Pediatric EM Morsels

AUGUST 18, 2023

None of the patients were documented to have joint disease at follow up. Ross 2021) Predisposing risk factors including older age , trauma to tendons or joints , and a family history of MAEs. There were 2523 children included. 451 pediatric patients were included. There was an increased risk of tendon rupture (1.9 Binz 2015).

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

RebelEM

AUGUST 22, 2024

1,2 Intra-arterial (IA) tPA has also shown benefit but is less well studied. 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.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

Don't Forget the Bubbles

MAY 10, 2023

Then you hear the words coming out of the speaker, “ Paediatric code black. Paediatric code black ”. You’ve heard the phrase code black before – it’s a traumatic cardiac arrest. You know a paediatric code black means paediatric traumatic cardiac arrest. 2021; 164: 70-78. You actually run down the corridor.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

Northwestern EM Blog

MARCH 1, 2025

In this study, they found that prone positioning resulted in significant improvement in oxygenation, as well as a 50% decrease in mortality at 28 days (Guerin et. Position arms in a comfortable position, avoiding any position that could cause a brachial plexus injury, and ensure they are well-supported to avoid pressure ulcers.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

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

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

Dr. Smith's ECG Blog

MARCH 10, 2025

Weve also published the largest study on this question: Emergency Department Code STEMI patients with initial electrocardiogram labeled normal by computer interpretation: a 7-year retrospective review. This underestimates computer false normal ECGs because we only included code STEMIs, not Non-STEMIs with OMI. 2021 ; 46 : 23 - 26.

EKG/ECG 89

EKG/ECG Outcomes Documentation/Coding Emergency Department 89

Dr. Smith's ECG Blog

MAY 26, 2023

Thus, since high dose insulin's (HDI) primary beneficial effect on calcium channel overdose is to as a positive inotrope, it does not work well for dihydropyridine overdose. A NSWER : In Figure-3 — I have color-coded P waves in the long lead II rhythm strip of ECG #2. How Are the P Waves Color-Coded? Learning Points: 1.

Shock 98

Shock EKG/ECG Documentation/Coding Resuscitation 98

The Skeptics' Guide to EM

JUNE 2, 2021

Date: May 28th, 2021 Guest Skeptics: Heather Logan is the executive Strategy lead for the Canadian Agency for Drug and Technologies in Health (CADTH). Date: May 28th, 2021 Guest Skeptics: Heather Logan is the executive Strategy lead for the Canadian Agency for Drug and Technologies in Health ( CADTH ).

Documentation/Coding 52

Documentation/Coding Hospitals Wellness 52

EMDocs

JULY 9, 2024

Insurance companies paying more attention to addressing social needs Medicaid: 1115 Demonstration Waivers, CalAIM in California ICD-10 code modifiers to acknowledge – and compensate—for the added complexity of social needs Additional resources/further reading: Liberman DB, Pham PK, Semple-Hess JE. Epub 2021 Sep 24. Acad Pediatr.

Pediatrics 74

Pediatrics Emergency Department Research Burns 74

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. He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR […] The post SGEM#329: Will Corticosteroids Help if…I Will Survive a Cardiac Arrest? Reference: Shah and Mitra.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

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

ACEP Now

NOVEMBER 13, 2023

For the safety of staff as well as patients, interventions that interrupt escalations before they blossom into violence deserve further study. 5 Hospitals commonly activate a “code” in response to agitated patients, alerting security personnel to the location of that patient. 2021;(7):1278-1287. Community Ment Health J.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

SheMD

OCTOBER 8, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. Actually, I wanted to ask what supports the program has in place for parents (male and female) as well as people increasing their families, be it biologically or through adoption?” Their well-being should be considered.

Leadership 105

Leadership Best Practices Academics Documentation/Coding 105

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 66

EKG/ECG Documentation/Coding EMS Wellness 66

Medical Law

JUNE 20, 2023

California Vehicle Code 21212 provides that all riders and passengers under the age of 18 are legally required to wear a helmet when using a bicycle, a non-motorized scooter, in-line roller skates, or a skateboard to travel along streets or bikeways, or on any other public bicycle path or trail.

Documentation/Coding 52

Documentation/Coding CDC Research Wellness 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

EMDocs

JUNE 2, 2023

You should always follow your local practice guidelines and recommendations as well as adhere to approved medications in your facility. Document what you gave and why, as well as the impact. doi: 10.1136/bmjopen-2021-059876. If a patient has a PRN on their med list do that! 2022 May 11;12(5):e059876.

Psychiatric 93

Psychiatric Pediatrics Emergency Department Administration 93

Dr. Smith's ECG Blog

JULY 21, 2024

In both tracings — an exceedingly fast PMVT is documented. In this study — Procainamide was superior to Amiodarone for terminating monomorphic VT, as well as having fewer adverse effects than Amiodarone ( Ortiz et al — Eur Heart J 1;38 (17): 1329-1335, 2017 ). The arrhythmia starts with a PVC having a short coupling interval.

EKG/ECG 131

EKG/ECG Shock Hospitals Sepsis 131

Mind The Bleep

FEBRUARY 27, 2024

1] It is worth mentioning this formula was designed for well, euvolaemic children, which does not represent the popluation of children who require IV fluids. The curve on this graph can be split into 3 linear sections corresponding to the following weight categories: 0-10kg, 10-20kg, and 20-70kg. [1]

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Hospitals Research 96

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

See Costagliola et al — Ann Clin Transl Neurol 8(7): 1557-1568, 2021 — for more on the complex "Brain-Heart Interaction" in Epilepsy ). Regarding my Systematic assessment of ECG #1: There is significant baseline artifact , as well as baseline wander. mEq/L for K+ and 1.76 Smith's ECG Blog.

Seizures 113

Seizures EKG/ECG EMS Stroke 113

Sensible Medicine

MARCH 27, 2024

Peter Attia - From Surgeon to Longevity Guru I first encountered Peter Attia online while researching ketosis , the Atkins diet and low carb diets in 2012 and found his writing to be incredibly well-researched and helpful. The Notes section at the back of his book cites a 2021 paper first-authored by Libby. To support his Medicine 3.0

Research 109

Research Documentation/Coding Wellness 109

SheMD

JULY 27, 2023

Unequal distribution of domestic responsibility has been documented as a factor in the underrepresentation in female physicians in leadership roles in academic medicine as well as contributing to career satisfaction. Epub 2021 Feb 16. How does this apply to us? Understanding the Impact of COVID-19 on Physician Moms.

Academics 52

Academics Leadership Documentation/Coding Research 52

ACEP Now

MAY 6, 2023

The emergency physician’s documentation of these injuries may prove to be crucial in law enforcement’s reconstruction of the crash and may have significant implications for subsequent legal proceedings. Updated January 4, 2021. Discussion There were over 2.1 million ED visits for injuries from motor vehicle accidents (MVAs) in 2020.

Forensics 52

Forensics Documentation/Coding Fractures Head Injuries 52

Taming the SRU

NOVEMBER 14, 2023

B) on right: hand drawn images of layers of ear demonstrating auricular hematoma The epidemiology and incidence of ED presentation for auricular hematomas has not been well-studied because it is a relatively uncommon condition. Philadelphia PA: Elsevier/Saunders; 2021. Courtesy of wiki commons under CC Attribution 3.0 Seventh ed.

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

SheMD

OCTOBER 5, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. If staying in a hotel- don’t forget to use discount codes the residency program may offer. I have heard stories of interviewees being rude to the Residency Coordinator- this did NOT end well for the student.

Research 52

Research Leadership Documentation/Coding Academics 52

Northwestern EM Blog

SEPTEMBER 26, 2022

It is well-documented that ED physicians have historically high rates of burnout compared to other specialties as well as a high incidence of post-traumatic stress disorder (PTSD) compared to the general population. 2021, August 16). References 1. Get With The Guidelines - Resuscitation Clinical Tools. Www.Heart.Org.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

Don't Forget the Bubbles

MAY 6, 2024

This multicentre retrospective cohort study looked at 202 children in California aged 1- 24 months who presented acutely between 2010 and 2021. of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) Data collected were the worst values documented within the same calendar day as the blood cultures were obtained.

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

Northwestern EM Blog

SEPTEMBER 12, 2022

It is well known that most hospitals in large population centers already operate at or near full capacity [4]. Other things listed on tags can be a patient’s name, bar code, MRN or other tracking criteria. This makes it even more challenging when presented with an acute influx of patients in a short period of time. EPM , 5 Apr.

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Hazardous Materials 52

Dr. Smith's ECG Blog

FEBRUARY 13, 2023

Thankfully this patient’s second ECG met STEMI criteria, so paramedics brought them as a code STEMI. Int J Cardiol Heart Vasc 2021 2. QUERY: Given the modest size of the QRS in lead aVL — Isn't the ST segment in lead aVL disproportionately elevated as well as abnormally shaped? ). Meyers et al. Aslanger et al.

EKG/ECG 52

EKG/ECG Documentation/Coding EMS Wellness 52

Don't Forget the Bubbles

MARCH 19, 2024

The Ombudsman for Children’s Office suggested that in 2020, 18 children were admitted to paediatric hospitals in Ireland, and 10 children in 2021 for reasons beyond their medical needs. Just 20% of a person’s health and general well-being is related to access to care and the quality of services. What can clinicians do?

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

ACEP Now

AUGUST 1, 2023

However, both the Rural Task Force (2020) and the Telehealth Task Force (2021) agreed that telehealth supervision of NPs and PAs in rural practice environments by board-certified emergency physicians is a viable model for improving patient safety and extending the reach of the BC EP through the use of a physician-led team.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Don't Forget the Bubbles

FEBRUARY 26, 2024

Increasing PEEP is thought to cause bronchodilation by providing direct mechanical stimulus as well as secondary stimulation through pulmonary stretch receptors coupled with activation of the non-cholinergic parasympathetic pathway. uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2019. 2018 Jun;54(6):633-7.

Pediatrics 72

Pediatrics Research Documentation/Coding Outcomes 72

ACEP Now

JULY 6, 2023

5 Patients with acute ischemic strokes, STEMIs, and trauma, as well as many other diagnoses, have their workup largely completed, and even sometimes definitive therapy executed, before they leave the emergency department, rather than requiring inpatient units. “A CDC website : Sexually Transmitted Disease Guidelines 2021.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

ACEP Now

DECEMBER 10, 2023

Corneal injury and defects have been documented from direct contact of milkweed sap to the eye and any exposure should be immediately treated with copious water irrigation. He was observed for several hours and eventually discharged with minimal intervention. It is unknown if digoxin specific antibody antidotal therapy would have any effect.

Poisoning 52

Poisoning Seizures Documentation/Coding Emergency Department 52

ACEP Now

MARCH 13, 2024

Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. Published online 2021:26. Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

PulmCCM

OCTOBER 30, 2023

The Society for Critical Care Medicine and Chest together opposed IDSA’s 2021 appeal of SEP-1, and generally support the Surviving Sepsis Campaign framework that SEP-1 grew from. And maybe, noticing all the fuss, some clinicians might have started coding for VAP slightly less often in equivocal cases.

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52