Sensible Medicine

JANUARY 26, 2024

As I wrote in 2021 for a similar trial, “The control arm of abiraterone or enzalutamide… is suboptimal since there is substantial cross-resistance between these agents, leading to poor response rates and short PFS [3], [4], [5].” This trial failed to do that. The control arm is known to be deficient.

Documentation/Coding 121

Documentation/Coding 121

EMDocs

OCTOBER 11, 2023

.” The tech cleans the wound and documents it as 2cm long and “ dirty.” The ED physician documents suturing a 3 cm laceration in a single layer, omitting any reference to any wound exploration, cleansing or debridement. I thought they were incidental “ bone islands” so I didn ’ t document them. Danks RR, Jun 22, 2021.

Documentation/Coding 77

Documentation/Coding Radiology Radiology Patient Safety 77

American Medical Compliance

OCTOBER 3, 2024

According to NSC Injury Facts, workplace injuries cost businesses $167 billion in 2021. This can be achieved by maintaining a centralized document repository. Have a digital document management system or a physical binder in a prominent area of the dental office. This includes dentistry.

PPE 105

PPE Hazardous Materials Documentation/Coding Operations 105

Sensible Medicine

SEPTEMBER 19, 2024

In addition, a 2021 Mayo Clinic study found that antibiotics given to a young child (known to alter the formation of the microbiome), was associated with higher rates of obesity, learning disabilities, attention deficit disorder, and celiac disease later in childhood. Health care needs new leaders.

Research 144

Research Military Poisoning Burns 144

Don't Forget the Bubbles

NOVEMBER 20, 2023

Document the size, consistency and location in the notes to compare if they represent. April 2021 Russell F, Lowe D. They may grow again with subsequent upper respiratory tract infections. This waxing and waning course is normal, and families should be reassured and given red flag features that necessitate further assessment.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

ACEP Now

DECEMBER 11, 2023

A recent article documents 56 additional U.S. physicians quit in 2021 alone. Published November 16, 2021. The wave of increasing hospital closures and service line cutbacks continues to sweep the U.S. hospitals that are closing clinical departments or ending or reducing services. industries, and the most dangerous of all U.S.

Hospitals 98

Hospitals Administration Documentation/Coding Research 98

EMDocs

APRIL 18, 2024

The admitting nurse documents an “OTJ injury” with a chief complaint of “My boss made me come.” Updat-ed Jun 23 2021. The employee is surprised when his boss tells him “Get to the E.R! Right now!” He arrives in the ED of his small community hospital about 30 minutes later. As so often happens, listening to our nurses saves our butt.

Patient Safety 99

Patient Safety Hospitals Documentation/Coding EMS 99

EB Medicine

OCTOBER 3, 2021

EMplify - October 2021 Announcements: The EB Medicine app is live and available for free in the Apple Store. Also, this month use code SB25 and get a $25 Starbucks gift card when you subscribe at ebmedicine.net Emergency Dept. Coming to Google Play soon. It is in Beta and your feedback is welcome. Coming to Google Play soon.

Documentation/Coding 52

Documentation/Coding Pediatrics 52

EB Medicine

NOVEMBER 1, 2021

EMplify – November 2021 Announcements: The EB Medicine app is live and available for free in the Apple Store. Also, this month use code ACEP21! It is in Beta and your feedback is welcome. ,* Also, this month use code ACEP21! Coming to Google Play soon. It is in Beta and your feedback is welcome. Coming to Google Play soon.

Fractures 52

Fractures Documentation/Coding Operations Emergency Department 52

PulmCCM

JUNE 12, 2023

But the most recent TTM2 trial (NEJM 2021, n=1850) , which was included in the analysis, by itself cast significant doubt on any benefit of temperature management below normothermia. Use code PULMCCM15 and get 15% off when you register online.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

Dr. Smith's ECG Blog

MAY 26, 2023

Details of management extend beyond the scope of this ECG Blog — with reviews by Atemnkeng at al ( J Med Cases 12[9]:373-376, 2021 ) and Chakraborty & Hamilton ( StatPearls, 2023 ) available for interested readers. A NSWER : In Figure-3 — I have color-coded P waves in the long lead II rhythm strip of ECG #2.

Shock 98

Shock EKG/ECG Documentation/Coding Resuscitation 98

Downeast Emergency Medicine

DECEMBER 1, 2021

Background Recent data from the National Center for Health Statistics reveal that in the 12-month period ending in April 2021, more than 100,000 Americans died of an overdose, a staggering increase of nearly 30% the prior year. 2021; 4(7): e2117128.[ 2021; 78(3): 434-442.[ The Journal of Rural Health. Pubmed ] 3. Herring, et al.

Emergency Department 52

Emergency Department Documentation/Coding Leadership Administration 52

EB Medicine

SEPTEMBER 7, 2021

EMplify - September 2021 Announcements: Be on the lookout for an announcement regarding the new EB Medicine app, coming to an App Store near you this month !! Also, this month use code SB25 and get a $25 Starbucks gift card when you subscribe at ebmedicine.net !

Documentation/Coding 52

Documentation/Coding Emergency Department 52

ACEP Now

JUNE 7, 2023

The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. ED leaders worked to develop new physician documentation and coding guidelines that needed to be implemented at the beginning of 2023. Patient volume losses in 2020 reversed in 2021. percent.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

RebelEM

AUGUST 22, 2024

What They Did: Retrospective review of consecutive RAO cases managed as part of a remote ophthalmology consult protocol activated on May 1, 2021, at three stroke centers across a health system. Documented at the following time points: Before treatment. Published 2021 Feb 16. Within 24 hours after treatment. Clin Ophthalmol.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

ALiEM

JANUARY 26, 2024

Ciprofloxacin has been documented as a cause of IgA vasculitis. 2021 Jan;34(1):e14591. Case Question: What are common triggers for this diagnosis? Common triggers include infection, drugs, and autoimmune. Case Discussion Take-Home Points Consider IgA vasculitis, even in an older patient. Ann Pharmacother. 1995 Jan;29(1):84.

Documentation/Coding 73

Documentation/Coding Academics EMS Hospitals 73

ACEP Now

NOVEMBER 7, 2024

Photographic documentation of the wound is helpful to enhance continuity of care. 2020;95(9):2021-2034. Social determinants, such as a history of poor medication compliance, housing insecurity, lack of a support system and transportation resources, comorbidities, or need for vascular intervention, may necessitate inpatient admission.

Burns 97

Burns Documentation/Coding Outcomes Emergency Department 97

Total Medical ComplianceHIPAA

JANUARY 12, 2023

During those two years, the OCR oversees all compliance activities and requires that all HIPAA related documentation and issues be submitted and approved or reported to them according to strict guidelines. The NPRM was published in 2021 for public comments.

Operations 104

Operations Best Practices Documentation/Coding Administration 104

The Skeptics' Guide to EM

MAY 8, 2021

Date: May 7th, 2021 Guest Skeptic: Dr. Ryan Stanton is a community emergency physician with Central Emergency Physicians in Lexington, KY. Date: May 7th, 2021 Guest Skeptic: Dr. Ryan Stanton is a community emergency physician with Central Emergency Physicians in Lexington, KY. first appeared on The Skeptics Guide to Emergency Medicine.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

Sensible Medicine

AUGUST 14, 2024

” Indeed, cause of death is coded differently over time and across counties, states, and countries. A 2021 AAP article by Parks and colleagues says, “Lack of uniformity in defining and classifying SUID is a long-standing limitation of surveillance. According to CDC data , 544 infants died per 100,000 live births in 2021.

CDC 95

CDC Sepsis Research Pediatrics 95

PulmCCM

JANUARY 15, 2025

Draft Guidance Document Wong et al. Draft Guidance for Industry and Food and Drug Administration Staff. January 2025. Analysis of Discrepancies Between Pulse Oximetry and Arterial Oxygen Saturation Measurements by Race and Ethnicity and Association With Organ Dysfunction and Mortality.

Documentation/Coding 81

Documentation/Coding Academics Administration Research 81

Sensible Medicine

AUGUST 28, 2024

in 2021, a relative increase of 105%—in part due to lack of sleep, because babies are constantly semi-aroused? Are parents more sleep-deprived as a result of Safe to Sleep, and what are the health consequence to children of that, for example car accidents? in 2010 to 19.3%

Research 98

Research CDC Documentation/Coding 98

Don't Forget the Bubbles

JANUARY 1, 2024

Data collected from 2002 to 2021 revealed a 72% decline in IPD incidence among children (<18 years), with continued reductions after the transition from PCV7 to PCV13. During the COVID-19 pandemic (2020-2021), the incidence of IPD reached its lowest level in 20 years. Pediatrics. Shikha A, et al. Eur J Pediatr. 2023 Dec 27.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

The Skeptics' Guide to EM

JANUARY 23, 2021

Date: January 20th, 2021 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. AEM January 2021 Case: A 50-year-old male presents to the Emergency Department (ED) with left lower quadrant abdominal pain. Reference: Pines et al.

Poisoning 52

Poisoning Research Documentation/Coding Operations 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Method and Design We conducted an observational retrospective cohort study on patients who visited ED in 2021. Abstract 2086 Table 1 Presentations Total first presentation over 2021 Total deaths (within 30 days ) Admission Admission (%) Percentage of deaths [CI ] INJURY OF SHOULDER/ARM/ELBOW/WRIST/HAND 8416 4 424 5 0.05[0.018

Documentation/Coding 40

Documentation/Coding Sexual Assault Hyperthermia / Hypothermia Head Injuries 40

PulmCCM

MARCH 11, 2024

About 544,000 99292 codes were billed to CMS in 2021, according to ACCP , reportedly stable at about 10% of the total bills. Centers for Medicare and Medicaid Services (CMS) made a change in reimbursement policy that devalued critical care time. At about $100 per , they would be worth ~$54 million in total.

Hospice 52

Hospice Documentation/Coding Administration Hospitals 52

EMDocs

AUGUST 8, 2023

Document consideration of torsion in males with abdominal pain. 2021 Nov;23(6):740-743. Epub 2021 Aug 18. Medicolegal considerations: 3rd most common cause of malpractice suits in males 12-17 years old & average settlement of $60,000. References: Rosenberg H, Long B, Keays M. doi: 10.1007/s43678-021-00189-6. PMID: 34406643.

Ultrasounds 79

Ultrasounds Documentation/Coding Outcomes Emergency Department 79

The Skeptics' Guide to EM

JANUARY 30, 2021

Date: January 22nd, 2021 Guest Skeptic: Dr. Steve Joseph. Date: January 22nd, 2021 Guest Skeptic: Dr. Steve Joseph. 2020 * Population: Adults (18 years and older) inpatient or outpatients with a diagnosis of certain long bone fractures (neck of femur/tibia/fibula/tibia and fibula/radius/ulna/humerus/clavicle) based on ICD-9 codes.

Fractures 52

Fractures Documentation/Coding Outcomes 52

EMDocs

FEBRUARY 12, 2025

She had previously undergone carbon ion radiotherapy, receiving a cumulative dose of 75 GyE in 20 fractions over two courses from December 2020 to January 2021. Symptoms of radiation-induced skin injury began on the eighth day after initiating radiotherapy, and by January 18, 2021, the lesion had progressed to Grade IV radiation dermatitis.

Best Practices 53

Best Practices Documentation/Coding Radiology Radiology 53

The Skeptics' Guide to EM

JANUARY 16, 2021

Date: January 5th, 2021 Reference: Shipman et al. Date: January 5th, 2021 Reference: Shipman et al. The first documented use of topical ophthalmologic anesthetics was in 1818. Short-Term Topical Tetracaine Is Highly Efficacious for the Treatment of Pain Caused by Corneal Abrasions: A Double-Blind, Randomized Clinical Trial.

EMS 52

EMS Documentation/Coding Emergency Department 52

Dr. Smith's ECG Blog

JULY 7, 2024

But because Code STEMI was cancelled on arrival and the patient had delayed angiography, the discharge diagnosis was 'non-STEMI' despite having the exact same pathology. The patient also had a 100% proximal LAD occlusion, with a peak troponin of 100,000 ng/L.

EKG/ECG 69

EKG/ECG Documentation/Coding EMS Wellness 69

PulmCCM

JANUARY 6, 2025

A 2021 analysis of Epic’s sepsis model revealed atrocious false positive and negative rates. The SCREEN Trial SCREEN was a stepped-wedge cluster randomized trial of an EMR alert for organ failure, conducted at 45 wards of 5 hospitals in Saudi Arabia from 2019 to 2021. 2021 Aug 1;181(8):1065-1070. 2021 Aug 1;181(8):1144.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

Cook County EM Blog

MARCH 28, 2023

Surgery was completed approximately one month after presentation with improvement in vision to 20/80 at last documented ophthalmology follow up appointment. 2021, [link] 2: Bell, Daniel J. 2021, [link] 3: Diagnosis of Traumatic Eye Injuries with Point-of-Care Ocular. 2021, [link] Cureus , Cureus, 24 Apr. EyeWiki , 4 Oct.

Dislocations 52

Dislocations Ultrasounds Fractures Radiology 52

American Medical Compliance

DECEMBER 26, 2023

On December 27, 2020, the United States Congress adopted the No Surprises Act (NSA) as part of the Consolidated Appropriations Act of 2021, which has various provisions to assist in protecting customers against unexpected costs beginning January 1, 2022. The following course highlights the NSA and how it impacts healthcare.

Ambulance Services 52

Ambulance Services Documentation/Coding 52

SheMD

OCTOBER 8, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. And if you worry about reporting a program because of retaliation, document all of it and submit after match or anonymously. Disclaimer: This post was written before the COVID-19 pandemic.

Leadership 105

Leadership Best Practices Documentation/Coding Academics 105

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Date: November 10th, 2021 Reference: Andersen, et al: Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest. JAMA Sept 2021. JAMA Sept 2021. He had been admitted the night before for a new diagnosis of rapid atrial fibrillation.

Advances Cardiac Life Support (ACLS) 40

Advances Cardiac Life Support (ACLS) Hospitals Emergency Department Resuscitation 40

RCEM Learning

JANUARY 23, 2024

The ELECT2 Trial as it was to be called, was to start on October 2021. But the principles and processes are very similar, considering the ethics approvals needed, the staff I needed to employ, the mountains of documents I needed to prepare, and the lack of sleep that is involved in those early months.

Research 72

Research Wellness Outcomes Documentation/Coding 72