ACEP Now

JULY 11, 2024

Deaths from drinking increased 25 percent from 2019 to 2020 and another 10 percent in 2021. The percentage of suicides while intoxicated with alcohol has increased, particularly among women, and traffic fatalities in 2020 were at their highest point in over a decade. 2020:8;279. problem drinking has reached a steady state.

Emergency Department 98

Emergency Department Psychiatric Outcomes Wellness 98

ACEP Now

MAY 9, 2024

These questionable practices led to a rash of bad outcomes. When seven South Florida gluteal AFT patients died tragically in one year alone, the Florida Board of Medicine issued an emergency regulation restricting fat injection to the subcutaneous space rather than injecting into muscle. units per patient.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

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. However, rapid initiation of treatment is actually patient-centered care that can both lead to better outcomes and limit ED boarding.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

Downeast Emergency Medicine

DECEMBER 1, 2021

While the ongoing COVID-19 pandemic has contributed to overdose deaths and taxed constrained Emergency Department (ED) resources, it has also clarified the important role that emergency physicians have in expanding access to life-saving medications to treat opioid use disorder. Annals of Emergency Medicine. Hawk, et al.

Emergency Department 52

Emergency Department Documentation/Coding Leadership Hospitals 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

Taming the SRU

SEPTEMBER 25, 2023

Musculoskeletal injuries are a common occurrence, representing a substantial number of Emergency Department visits on an annual basis. 1) Oftentimes, Emergency Physicians are the first provider patients encounter after an injury. 2020 Feb 12;4(2):e20.00005. 2020 Dec;12(6):1644-1651. Epub 2020 Sep 7.

Fractures 101

Fractures Operations Emergency Department EMS 101

Taming the SRU

MARCH 27, 2024

The parent trial was conducted from October 2020 to July 2022 in the capital region of Denmark. The primary outcome was cumulative norepinephrine use during the first 48 hours of admission. That said, outcomes for these patients are generally poor and the use of steroids as a one-time dose likely has little risk. Hill, J.

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Resuscitation Outcomes CPR Hospitals 98

PulmCCM

NOVEMBER 6, 2023

The therapy was approved for emergency use in 2020 by FDA after an observational study of 10 patients showed likely benefit (yes, 10, which should remind us of our collective desperation). patients infected with the Wuhan/Delta variants in 2020-2021). Thromboelastometry (e.g., The balloon generally required 30 minutes to insert.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Emergency Medicine Journal

NOVEMBER 21, 2024

of self-injury-related ED visits in 2020 and 2021, respectively (pandemic years), compared with an average of 8.4% Future studies should assess longer-term trends in these visits and explore interventions to address the societal, health and mental healthcare needs in order to improve the health outcomes of these marginalised individuals.

Emergency Department 52

Emergency Department Outcomes Hospitals 52

EMDocs

AUGUST 3, 2024

He Was Right Spoon Feed This systematic review found that approximately 4%-27% of patients presenting to the ED with presyncope experienced serious outcomes within a 30-day period. Source Serious outcomes among emergency department patients with presyncope: A systematic review. Acad Emerg Med. Ann Emerg Med.

Emergency Department 75

Emergency Department Outcomes Hospitals 75

PulmCCM

JUNE 12, 2023

TTM2 found no improvement in survival or neurologic outcome among patients randomized to cooling to a target of 33 °C, as compared to controls receiving fever prevention (e.g. with acetaminophen) until temperatures reached 37.8 °C who then received external cooling to maintain a target temperature of 37.5 °C.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

Don't Forget the Bubbles

JULY 19, 2023

Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation. This data was collected over a five-year period (2016-2020) had true papilloedema. 2020 and Hyde et al. 2020 Oct [cited 2023 May 14];10:966–7.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98

Don't Forget the Bubbles

JANUARY 8, 2024

Dr Bourke’s work is not only about deepening academic understanding but also about forging practical approaches to help healthcare professionals navigate the nuanced and often uncertain waters of adolescent care in emergency settings. Mulraney, M., Coghill, D., Sciberras, E., and Sawyer, M., Mulraney, M., Coghill, D., Sciberras, E.,

Research 105

Research Emergency Department Psychiatric Outcomes 105

Emergency Medicine Journal

MARCH 21, 2024

This month’s journal covers a wide variety of topics, from COVID-19 and fever in the Emergency Department (ED) to prehospital care. Reflecting backwards to early 2020, it thus far remains one of the most challenging times in my career. One of the notable outcomes was the disparities among different ethnic groups.

Emergency Department 52

Emergency Department Outcomes 52

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

RebelEM

JUNE 5, 2023

One study from a county in Massachusetts found that of all nonfatal opioid doses seen in the emergency department from 2011-2015, 1 in 20 patients subsequently died within one year of initial visit with 66% of these deaths being directly related to an opioid overdose (4). PMID 33392580. mg tablet) 1 Buprenorphine 0.5

Emergency Department 98

Emergency Department Hospitals Outcomes EMS 98

The Skeptics' Guide to EM

OCTOBER 14, 2023

Case: A 5-year-old boy presents to the emergency department (ED) with his parents for fever and fatigue. Time to change the reference ranges of children’s physiological observations in emergency care? He has had three days of high fevers at home. A prospective study. J Paediatr Child Health.

Pediatrics 87

Pediatrics Sepsis Urgent Care Emergency Department 87

ACEP Now

JULY 7, 2023

CASE A 30-year-old woman presents to the emergency department with left arm pain from a chronic wound. Since 2020 to 2021, the Drug Enforcement Administration has reported a sharp rise in xylazine use across the U.S., percent of all overdose deaths in 2020. US Department of Justice, Drug Enforcement Administration.

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Forensics Airway Management Administration Emergency Department 98

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Certified interpreter use can improve communication and patient outcomes. An implementation science approach improves language access in the emergency department. One cohort study in a public ED found that 84.5% 45:446-458. Taira B, et al.

Documentation/Coding 82

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

EMDocs

SEPTEMBER 30, 2024

Inhaled Corticosteroids Rarely Prescribed at Emergency Department Discharge Despite Low Rates of Follow-Up Care. J Emerg Med. 2020 Feb;8(2):605-617.e6. The primary outcome was hospital admission rates. They reduce inflammation and improve the sensitivity of beta-receptors to improve beta-agonist efficacy.

Outcomes 83

Outcomes Documentation/Coding Academics Administration 83

The Skeptics' Guide to EM

AUGUST 22, 2020

Date: August 18th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Exam, Labs, Imaging Accuracy and Biases. Reference: Carpenter et al.

Emergency Department 52

Emergency Department Academics Research Administration 52

Don't Forget the Bubbles

JUNE 17, 2024

Introduction: Civility Matters Healthcare environments, particularly emergency departments, are characterised by high levels of Volatility, Uncertainty, Complexity, and Ambiguity ( VUCA ). High levels of incivility correlate with adverse outcomes for patients, staff, and the organisation. 2020 Aug 20.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

EMDocs

JUNE 12, 2024

HypoCa is common in trauma patients and is associated with poor outcomes. We need RCTs to determine if Ca administration in trauma impacts mortality and other patient-centered outcomes. Ionised calcium levels in major trauma patients who received blood in the Emergency Department. Emerg Med J. doi:10.1097/TA.0000000000002570

Hyperthermia / Hypothermia 89

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 89

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 2,3 In general, patients who develop cardiac arrest with an initial rhythm of VT or VF tend to have favorable outcomes compared to patients who develop cardiac arrest from either asystole or pulseless electrical activity.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

The Skeptics' Guide to EM

JULY 8, 2023

Case: A 57-year-old woman with hypertension, hyperlipidemia and type-2 diabetes mellitus presents to the emergency department (ED) with fever, cough, myalgias, headache and congestion. There was a large unblinded RCT of over 3,000 patients published in the Lancet in 2020.

CDC 93

CDC Hospitals EMS Emergency Department 93

Don't Forget the Bubbles

JULY 17, 2023

Clinical Outcomes of COVID-19 in Newborns and Infants: A Multicenter Experience of 576 Cases. 2023 Jun Oral food challenge outcomes in children and adolescents in a tertiary centre: A 5-year experience. Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review. 2023 Jun 9.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

RebelEM

APRIL 29, 2024

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ). Resuscitation.

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Resuscitation Administration Emergency Department Hospitals 105

Emergency Medicine Journal

JANUARY 22, 2024

The primary outcome was reduction in VAS score 15–20 min after randomisation.

Emergency Department 40

Emergency Department Outcomes 40

Don't Forget the Bubbles

JANUARY 17, 2024

After Meshram et al, 2020 When Orbeez are exposed to water, the water molecules diffuse into the polymer network through osmosis. Curious Ken is brought into your emergency department. There have been reports of the Orbeez Challenge leading to serious outcomes. Clinical and Experimental Emergency Medicine , 7 (4), p.330.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

The Skeptics' Guide to EM

JANUARY 18, 2020

Date: January 16th, 2020 Reference: Troponin Testing and Coronary Syndrome in Geriatric Patients With Nonspecific Complaints: Are We Overtesting? AEM January 2020 Guest Skeptics: Dr. James VandenBerg: James has a master’s degree in clinical investigation from Washington University in St. Reference: Wang et al.

Emergency Department 52

Emergency Department Hospitals Outcomes 52

Emergency Medicine Journal

MAY 23, 2023

Background To identify the impact of enrolment onto a national pulse oximetry remote monitoring programme for COVID-19 (COVID-19 Oximetry @home; CO@h) on health service use and mortality in patients attending Emergency Departments (EDs).

Emergency Department 40

Emergency Department Outcomes Hospitals 40

Taming the SRU

JANUARY 10, 2024

89% agree that violence in the emergency department has harmed patient care. Phenobarbital has been proven to be equivalent to benzodiazepines with regard to clinical, pharmacologic and utilization outcomes. None of the physicians in the study believe that the rate of violence has decreased at all.

EKG/ECG 93

EKG/ECG Shock Fractures Emergency Department 93

The Skeptics' Guide to EM

DECEMBER 12, 2020

Date: December 10th, 2020 Reference: Ladde et al. AEM December 2020 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). Date: December 10th, 2020 Reference: Ladde et al.

Operations 52

Operations Outcomes Research Academics 52

Don't Forget the Bubbles

JULY 22, 2024

Randomised controlled trials addressing the benefit of steroids in preschool wheeze have compared different cohorts, used different trial designs and measured different outcomes. This is a way to overcome different trial outcomes. This paper’s primary outcome was a change in wheeze severity score (WSS). What does this mean?

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

Don't Forget the Bubbles

AUGUST 7, 2023

This prospective cohort study included patients between 0-16 years old, who presented to one of four NHS hospital sites in Greater Manchester (a large metropolitan area in the North of England), consisting of an Urgent Care Centre and three Emergency Departments. Yes Was the outcome accurately measured to minimize bias?

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Sepsis Pediatrics Urgent Care Emergency Department 98

The Skeptics' Guide to EM

JUNE 6, 2020

Date: June 2nd, 2020 Reference: Permpikul et al. Guest Skeptic: Dr. Max Hockstein trained as an Emergency Medicine physician at University of Texas Southwestern and is finishing his Intensive Care fellowship at Emory. Date: June 2nd, 2020 Reference: Permpikul et al. Case: It’s another day in your emergency department (ED).

Sepsis 52

Sepsis Shock Resuscitation Outcomes 52

ACEP Now

OCTOBER 15, 2023

prescriptions annually per 100 persons in 2020. 1 The emergency department remains an important frontier for work in judicious prescribing, but opiate analgesia remains a valuable tool for the initial treatment of a variety of presentations. In this respect, the conclusion is absolutely true.

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Emergency Department Outcomes CDC Research 52