Pediatric EM Morsels

APRIL 28, 2023

In general, non-operative treatment is reserved for Type I fractures and type II. Non-operative management is appropriate if extensor mechanism is intact and the avulsed fragment is displaced less than 2 mm or able to be reduced (hyperextension at the knee) to an acceptable degree of displacement. 2020): e0186–e0186.

Fractures 130

Fractures Pediatrics Operations Wellness 130

The Trauma Pro

OCTOBER 25, 2024

This is probably because there is no need to perform repeated operations to insert and remove the preperitoneal packs when angiography is used. Here are the factoids: The original data were derived from a 17-center study conducted from 2018-2020; this study only included 1,387 patients who had pelvic fractures (as well as other injuries).

Fractures 113

Fractures Head Injuries Operations Ultrasounds 113

RebelEM

OCTOBER 2, 2023

The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics.

Operations 97

Operations Academics Fluid Resuscitation Outcomes 97

Don't Forget the Bubbles

JUNE 26, 2023

Whilst waiting for an operation, they need to be managed medically. The underlying heart defect determines the precise operation performed – you might have heard of the Norwood procedure , an example used for HLHS specifically. Six hours post-operatively, they become more mottled, with weak pulses – signs of poor systemic perfusion.

Operations 128

Operations Research Hyperthermia / Hypothermia Hospitals 128

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. Background NHS 111 is a phone and online urgent care triage and assessment system that aims to reduce UK ED demand.

Emergency Department 75

Emergency Department Urgent Care Documentation/Coding Patient Safety 75

EMDocs

SEPTEMBER 7, 2024

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 93

EMS Fluid Resuscitation Resuscitation Radiology 93

Ken Grauer, MD

SEPTEMBER 6, 2024

Depending on which of above considerations is operative — the differential diagnosis of the rhythm in ECG #1 will be between: i ) A reentry SVT rhythm with retrograde atrial conduction; ii ) ATach ( A trial T achycardia ) ; — or — iii ) Junctional Tachycardia. The October 31, 2016 post in Dr. Smith's ECG Blog.

EKG/ECG 245

EKG/ECG Administration Operations Wellness 245

PulmCCM

SEPTEMBER 20, 2024

From the 1990s through 2020, Chinese researchers were paid large bonuses for publishing in medical journals, as part of a formal government policy to accelerate universities’ research output. This process can’t be trusted to operate in China. Second, the Chinese government ultimately controls research production there.

Academics 105

Academics Forensics Research Operations 105

EMDocs

NOVEMBER 1, 2023

McGraw-Hill Education; 2020. Answer : Esophageal Perforation 1-6 Epidemiology : Most frequent etiology is iatrogenic injury from instrumentation accounting for 60% of cases (e.g. upper endoscopy, transesophageal echo, etc.). 2 Additional etiologies include caustic ingestion, trauma, foreign body, or malignancy. aid=1104586430 Bono MJ.

Operations 86

Operations Radiology Radiology Fluid Resuscitation 86

Ken Grauer, MD

FEBRUARY 9, 2024

Awareness of this common association made me instantly suspect that some type of Wenckebach conduction is probably operative in today's rhythm — even though I admittedly do not see any pattern of consistent group beating, or any repetitive PR intervals that typically clue me in to Mobitz I conduction defects.

EKG/ECG 262

EKG/ECG Operations Wellness 262

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

NIOSH Science Blog

MAY 14, 2020

The World Health Organization proclaimed 2020 the Year of the Nurse and Midwife. This year has seen nurses all over the world step up and battle coronavirus disease 2019 (COVID-19) fearlessly, often while navigating evolving guidance and operating under difficult conditions with strained resources.

Wellness 52

Wellness Operations 52

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. They passed away a few days after a second operation. This network enables Orbeez to retain their structure and not dissolve in water, yet allows them to swell. Unfortunately, the anastomosis broke down.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

EMDocs

MAY 25, 2024

Cham: Springer International Publishing; 2020:387-395. Accessed June 22, 2023. link] Haidar H, Menon A, Al Duhirat E. Diseases of the salivary glands. In: Textbook of Clinical Otolaryngology. Abdel Razek AAK, Mukherji S. Imaging of sialadenitis. Neuroradiol J. 2017;30(3):205-215.

EMS 96

EMS Dehydration Operations Hospitals 96

ACEP Now

JUNE 7, 2023

The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. Patient volume losses in 2020 reversed in 2021. EDs weathered attacks from a variety of sources in recent years.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

ACEP Now

JULY 7, 2023

One operator should perform defibrillation in the anterolateral position, followed by another operator providing a second shock in the anteroposterior position after a delay of less than one second. 9,10 To perform dual sequence defibrillation, place pads in the anterolateral and anteroposterior position.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Cook County EM Blog

APRIL 7, 2022

Treatment can be achieved non-operatively if only the posterior ligaments of the tibiofibular syndesmosis are partially damaged. Otherwise, most cases require operative repair. 2020 Dec;12(6):1644-1651. Epub 2020 Sep 7. Created By: Maria Gomez, M.D. He JQ, Ma XL, Xin JY, Cao HB, Li N, Sun ZH, Wang GX, Fu X, Zhao B, Hu FK.

Fractures 52

Fractures Operations Hospitals 52

Taming the SRU

OCTOBER 23, 2023

At this point, the patient is taken to the operating room for a diagnostic laparoscopy. She was taken to the operating room and found to have a right tubal ectopic pregnancy with a pseudogestational sac. 2007), Free Fluid in Morison's Pouch on Bedside Ultrasound Predicts Need for Operative Intervention in Suspected Ectopic Pregnancy.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

Dr. Smith's ECG Blog

JUNE 26, 2023

As I discuss in detail in My Comment at the bottom of the page in the May 24, 2020 post in Dr. Smith's ECG Blog — AV dissociation is not the same as AV block. Most occurrences are associated with events such as sepsis, shock, recent infarction, post-operative state, electrolyte disturbance — or "sick patient".

EKG/ECG 97

EKG/ECG Seizures Sepsis Operations 97

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

PulmCCM

SEPTEMBER 4, 2024

OP is operating point, the operating point defines the cardiac output on the y-axis and Pra on the x-axis; Rcardiac is cardiac resistance (i.e., OP1 is operating point 1 at baseline. With tamponade, operating point 2 (OP2) is formed. Pmsa and Pra do not correlate (inset, upper right). cardiac function).

Ultrasounds 84

Ultrasounds Operations Research Outcomes 84

Don't Forget the Bubbles

JUNE 17, 2024

2020 Aug 20. 2020 Jan 1;35(1):70-6. Exposure to incivility hinders clinical performance in a simulated operative crisis. Further Resources: Civility Saves Lives NHS England Civility & Respect Toolkit RCS Edinburgh Anti-Bullying Campaign Learning from Excellence References: Baran BE, Woznyj HM. Organizational dynamics.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

That said — in a patient who develops TdP — the overall ECG appearance of this initial ECG is consistent with low K+ and/or low Mg++ ( See My Comment in the May 9, 2020 post — for more on the ECG diagnosis of hypokalemia and hypomagnesemia ). Figure-1: I labeled the initial ECG in today's case. Perhaps this patient may not need ICD placement?

Seizures 114

Seizures EKG/ECG EMS Stroke 114

EMDocs

SEPTEMBER 25, 2023

Improved Visualization: Video laryngoscopes allow for the use of standard or hyperangulated geometry, essentially allowing the operator to “look around the corner” on an anterior airway. Operators can manipulate the blade with less force to optimize the view, making it easier to identify and navigate the endotracheal tube into the trachea.

Emergency Department 84

Emergency Department Soft Tissue Injuries Airway Management Operations 84

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. Resuscitation. 9 Zhang W et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Taming the SRU

MAY 13, 2024

Acute stump appendicitis without evidence of perforation or abscess (Figure 1) HOSPITAL Course Acute Care Surgery was consulted from the ED and recommended admission for operative resection of a 3 cm remnant of the appendix. No free intraperitoneal air. Point-of-care ultrasound diagnosis of Stump appendicitis in the emergency department.

Ultrasounds 98

Ultrasounds Emergency Department Wellness Operations 98

SheMD

MAY 4, 2023

Women were more likely to be first appointed to educational rather than operational roles (52.6% The most common pathway to a departmental chair role was through an operations track, and male physicians were more likely to have an initial role in operations, while females were more likely to have an initial role in education.

Leadership 52

Leadership Academics Operations Emergency Department 52

Don't Forget the Bubbles

JANUARY 8, 2024

O ral sedation if the patient will co-operate Diazepam 0.2mg/kg up to 10mg orally – up to two doses OR Olanzapine 5mg (if <40kg) and 10mg (if >40kg) – one dose only – acts within 20 minutes OR Risperidone 0.02-0.04mg/kg Mulraney, M., Coghill, D., Sciberras, E., and Sawyer, M., Mulraney, M., Coghill, D., Sciberras, E.,

Research 105

Research Emergency Department Psychiatric Academics 105

PulmCCM

NOVEMBER 11, 2023

Additionally, this model clarifies that the dependent variable is the ‘operating point’ [OP] which is composed of both CO and P ra , simultaneously. The dependent variable is the operating point [i.e., The ultrasound journal 2020, 12(1):1-12. the mean systemic filling pressure; 2.) Clin Chest Med 1983, 4(2):111-126.

Ultrasounds 87

Ultrasounds Operations Shock 87

Emergency Medicine Journal

MAY 23, 2023

We report overall sensitivity, specificity, positive and negative predictive values, and the hierarchical summary receiver operating characteristic curve for LUS. Results Twenty studies were included, published between October 2020 and April 2021, providing data from a total of 4314 patients.

Ultrasounds 52

Ultrasounds Operations Research Hospitals 52

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. Aesthetic Plastic Surgery National Databank Statistics 2020–2021. These questionable practices led to a rash of bad outcomes.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

American Medical Compliance

MAY 13, 2024

Ensuring a safe and secure environment for both patients and staff is crucial for the effective operation of any dental facility. workers were victims of workplace homicides in 2020. Workplace violence is an issue that can affect any professional setting, and dental practices are no exception.

Operations 52

Operations Wellness 52

Intensive Blog

AUGUST 17, 2023

Show answer Commonly, clinicians use a trigger of 80g/L (Tenure et al, 2020). Epub 2020 Sep 10. Epub 2020 Sep 10. Alfred Health (2020, April 18). The many causes of anaemia include: Decreased production Malnutrition Bone marrow suppression (e.g., Cannula site bleeding. What is your action now? J Cardiothorac Vasc Anesth.

Blood Transfusions 52

Blood Transfusions Operations Wellness 52

ACEP Now

DECEMBER 11, 2023

Most Important Data Trends for Emergency Physicians and ED Leaders Large losses (around 14 percent) in ED volume in 2020 reversed in 2021 and volumes increased further during 2022. The overall length of stay for all ED patients increased to 211 minutes in 2022, up from 194 minutes in 2021, 184 minutes in 2020, and 182 minutes in 2019.

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

ACEP Now

SEPTEMBER 3, 2024

During the legislative fight to pass the federal No Surprises Act of 2020, it was asserted that most balance billing in the U.S. While secrecy surrounds the operations of many PE-owned groups, Envision serves as a case study. Published March 15, 2020. Published April 20, 2020. Accessed August 25, 2024. J Hosp Med.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

The Skeptics' Guide to EM

JULY 30, 2022

Background: Somewhere between two and four percent of patients presenting to US EDs with abdominal pain have a small bowel obstruction (SBO) – those who are managed operatively (who are only 20-30%) account for 60,000 hospitalizations and 565,000 inpatient care days per year. sensitivity and 96.6% specificity with ultrasound [1].

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Methods This multicentre randomised controlled trial was undertaken between December 2018 and July 2020 in the ED of four hospitals in the Netherlands. The secondary outcomes were time to complete reduction and treatment plan at ED discharge (conservative or operative repair).

Fractures 40

Fractures Ultrasounds Emergency Department Operations 40