes Dehydration 98