Pediatric EM Morsels

OCTOBER 27, 2023

James Broselow, a family medicine-turned-emergency medicine physician from Hickory, North Carolina , recognized that his team spent a lot of time trying to calculate doses of medications rather than spending their mental energy on the actual medical decisions for the resuscitation. Came out in 1986. Recommended by ATLS and PALS. Resusc Plus.

Pediatrics 268

Pediatrics Resuscitation Documentation/Coding Wellness 268

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Safety net advice and provision of written resources are core to delivering safe care in paediatric emergency medicine. In 2020 a new QI project commenced at Sheffield Children’s NHS Foundation Trust (65,000 PEM attendances/year) aiming to digitalise all paper information leaflets into an electronic format.

Emergency Department 40

Emergency Department Head Injuries Documentation/Coding 40

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.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

ACEP Now

OCTOBER 26, 2023

Using Maryland state law as a guide, the American College of Emergency Physicians (ACEP) and the Emergency Department Practice Management Association (EDPMA) lobbied for passage of federal protections beginning in the mid-1990s. There were multiple interpretative letters issued by the HCFA (now CMS) to interpret BBA ’97.

Documentation/Coding 124

Documentation/Coding Hospitals Administration Emergency Department 124

Pediatric EM Morsels

FEBRUARY 2, 2024

In one ED study, ALL cases of missed travel-related illness did not have a documented travel history in their ED note , whereas 90% of the identified travel-related illnesses had a provider documented travel history (Greenky 2022) Those who are visiting friends and relatives (VFR) are typically at highest risk. Pediatr Emerg Care.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

The Skeptics' Guide to EM

NOVEMBER 21, 2020

Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. The impact of advanced practice provider staffing on emergency department care: productivity, flow, safety, and experience. AEM November 2020.

Emergency Department 52

Emergency Department Telemedicine Academics Outcomes 52

Northwestern EM Blog

SEPTEMBER 26, 2022

Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The Emergency Department is a challenging work environment for a variety of reasons. Any team member of the resuscitation may lead the hot debrief.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. But only 6.4% of such ‘high risk Non-STEMI’ patients get angiography within 2 hours.[2] Take away 1.

EKG/ECG 121

EKG/ECG Documentation/Coding Fractures Emergency Department 121

PulmCCM

JUNE 12, 2023

Temperature management (or fever avoidance) should begin immediately after cardiac arrest (ideally in the emergency department, for out-of-hospital arrests) and continued for at least 72 hours. Use code PULMCCM15 and get 15% off when you register online.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

Ultrasounds 71

Ultrasounds Documentation/Coding Wellness EMS 71

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. In turn, concerns have arisen regarding when information blocking is appropriate and what ethical issues emergency department (ED) physicians must consider prior to information blocking.

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Neil Dasgupta is an emergency physician and ED intensivist from Long Island, NY, and currently an assistant clinical professor and Director of Emergency Critical Care at Nassau University Medical Center. Case: A code blue is called for a 71-year-old male in-patient that is boarding in the emergency department (ED).

Advances Cardiac Life Support (ACLS) 40

Advances Cardiac Life Support (ACLS) Hospitals Emergency Department Resuscitation 40

The Skeptics' Guide to EM

JULY 30, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 63-year-old woman presents to your emergency department (ED) with two-day history of nausea, vomiting and constipation. She is also the creator of all those wonderful Paper in a Pictures. sensitivity and 96.6%

Ultrasounds 52

Ultrasounds Operations Outcomes Documentation/Coding 52

Don't Forget the Bubbles

MARCH 19, 2024

The Ombudsman for Children’s Office suggested that in 2020, 18 children were admitted to paediatric hospitals in Ireland, and 10 children in 2021 for reasons beyond their medical needs. Becasue paediatric emergency departments are accessible out-of-hours they become the de facto place of safety with access to immediate support.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 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. Glaucomflecken” on Twitter and […] The post SGEM#315: Comfortably Numb with Topical Tetracaine for Corneal Abrasions first appeared on The Skeptics Guide to Emergency Medicine.

EMS 52

EMS Documentation/Coding Emergency Department 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

The Skeptics' Guide to EM

DECEMBER 5, 2020

Date: November 30th, 2020 Reference: Ohle R et al. Can Emergency Physicians Accurately Rule Out a Central Cause of Vertigo Using the HINTS Examination? AEM 2020 Guest Skeptic: Dr. Mary McLean is an Assistant Program Director at St. John’s Riverside Hospital Emergency Medicine Residency in Yonkers, New York.

Stroke 40

Stroke Documentation/Coding Emergency Department Hospitals 40

ACEP Now

SEPTEMBER 13, 2023

billion for specialty-care rate increases, $500 million for hospital emergency-department reimbursement, at least $500 million for family planning and reproductive-health care, and $600 million for behavioral-health facilities, including some for new inpatient psychiatric beds. billion for primary-care rate increases, $1.15

Emergency Department 40

Emergency Department Psychiatric Forensics Hospitals 40

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 91

Emergency Department Pediatrics Wellness Documentation/Coding 91

RCEM Learning

MAY 20, 2022

Author: Damian Roland / Editor: Govind Oliver / Code: / Published: 06/02/2020 There are many old and unhelpful stereotypes in medicines. On paper Emergency Medicine (EM) research is flourishing. None of these represent a true reality.

Academics 52

Academics Research EMS Documentation/Coding 52

The Skeptics' Guide to EM

JANUARY 23, 2021

Emergency Physician and Advanced Practice Provider Diagnostic Testing and Admission Decisions in Chest Pain and Abdominal Pain. AEM January 2021 Case: A 50-year-old male presents to the Emergency Department (ED) with left lower quadrant abdominal pain. The patient is seen by an advanced practice provider (APP).

Research 52

Research Poisoning Documentation/Coding Outcomes 52

Don't Forget the Bubbles

JULY 3, 2023

This time we have our first group of colleagues from Birmingham Children’s Hospital Emergency Department. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Am J Hematol.

Emergency Department 105

Emergency Department Hospitals Domestic Violence Pediatrics 105

Dr. Smith's ECG Blog

DECEMBER 14, 2022

I am going to code this as an acute STEMI as he had transient ST elevation which started to evolve in the emergency department but I think this is most appropriately termed STEMI." With nitroglycerin there is improvement in the 90% stenosis but still persistent stenosis consistent with the dynamic nature of his presentation.

EKG/ECG 52

EKG/ECG EMS Documentation/Coding Emergency Department 52

Emergency Medicine Journal

AUGUST 23, 2023

In 2020, 111 First was introduced to triage patients before entry to the ED and to offer direct booking for patients needing ED or urgent care into same-day arrival time slots. Interviews were transcribed verbatim and coded inductively by the primary researcher.

Urgent Care 75

Urgent Care Emergency Department Documentation/Coding Patient Safety 75

EMDocs

JULY 3, 2023

Louis); Alex Koyfman, MD (@EMHighAK); Marina Boushra, MD (EM-CCM Attending, Cleveland Clinic Foundation) Case A 62-year-old male with past medical history of hypertension (HTN), hyperlipidemia (HLD), and prior cerebrovascular accident (CVA) presents to the emergency department (ED) via ambulance. 2020 Sep 29;95(13):e1819-e1829.

Seizures 85

Seizures Stroke Outcomes EMS 85

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. JAMA Cardiol [Internet] 2020;Available from: [link] 4. JAMA Cardiol [Internet] 2020;Available from: [link] 5. medRxiv [Internet] 2020;Available from: [link] 8.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

Dr. Smith's ECG Blog

OCTOBER 2, 2021

Because the patient's pain had resolved completely and cardiology had declined immediate intervention, the patient was admitted but continued to board in the emergency department. Approximately 4 hours after arrival, the patient was re-examined by the emergency physician. The iStat POC assay is 0.08 1] Wereski, R., Chapman, A.

EKG/ECG 52

EKG/ECG Ultrasounds EMS Documentation/Coding 52

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

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Written by Destiny Folk MD, with edits by Meyers, peer reviewed by Smith and Grauer A woman in her late 20s with a past medical history of cervical cancer status post chemotherapy and radiation therapy presented to the emergency department for shortness of breath, chest tightness, and two episodes of syncope.

EKG/ECG 52

EKG/ECG Ultrasounds Documentation/Coding COPD 52

PEMBlog

JUNE 14, 2023

Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. Pediatrics October 2020; 146 (4): e20201174. 2020-1174 AAP-AACAP-CHA Declaration of a National Emergency in Child and Adolescent Mental Health Jennifer A. West J Emerg Med.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

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.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

The Skeptics' Guide to EM

DECEMBER 26, 2020

Date: December 18th, 2020 Reference: Hulme et al. Mortality among patients with frequent emergency department use for alcohol-related reasons in Ontario: a population-based cohort study. CMAJ 2020 Guest Skeptic: Dr. Hasan Sheikh is an emergency and addictions physician in Toronto and a lecturer at the University of Toronto.

Emergency Department 52

Emergency Department Administration Documentation/Coding EMS 52

EMDocs

JUNE 16, 2023

And now we’re here at our destination, the place we know and love, the emergency room to talk about what we should be doing for the growing volume of children with mental health problems boarding in the emergency department. Pediatrics October 2020; 146 (4): e20201174. McEnany, Olutosin Ojugbele, Julie R. 10.1542/peds.2020-1174

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

The Skeptics' Guide to EM

OCTOBER 1, 2022

Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference. Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. AEM September 2022. AEM September 2022.

Pediatrics 52

Pediatrics Emergency Department Documentation/Coding Research 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. Acad Emerg Med 2024;31:296-300 == MY Comment , by K EN G RAUER, MD ( 6/6 /2024 ): == Recognition of repolarization variants can be challenging.

EKG/ECG 114

EKG/ECG Documentation/Coding Emergency Department Wellness 114

ACEP Now

MAY 6, 2023

Case A 35-year-old male is brought to the emergency department (ED) following a single-motor-vehicle collision in which two people were ejected and pronounced dead at the scene. million ED visits for injuries from motor vehicle accidents (MVAs) in 2020. He is completely amnestic to the events of the accident.

Forensics 52

Forensics Documentation/Coding Fractures Head Injuries 52

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior.

EKG/ECG 119

EKG/ECG Documentation/Coding Wellness Emergency Department 119