Pediatric EM Morsels

FEBRUARY 2, 2024

Abdel-Haq 2021). Travel dates can help to exclude certain infections by their incubation periods (Abdel-Haq 2021) Physical examination can sometimes reveal concerning features including hepatomegaly , jaundice or a rash that may guide differential. A study of swiss tourists found they compromised 53.4%

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. 2021 Feb 5;14(2):e240532.

Hyperthermia / Hypothermia 152

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 152

ACEP Now

JUNE 7, 2023

The role of emergency physicians has been made dramatically more important due to the pandemic. The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. Commercial payers aggressively abused the No Surprises Act as a method to delay, downcode, and deny payment for emergency services.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

ACEP Now

DECEMBER 11, 2023

The Emergency Department Benchmarking Alliance (EDBA) is a membership organization composed of high-performance emergency departments (EDs) that share a commitment to quality. In the year 2021, the ED boarding time was 167 minutes, and in 2022 it soared to the 190-minute mark. percent in 2021, 2.8

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

Don't Forget the Bubbles

NOVEMBER 29, 2023

You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. Pediatric Endotracheal Intubations for Airway Management in the Emergency Department.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

Emergency Medicine Journal

NOVEMBER 21, 2024

million ED visits from 2016 to 2021. of self-injury-related ED visits in 2020 and 2021, respectively (pandemic years), compared with an average of 8.4% Results Our analysis covered 419.4 Individuals experiencing homelessness constituted 1.8% (7.4 million) of ED visits. Overall, 1.8% of ED visits (7.7 in the previous years.

Emergency Department 52

Emergency Department Outcomes Hospitals 52

EB Medicine

MAY 4, 2021

EMplify - May 2021 Announcements: The Clinical Decision Making in the Emergency Department conference is June 23-27 live and virtual. More information here: [link] Be on the lookout for an announcement regarding the new EB Medicine app, coming to an App Store near you this summer !!

Emergency Department 52

Emergency Department EKG/ECG 52

RebelEM

JULY 1, 2024

Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. Balkan Med J 2021. Balkan Med J 2021. Cureus 2021. There are very limited studies however in the literature on the AVAPS mode of NIPPV.

COPD 127

COPD Emergency Department Outcomes EMS 127

EB Medicine

MARCH 1, 2021

EMplify - March 2021 Management of Acute Urinary Retention in the Emergency Department An algorithmic approach to urinary retention. EMplify - March 2021Management of Acute Urinary Retention in the Emergency Department * An algorithmic approach to urinary retention.*

Emergency Department 52

Emergency Department Airway Management 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. Emergency Department-Initiated Buprenorphine/Naloxone Treatment for Opioid Dependence: A Randomized Clinical Trial.

Emergency Department 52

Emergency Department Documentation/Coding Leadership Administration 52

ACEP Now

MAY 9, 2024

The procedure has soared in popularity as beauty standards have shifted and cosmetic surgery has become increasingly transparent on social media platforms, with reported cases in the United States increasing from 614 in 2002 to 61,387 by 2021, a nearly 10,000 percent increase. Aesthetic Plastic Surgery National Databank Statistics 2020–2021.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Northwestern EM Blog

DECEMBER 27, 2021

Congratulations to all of the authors with the most popular posts of 2021! Despite previous black box warnings on droperidol causing it to fall out of favor, it is safe and well-tolerated at the doses typically used in an emergency department setting. Dr. Seth Trueger, NUEM faculty, provides expert commentary.

Dislocations 52

Dislocations Emergency Department Burns Shock 52

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

EB Medicine

APRIL 6, 2021

EMplify - April 2021 Announcements Traumatic Hemorrhage in the ED- with Dr Scott Weingart - April 13th, 8pm EST Free ! Mt Sinai COVID-19 Treatment Protocols have been updated and are available for free here: [link] The Clinical Decision Making in the Emergency Department conference is June 23-27 live and virtual.

Emergency Department 52

Emergency Department Administration 52

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. Dr. Kluesner is an emergency physician in Iowa City, Iowa, at UnityPoint Health-Iowa Methodist Medical Center. Academic Emergency Medicine 22.2 Published online 2021:26.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

EM Literature of Note

AUGUST 25, 2024

It’s NHAMCS – so it is representative data being transformed into rough weighted estimates – between 2010-2021, but we see its use increasing from 3.5% emergency departments” [link] Tweet of asthma visits to 17.3% – and the rates are over double that in children.

Administration 94

Administration Emergency Department Wellness Pediatrics 94

Emergency Medicine Journal

AUGUST 21, 2024

The Clinical Frailty Scale (CFS) is a 9-point frailty assessment instrument that has shown promise to identify frail emergency department (ED) patients at increased risk of adverse outcomes.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

EB Medicine

JANUARY 7, 2021

EMplify January 2021 Evaluation and Management of ST-Segment Elevation Myocardial Infarction in the Emergency Department Authors Marshall Frank, DO, MPH, FACEP Carson Sanders, BS, NRP, CCEMT-P Bryan P.

Emergency Department 52

Emergency Department EKG/ECG 52

ACEP Now

DECEMBER 11, 2023

Patients with severe agitation are frequently encountered in the emergency department (ED) setting. Emergency departments can be crowded and chaotic, further exacerbating mental health issues. ACEP Policy statement: Use of droperidol in the emergency department. Published January, 2021. Ann Emerg Med.

Emergency Department 52

Emergency Department Pediatrics Research Hospitals 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 87

Emergency Department Pediatrics Administration Wellness 87

ALiEM

NOVEMBER 17, 2023

A 4-year-old female with no significant past medical history is brought to the Emergency Department by her grandmother for concern for two days of progressive vaginal bleeding. It often presents to the emergency department with complaints of vaginal bleeding, difficulty urinating, or dysuria. link] Published 2021.

Pediatrics 100

Pediatrics Emergency Department Academics OB/GYN 100

The Skeptics' Guide to EM

APRIL 20, 2024

Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. Background: We have covered rib fractures once before on the Skeptics’ Guide to Emergency Medicine.

Fractures 82

Fractures Ultrasounds Emergency Department CDC 82

Emergency Medicine Journal

APRIL 22, 2024

Objective We sought to validate the clinical performance of a rapid assessment pathway incorporating the Siemens Atellica IM high sensitivity cardiac troponin I (hs-cTnI) assay in patients presenting to the emergency department (ED) with suspected acute myocardial infarction (AMI).

Emergency Department 98

Emergency Department Outcomes EKG/ECG Hospitals 98

ACEP Now

MAY 10, 2024

Patients often seek care in the emergency department (ED) setting when flares of pain affect their ability to ambulate, climb stairs, or even stand up from sitting. Presentation of Knee Osteoarthritis in the Emergency Department: A Problem Worth Mentioning? 52, 196 (2021). J Emerg Med. Epub 2021 Jun 25.

Ultrasounds 92

Ultrasounds Emergency Department Hospitals Wellness 92

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? An implementation science approach improves language access in the emergency department. Association of limited English proficiency and increased emergency department waiting room lengths of stay. Annals of Emergency Medicine.

Documentation/Coding 94

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 94

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. This is endorsed in the 2022 ACC pathway [1] and the 2021 AHA chest pain guidelines [7]. 2021 May 13;:]. 2021 May 13;:].

EKG/ECG 110

EKG/ECG Emergency Department Burns Wellness 110

AENJ: Current Issue

DECEMBER 31, 2023

The review was conducted to develop an evidence-based algorithm specific for management of heatstroke in the emergency department with implications for improving recognition, initiating rapid cooling, and providing supportive care to reduce patient mortality and morbidity. Rublee et al.

Emergency Department 40

Emergency Department Research 40

RebelEM

NOVEMBER 15, 2023

. “The ED-AWARENESS study: A prospective, observational cohort study of awareness with paralysis in mechanically ventilated patients admitted from the emergency department.” ” Annals of emergency medicine 77.5 2021): 532-544.

EMS 101

EMS Emergency Department 101

EM Literature of Note

JANUARY 9, 2022

link] Pathway with single-dose long-acting intravenous antibiotic reduces emergency department hospitalizations of patients with skin infections A sponsor encouraging discharge of patients with SSTI results in discharge of patients with SSTI. the subsequent hospitalization rate was around 10%.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

EMDocs

JUNE 15, 2024

Source Shifts in Diagnostic Testing for Headache in the Emergency Department, 2015 to 2021. The post Journal Feed Weekly Wrap-Up appeared first on emDOCs.net - Emergency Medicine Education. JAMA Netw Open. 2024 Apr 1;7(4):e247373. doi: 10.1001/jamanetworkopen.2024.7373. PMID: 38639937; PMCID: PMC11031686.

Sepsis 88

Sepsis Emergency Department 88

Dr. Smith's ECG Blog

MAY 27, 2024

Curr Cardiol Red 2021 3. 2022 ACC expert consensus decision pathway on the evaluation and disposition of acute chest pain in the emergency department: a report of the American College of Cardiology solution set oversight committee. J Am Heart Assoc 2021 6. IJC Heart and Vasc 2021 8. Int J Cardiol 2024 2.

EKG/ECG 126

EKG/ECG Documentation/Coding Emergency Department 126

EMergucate

OCTOBER 27, 2021

A 81 year old male presents to a regional emergency department, 4 hours away from a cath lab, complaining of chest pain. Below is the patients ECG:

EKG/ECG 52

EKG/ECG Emergency Department 52

ALiEM

AUGUST 7, 2023

A 10-year-old male with no past medical history presents to the Emergency Department (ED) by EMS for evaluation of an injury sustained while playing tackle football. The patient was forcibly hit by another child against a tree. View other cases from this Clinical Image Series on ALiEM.

Dislocations 98

Dislocations Fractures Academics Emergency Department 98

ACEP Now

JULY 11, 2024

Deaths from drinking increased 25 percent from 2019 to 2020 and another 10 percent in 2021. 2 Although the opiate epidemic is certainly worthy of attention, it accounts for only about half of the number of deaths annually and only around a quarter of the number of emergency department visits annually relative to alcohol use.

Emergency Department 98

Emergency Department Psychiatric Outcomes Wellness 98

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. Our objective was to compare care delivery for low back pain in Australian EDs between culturally and linguistically diverse (CALD) and non-CALD patients.

Emergency Department 40

Emergency Department Administration Hospitals Outcomes 40

EB Medicine

JANUARY 31, 2021

EMplify - February 2021 Community Acquired Pneumonia - An Interview with Dr. Matthew DeLaney, FACEP 1. Pneumonia and nomenclature : healthcare associated vs hospital associated 2. COVID-19 and antibiotics 3. Bacteriology - Strep is only 10-15% of hospitalized pneumonia, Viral pneumonia is about 20% (pre covid) 4.

Emergency Department 52

Emergency Department Hospitals 52

RebelEM

JUNE 5, 2023

from 2019 to 2021 (from 48,000 to 81,400 annual deaths), which includes prescription opioids (natural and semi-synthetic opioids and methadone), heroin, and synthetic opioids other than methadone including fentanyl (1). Microdosing and standard‐dosing take‐home buprenorphine from the Emergency Department: A feasibility study.

Emergency Department 84

Emergency Department Hospitals Outcomes EMS 84