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. Accessed October 10, 2023. Lee H, Yun H, Choi M, Kim H.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

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

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. Mental health evaluation teams can rely on documentation and interviews to understand a patient’s initial agitation level.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

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

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? 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.

Documentation/Coding 82

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

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

PEMBlog

OCTOBER 18, 2024

Duchenne Muscular Dystrophy (DMD) is a complex and progressive disease requiring highly specialized care, especially in emergency situations. When patients with DMD present in the Emergency Department (ED), an understanding of the nuanced aspects of their care is essential for optimal management. 2020 Jun 5;15(1):141.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 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 124

EKG/ECG Documentation/Coding Fractures Emergency Department 124

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

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

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

EMDocs

SEPTEMBER 30, 2024

Inhaled Corticosteroids Rarely Prescribed at Emergency Department Discharge Despite Low Rates of Follow-Up Care. J Emerg Med. 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. 2023 May;64(5):555-563.

Outcomes 83

Outcomes Documentation/Coding Academics Administration 83

ACEP Now

NOVEMBER 6, 2024

Native American emergency physicians make up 0.1 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. percent of physicians in U.S.

Military 98

Military Emergency Department Documentation/Coding Research 98

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

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

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

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 116

EKG/ECG Documentation/Coding Emergency Department Wellness 116

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

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.

Resuscitation 52

Resuscitation EKG/ECG Documentation/Coding COPD 52

ACEP Now

NOVEMBER 7, 2024

Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. A 2020 study in the journal Pediatrics found that close to three in every five patients who sought mental health treatment at EDs were boarded. West J Emerg Med.

Psychiatric 59

Psychiatric Pediatrics Hospitals Emergency Department 59

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 93

Emergency Department Pediatrics Wellness Documentation/Coding 93

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

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

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 Documentation/Coding Outcomes 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

EMDocs

NOVEMBER 6, 2024

2020-0841 Lin TS, Chen LK, Lin TY, Wen SH, Chen MC, Jan RH. He denies any past medical history other than polysubstance abuse and depression. 2002;122(4):1488-1492. doi:10.1378/chest.122.4.1488 122.4.1488 Li L, Liu Z. Rhabdomyolysis with acute anuria renal failure caused by surgical injection-induced tetanus in an adult. 2021;21(1):e103-e105.

Poisoning 78

Poisoning Airway Management Dislocations Forensics 78

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 Head Injuries Fractures 52

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

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

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

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

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 125

EKG/ECG Documentation/Coding Wellness Emergency Department 125

Dr. Smith's ECG Blog

JANUARY 9, 2024

She presented to the emergency department after a couple of days of chest discomfort. She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. The last echocardiography 12 months ago showed HFmrEF. The ECG below was recorded. What is your assessment? How would you manage this patient?

EKG/ECG 107

EKG/ECG Stroke Hospitals Documentation/Coding 107

Northwestern EM Blog

SEPTEMBER 12, 2022

Other things listed on tags can be a patient’s name, bar code, MRN or other tracking criteria. History: Emergency Physicians Monthly.” 2020, epmonthly.com/article/not-heroes-wear-capes-one-las-vegas-ed-saved-hundreds-lives-worst-mass-shooting-u-s-history/. 2020, www.ncbi.nlm.nih.gov/books/NBK482373/. EPM , 5 Apr.

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Operations 52

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

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

Mind The Bleep

SEPTEMBER 17, 2024

Introduction Patients regularly present to the emergency department with animal bites. Document clearly: The location of all wounds Medical photography or drawn labelled diagrams can aid in explaining the exact location. Always consider an ATLS approach to the assessment. Feel for any swelling/collection/abscess. Markeson, D.,

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52