RebelEM

SEPTEMBER 29, 2022

to 6.8L) WATERFALL Trial Fluid Administration Critical Findings: The trial was stopped early due to an interim analysis demonstrating a high incidence of fluid overload with no significant difference in the primary outcome. The aggressive fluid administration arm is far less aggressive than what was historically recommended for pancreatitis.

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

PulmCCM

JANUARY 6, 2025

With financial penalties coming for noncompliance with the new rule, hospital administrators rapidly deployed the alerts to fire on all eligible inpatients. A 2021 analysis of Epic’s sepsis model revealed atrocious false positive and negative rates. 2021 Aug 1;181(8):1065-1070. 2021 Aug 1;181(8):1144.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

ACEP Now

AUGUST 25, 2023

The National Heart, Lung, and Blood Institute released an expert panel report in 2014 with evidence-based guidelines for management of SCD recommending timely administration of parenteral opioids for VOE.2 Two interesting findings were time to parenteral opioid administration and total dose of opioid morphine equivalents. Am J Hematol.

Administration 97

Administration Pediatrics Emergency Department Outcomes 97

ACEP Now

DECEMBER 11, 2023

physicians quit in 2021 alone. physicians quit in 2021 alone. Published November 16, 2021. Conditions in the Workplace Over 20 percent of our health care workforce left health care in the last two years, and 10 percent of all practicing U.S. industries, and the most dangerous of all U.S. workplace professions.

Hospitals 98

Hospitals Administration Documentation/Coding Research 98

EM Literature of Note

JANUARY 9, 2022

link] Rapid Administration of Methoxyflurane to Patients in the Emergency Department (RAMPED) Study: A Randomized Controlled Trial of Methoxyflurane Versus Standard Care More patients treated with methoxyflurane had reductions in pain, but more patients in the methoxyflurane arm received oral and/or parenteral opioids.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

RebelEM

AUGUST 22, 2024

Administration of intravenous tissue plasminogen activator (IV tPA) within 4.5 Administration of intravenous tissue plasminogen activator (IV tPA) within 4.5 Moreover, there are multiple operational and patient-specific barriers rendering timely thrombolytic administration difficult. Timely recognition of RAO is challenging.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

EM Literature of Note

SEPTEMBER 13, 2024

The two “COVID seasons” of 2020-21 and 2021-22 were excluded from their comparisons. Generally speaking, the administration of nirsevimab diminished lower respiratory tract infection presentations, bronchiolitis presentations, and bronchiolitis admission by approximately 60% as compared to prior years.

Emergency Department 87

Emergency Department Pediatrics Administration Wellness 87

RebelEM

APRIL 29, 2024

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. Intravenous vs intraosseous adrenaline administration in cardiac arrest: A protocol for systematic review and meta-analysis. 2021 PMID: 34273470 12 Petitpas F et al. Resuscitation. 2012 PMID: 21893125. 9 Zhang W et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Don't Forget the Bubbles

OCTOBER 12, 2024

When comparing corticosteroids to a placebo, children who received corticosteroids had a more significant reduction in croup scores between 2 and 12 hours of administration. Five studies explored different routes of dexamethasone administration. Croup, Don’t Forget the Bubbles, 2021. How should we give the corticosteroids?

Airway Management 85

Airway Management Emergency Department Administration Hospitals 85

PEMBlog

MAY 31, 2023

Marianne Gausche-Hill New England EMSC: New England Regional Behavioral Health Toolkit Disclaimer The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. doi: 10.1136/bmjopen-2021-059876. 2022 May 11;12(5):e059876.

Psychiatric 93

Psychiatric Emergency Department Pediatrics Administration 93

RebelEM

NOVEMBER 6, 2023

ug/kg/min of norepinephrine equivalent at time of hydroxocobalamin or methylene blue administration Exclusion Criteria: Administration of hydroxocobalamin or methylene blue for non-VS indications Hydroxocobalamin or methylene blue given > 48 hours after CPB Pre-intervention cardiac index < 2.0 J Cardiothorac Vasc Anesth.

Shock 71

Shock Administration Academics Hospitals 71

Emergency Medicine Journal

AUGUST 23, 2023

Method Semistructured telephone interviews were conducted with ED/UCC practitioners across England between October 2020 and July 2021 as part of a larger multimethod study examining the impact of NHS 111 online. This paper examines ED and urgent care centre (UCC) staff experiences of NHS 111 First.

Emergency Department 75

Emergency Department Urgent Care Documentation/Coding Patient Safety 75

PulmCCM

JANUARY 23, 2025

Of course, they also have limitations you won’t likely learn from the marketers and hospital administrators eager to implement the latest advancements. Septicyte was cleared by FDA in 2021 for use in hospitalized patients with suspected sepsis. organ dysfunction plus suspected infection with or without evidence).

Sepsis 45

Sepsis Wellness Emergency Department Research 45

ACEP Now

NOVEMBER 8, 2024

References National Association of State EMS Officials, National Highway Traffic Safety Administration. Published August 2021. John Wiley & Sons; 2021:21-29. Glauser is professor of emergency medicine at Case Western Reserve University at MetroHealth Cleveland Clinic in Cleveland, Ohio. DOT HS 813 151). 3rd Edition.

Airway Management 40

Airway Management EMS Hospitals Administration 40

Core Ultrasound

MARCH 25, 2024

Old IVC Vid (2021) TEE VTI Here are Dr. Spiegel’s Notes: 1. The IVC is unable to reliably tell you anything about fluid responsiveness but fluid responsiveness is a flawed outcome and we have to start taking a more holistic view on the administration of fluid. It is our job as clinicians to interpret what that means.

Administration 75

Administration Sepsis Ultrasounds Outcomes 75

The Skeptics' Guide to EM

FEBRUARY 27, 2021

Date: February 18th, 2021 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Date: February 18th, 2021 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. AEM Feb 2021. AEM Feb 2021.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Administration Research 52

RebelEM

SEPTEMBER 7, 2023

However, guidelines offer no strong recommendations for its use, specifically in spontaneous ICH ( Fang 2021 ). Epub 2021 Jul 20. Levetiracetam is frequently used to prevent seizures in patients with conditions such as ICH, traumatic brain injury (TBI), supratentorial neurosurgery, and subarachnoid hemorrhage (SAH). PMID: 35963261.

Seizures 130

Seizures Stroke Outcomes Research 130

Emergency Medicine Journal

JUNE 22, 2023

Methods This is a retrospective review of medical records of the ED of three public hospitals in Sydney, New South Wales, Australia from January 2016 to October 2021. The main outcome measures were ambulance transport, lumbar imaging, opioid administration and hospital admission.

Emergency Department 40

Emergency Department Administration Hospitals Outcomes 40

RebelEM

FEBRUARY 21, 2024

One important thing to understand is that the different NSAIDs have widely accepted equianalgesic doses; at the right dose, all NSAIDs (whether it be naproxen, ibuprofen, ketorolac or diclofenac) give equivalent pain relief ( Irizarry 2021 ). Ibuprofen superior secondary to cost, ease of administration + lack of pain w/ administration.

Administration 63

Administration Emergency Department EMS Research 63

ALiEM

SEPTEMBER 11, 2023

Timely administration of antibiotic drops and ophthalmology evaluation is crucial to prevent progression to corneal ulcer and the need for corneal transplant. 2021 Apr;44(2):330-367. Epub 2021 Mar 25. Food and Drug Administration. Case Discussion Take-Home Points Corneal abrasions can occur in both eyes at once.

Administration 60

Administration Academics Emergency Department 60

The Skeptics' Guide to EM

DECEMBER 25, 2021

Date: December 21st, 2021 Guest Skeptic: Dr. Spencer Greaves is an Emergency Medicine resident at Florida Atlantic University. Date: December 21st, 2021 Guest Skeptic: Dr. Spencer Greaves is an Emergency Medicine resident at Florida Atlantic University. Spencer completed his medical doctorate at the Medical College of Wisconsin.

CPR 52

CPR Administration Outcomes Hospitals 52

EMDocs

AUGUST 31, 2023

Approximately 12 hours following F(ab’) 2 antivenom administration, the child is noted to have progressive swelling, firmness, tension, and pain of the right calf. Published online April 2021. doi:10.1080/19420862.2015.1111497 Antivenom administration North American Crotalinae snakebites – UpToDate. Ann Emerg Med.

Allergic Reactions 96

Allergic Reactions Anaphylaxis Poisoning EMS 96

Total Medical ComplianceHIPAA

JANUARY 12, 2023

The NPRM was published in 2021 for public comments. Updates should also contain any practice-specific issues that may be identified in a risk assessment or by reviewing privacy or security incidents or breaches from the previous 12 months. The NPRM received around 1,390 public comments. Covered entities (providers, practices, etc.)

Operations 104

Operations Best Practices Documentation/Coding Administration 104

ACEP Now

JUNE 5, 2023

Finally, on the legislative side, we are working with our Congressional allies to put pressure on the Administration to address these significant implementation issues. For now, that guidance still stands, even though the administration is not enforcing it. ACEP submitted amicus briefs for both earlier this year. What’s Next?

Administration 59

Administration Radiology Radiology 59

Don't Forget the Bubbles

NOVEMBER 27, 2023

Myth busting: Is peripheral administration safe? Adverse events associated with administration of vasopressor medications through a peripheral intravenous catheter: a systematic review and meta-analysis. Published 2021 Apr 16. However, you have no central access. While you are thinking about this, you give another 20 ml/kg of 0.9%

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

The Skeptics' Guide to EM

JANUARY 1, 2022

Date: December 21st, 2021 Guest Skeptic: Dr. Howard “Howie” Mell began his career as a firefighter / paramedic in Chicago. NEJM 2021 […] The post SGEM#354: Everybody Walk the Dinosaur and Not Take the MSU first appeared on The Skeptics Guide to Emergency Medicine. Howie also has a Master of Public Health. Reference: Grotta JC et al.

Stroke 52

Stroke EMS Outcomes Administration 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Date: September 8th, 2021 Reference: Desch et al. He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP).

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

RebelEM

AUGUST 28, 2023

One important thing to understand is that the different NSAIDs have widely accepted equianalgesic doses; at the right dose, all NSAIDs (whether it be naproxen, ibuprofen, ketorolac or diclofenac) give equivalent pain relief ( Irizarry 2021 ). Ibuprofen superior secondary to cost, ease of administration + lack of pain w/ administration.

Administration 52

Administration Emergency Department EMS Research 52

PEMBlog

MAY 17, 2023

Pediatrics 2021; 147. Department of Health and Human Services (HHS) as part of an award (U07MC37471) totaling $3M with 0 percent financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. J Inherit Metab Dis 2007; 30:631.

Psychiatric 80

Psychiatric Pediatrics Emergency Department Best Practices 80

The Skeptics' Guide to EM

JUNE 5, 2021

Date: May 25th, 2021 Guest Skeptic: Dr. Garreth Debiegun is an emergency physician at Maine Medical Center in Portland, ME and clinical assistant professor with Tufts University School of Medicine. JAMA 2021 * Zi et al. JAMA 2021 Case: A 74-year-old woman presents to your emergency department with 1.5

Stroke 52

Stroke Urgent Care Critical Access Outcomes 52

AENJ: Current Issue

DECEMBER 19, 2024

Background: Delays in sepsis recognition contribute to delays in antibiotic administration, which lead to increased morbidity and mortality in patients with sepsis. In fiscal year 2021, the ED Sepsis Nursing Team was launched with the goal of improving sepsis-related outcomes. at a rate of 0.5.

Documentation/Coding 40

Documentation/Coding Sepsis Outcomes Emergency Department 40

American Medical Compliance

OCTOBER 3, 2024

Occupational Safety and Health Administration (OSHA) regulations are vital for maintaining a safe and healthy work environment in all industries. According to NSC Injury Facts, workplace injuries cost businesses $167 billion in 2021. This includes dentistry.

PPE 105

PPE Hazardous Materials Documentation/Coding Operations 105

ACEP Now

JANUARY 11, 2024

physicians quit in 2021 alone. physicians quit in 2021 alone. Published November 16, 2021. Conditions in the Workplace More than 20 percent of our health care workforce left health care in the last two years, and 10 percent of all practicing U.S. industries, and the most dangerous of all U.S. workplace professions. Newitt, P.

Hospitals 52

Hospitals Administration Documentation/Coding Research 52

RebelEM

OCTOBER 2, 2023

tests/hr (0.8 Traditional: 1.0 tests/hr (0.8 Pre-Intervention: 1.0 tests/hr (0.9 to 1.2); No Reduction/Increase 0.0% Pre-COVID: 1.0 tests/hr (0.8 to 1.1); No Reduction/Increase 0.0% High fidelity for patients on the SQuID pathway Performance of blood glucose checks exceeded the q2hr testing requirement: Median 1.0 Traditional: 3.6%

Operations 102

Operations Academics Fluid Resuscitation Outcomes 102

EMDocs

JUNE 2, 2023

Route of administration If the patient is cooperative, offer oral medications first. doi: 10.1136/bmjopen-2021-059876. You should always follow your local practice guidelines and recommendations as well as adhere to approved medications in your facility. If a patient has a PRN on their med list do that! 2022 May 11;12(5):e059876.

Psychiatric 91

Psychiatric Pediatrics Emergency Department Administration 91

ACEP Now

JUNE 7, 2023

The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. These data can be shared with hospital administration as there is mutual need to find solutions to the current ED flow challenges and very high ED walkaway rates. Patient volume losses in 2020 reversed in 2021. percent.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

Northwestern EM Blog

JANUARY 10, 2022

Of note, you do NOT need a central line for hypertonic saline administration. Though if your administration says differently, do not waste time putting in a triple lumen catheter if hypertonic is truly indicated in your hyponatremia patient. 2021 Feb 1;41(1):25-30. McGraw Hill; Accessed July 21, 2021. Crit Care Nurse.

Administration 52

Administration Seizures Emergency Department Wellness 52