Pediatric EM Morsels

JULY 21, 2023

Orso 2020] One pediatric study in this systematic review, and the intubated patients had worse outcome than non-intubated Early airway protection = lower rates of complications (in TRAUMA), but this is not always true with medical patients. Interrater reliability of Glasgow Coma Scale scores in the emergency department.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

ALiEM

FEBRUARY 9, 2024

Intermediate-risk patients may be further stratified based on recent stress testing or coronary angiogram findings plus a modified HEART or Emergency Department Assessment of Chest Pain (EDACS) score. Let’s apply the ESC 2020 0/1 hour pathway [2], with some modifications based on the 2022 ACC guidelines [1]: Figure 1.

EKG/ECG 110

EKG/ECG Emergency Department Burns Wellness 110

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. J Am Coll Emerg Physicians Open. 2020;(5):898-907.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

EM Literature of Note

SEPTEMBER 13, 2024

These are each awful, of course, in their own way from a patient- and parent-oriented standpoint, but they’re also quite awful at the population level, overburdening limited pediatric and emergency department resources. The two “COVID seasons” of 2020-21 and 2021-22 were excluded from their comparisons.

Emergency Department 85

Emergency Department Pediatrics Administration Wellness 85

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

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 Administration 52

Dr. Smith's ECG Blog

OCTOBER 20, 2024

The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization. On arrival in the emergency department, invasive blood pressure was 35/15mmHg and the patient was in profound cardiogenic shock with severe confusion secondary to brain hypoperfusion. There is now some flow in the LMCA!

EKG/ECG 132

EKG/ECG Shock Emergency Department Ambulance Services 132

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

The Skeptics' Guide to EM

OCTOBER 12, 2024

A national survey of children’s experiences and needs when attending Canadian pediatric emergency departments. June 2024 Date: Oct 1, 2024 Guest Skeptic: Dr. Andrew (Andy) Tagg is an Emergency Physician with a special interest in education and lifelong learning. Reference: Ma K et al. He is accompanied by his worried parents.

Emergency Department 90

Emergency Department Pediatrics Outcomes EMS 90

The Skeptics' Guide to EM

FEBRUARY 22, 2020

Date: January 27th, 2020 Guest Skeptics: Dr. Richelle Cooper is a Professor of Emergency Medicine at the UCLA Department of Emergency Medicine. Dr. Maia Dorsett is an Emergency and EMS Physician at the University of Rochester Medical Center. ” Where does emergency medicine fit into the RCA initiative?

Wellness 52

Wellness Emergency Department EMS 52

The Skeptics' Guide to EM

FEBRUARY 15, 2020

Date: February 11th, 2020 Reference: Yeh et al. Case: A 32-year-old woman with no previous medical history calls you while a passenger on a […] The post SGEM#284: Might as Well Jump, but We would Recommend a Parachute first appeared on The Skeptics Guide to Emergency Medicine. Date: February 11th, 2020 Reference: Yeh et al.

Wellness 52

Wellness Outcomes Emergency Department Research 52

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). Only it turns out, it did help. Or could, anyway.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Don't Forget the Bubbles

JULY 19, 2023

Olivia, a previously well 13-year-old girl, is referred to the paediatric ED from the Ophthalmology ED. Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation. 2020 and Hyde et al. Clin Ophthalmol.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98

Taming the SRU

MAY 13, 2024

The patient is a well-appearing male who is awake, alert, and oriented. There is also a well-appearing, healed surgical scar. There is also a well-appearing, healed surgical scar. The skin is warm and well perfused with brisk capillary refill. Respiratory and cardiovascular exams are normal. BMP : Na 136, K 4.3,

Ultrasounds 97

Ultrasounds Emergency Department Wellness Operations 97

Pediatric EM Morsels

FEBRUARY 2, 2024

Internationally Acquired Severe Systemic Infections in Febrile Pediatric Travelers Presenting to the Emergency Department. Pediatr Emerg Care. Hospitalization for travel-related illness are around 10% for both VFR and tourists (Leuthard 2015) Multiple studies have reported the most common travel infections in various countries.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. Tilly is normally fit and well, with no significant past medical history. by her father. She is obviously uncomfortable.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

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

Taming the SRU

MARCH 27, 2024

The parent trial was conducted from October 2020 to July 2022 in the capital region of Denmark. In this study, the authors aim to assess the hemodynamic effects of prehospital high-dose glucocorticoid treatment in resuscitated comatose OHCA patients. Hill, J.

Resuscitation 98

Resuscitation Outcomes CPR Hospitals 98

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. 1997: Congress enacts the PLP for Medicare and Medicaid managed care plans via BBA ’97.

Documentation/Coding 124

Documentation/Coding Hospitals Administration Emergency Department 124

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

EMDocs

OCTOBER 8, 2024

Tachycardia may be present both from many medications or drugs, as well as withdrawal. Let’s use the example of the well appearing patient, without significant comorbidities. Disposition of sinus tachycardia depends on many factors, however the well-appearing asymptomatic patient does not require admission for tachycardia alone.

Shock 95

Shock Emergency Department Pediatrics EKG/ECG 95

The Skeptics' Guide to EM

OCTOBER 10, 2020

Date: October 9th, 2020 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. He is also one of the world’s leading researchers on pain management in the emergency department, specifically the use of ketamine.

Emergency Department 52

Emergency Department Research Wellness 52

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4. Resuscitation.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

The Skeptics' Guide to EM

JUNE 13, 2020

Date: June 9th, 2020 Guest Skeptic: Dr. Chris Bond is an Emergency Medicine Physician and Assistant Professor at the University of Calgary. AEM […] The post SGEM#295: Teacher Teacher – Tell Me How to Do It (Diagnose a PE) first appeared on The Skeptics Guide to Emergency Medicine. AEM June 2020. Reference: Westafer et al.

Anaphylaxis 52

Anaphylaxis Emergency Department Wellness EKG/ECG 52

The Skeptics' Guide to EM

JULY 29, 2023

Another core element of emergency department (ED) and pre-hospital care is the assessment for potential spinal injuries [1,2]. This has evolved due to recognition of some of the adverse effects of immobilization as well as limitations to its benefits. We have also covered concussions ( SGEM#112 , SGEM#331 , and SGEM#362 ).

Head Injuries 75

Head Injuries EMS Research Emergency Department 75

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

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Providers should respect and utilize this mode of communication, as well as document the patient’s request for a non-certified interpreter.

Documentation/Coding 82

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

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. Journal of The Korean Society of Emergency Medicine , 33 (1), pp.134-138. Clinical and Experimental Emergency Medicine , 7 (4), p.330.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

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. Acad Emerg Med. 2020 Sep 17;8:548154. Pediatrics.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Adult cardiac arrest in the emergency department – A Swedish cohort study. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. Circulation. 2018;137(12). Kimblad H, et al. Resuscitation.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

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

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

OCTOBER 31, 2020

Date: October 29th, 2020 Guest Skeptic: Martha Roberts is a critical and emergency care, triple-certified nurse practitioner currently living and working in Sacramento, California. She is the host of EM Bootcamp in Las Vegas, as well as a usual speaker and faculty member for The Center for Continuing Medical Education (CCME).

Burns 52

Burns Emergency Department EMS Wellness 52

Taming the SRU

FEBRUARY 5, 2024

Traumatic brain injury (TBI) accounts for millions of Emergency Department visits annually. While moderate and severe TBI is often managed on an inpatient basis, patients presenting with mild TBI, or concussion, are often managed solely by Emergency physicians.

Head Injuries 59

Head Injuries Emergency Department Seizures Pediatrics 59

The Skeptics' Guide to EM

SEPTEMBER 12, 2020

Date: September 11th, 2020 This is an SGEM Xtra episode. I have discussed burnout and wellness a number […] The post SGEM Xtra: The Water is Wide first appeared on The Skeptics Guide to Emergency Medicine. Date: September 11th, 2020 This is an SGEM Xtra episode.

Emergency Department 52

Emergency Department Wellness 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. It’s stressful for the ED clinical staff as well. This has a downstream effect.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52