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. About 19 percent of ED visits result in hospital admission and 66 percent of hospital admissions are processed through the ED.

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

EMDocs

JANUARY 11, 2025

Stercoral colitis in the emergency department: a review of the literature. International journal of emergency medicine, 17(1), 3. Stercoral Colitis: When Constipation is an Emergency. Stercoral Colitis in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes. Carlson, J.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

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 132

COPD Emergency Department Outcomes EMS 132

Don't Forget the Bubbles

AUGUST 30, 2023

The parents of 9-month-old Josie bring her into the Emergency Department with coryzal symptoms and difficulty breathing. A secondary analysis of a nationwide study of Emergency Department attendance in America from 2006 to 2008 found that CXRs increase the average length of stay by 27 minutes. Am J Emerg Med.

Emergency Department 131

Emergency Department Pediatrics Infectious Diseases Research 131

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. are caused by a behavioral crisis.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

EMDocs

AUGUST 22, 2024

3,4 Notably, institutions receiving federal funding (such as hospitals receiving Medicare reimbursement) must abide by Title VI of the 1964 Civil Rights Act, which entitles persons with NELP to language assistance. 12 How do we address these disparities in the emergency department? Lion KC, et al. Pediatrics. 135:e709-e716.

Documentation/Coding 105

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 105

ACEP Now

MARCH 10, 2025

1,2 Approximately 2 percent of emergency department (ED) patients in the United States leave prior to evaluation or AMA. National Hospital Ambulatory Medical Care Survey: 2021 Emergency Department Summary Tables. Am J Emerg Med. BMC Emerg Med. Ann Emerg Med. Acad Emerg Med.

Documentation/Coding 52

Documentation/Coding Emergency Department Psychiatric Risk Management 52

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. All patients ≥65 years of age were eligible for inclusion. Logistic regression was used to adjust for confounders. days versus 2.7

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

Don't Forget the Bubbles

JANUARY 31, 2024

As a Trauma Unit within the Thames Valley Trauma Network, Wexham Park Hospital hosts trainees from across the spectrum of acute specialties. Article 1: What predicts parental anxiety in the Paediatric Emergency Department? Predictors of parental anxiety in a paediatric emergency department. Martin, S.R.,

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. 1 Hospital boarding is the main driver of ED crowding, with patients nearly always awaiting transfer to inpatient beds and now more commonly, to other hospitals.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

Don't Forget the Bubbles

AUGUST 19, 2024

Sione, a young Pacific Islander boy, is brought to the emergency department with a 3-day history of acute onset, progressively worsening central chest pain. of child emergency department presentations. References Children’s Health Queensland Hospital and Health Service. The Royal Children’s Hospital Melbourne.

Infectious Diseases 104

Infectious Diseases Pediatrics Emergency Department Hospitals 104

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. Stegeman is an Ultrasound Fellow at Alameda Health System / Highland Hospital. Dr. Mikell is an Ultrasound Fellow at Alameda Health System / Highland Hospital.

Ultrasounds 92

Ultrasounds Emergency Department Hospitals Wellness 92

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 87

Fractures Ultrasounds Emergency Department CDC 87

ALiEM

OCTOBER 30, 2024

Bupe Allergy Buprenorphine induction has been the mainstay of emergency department treatment of opioid use disorder for more than a decade [11, 12]. 2021 Aug 1;94:103086. Emergency department-initiated buprenorphine for opioid dependence with continuation in primary care: outcomes during and after intervention.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

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

Don't Forget the Bubbles

SEPTEMBER 30, 2024

In the UK, as in most developed countries, more patients are presenting to Emergency Departments (EDs) with minor illnesses or injuries. examined 977,907 first-time ED presentations by children aged 0-15 across thirteen acute hospital trusts (between April 2014 and March 2017), trying to figure out how many were non-urgent.

Emergency Department 89

Emergency Department Research Pediatrics Hospitals 89

Don't Forget the Bubbles

OCTOBER 12, 2024

doi: 10.1136/archdischild-2023-326773 Two-year-old Moyo is brought to the emergency department because her parents were concerned about noisy breathing. Most children can be discharged from the emergency department after a dose of corticosteroids and an appropriate safety net. Croup, Don’t Forget the Bubbles, 2021.

Airway Management 85

Airway Management Emergency Department Administration Hospitals 85

Northwestern EM Blog

MARCH 1, 2025

While a randomized control trial should be done to evaluate the effect of early proning in a controlled environment, these studies suggest that we should consider using this in our Emergency Department for patients who present with hypoxia and concern for mild to moderate ARDS without urgent need for intubation. Crit Care Med.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

PEMBlog

MAY 31, 2023

Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry. West J Emerg Med. Erratum in: West J Emerg Med. doi: 10.1136/bmjopen-2021-059876. 2019 Mar;20(2):409-418. 2023.03.005.

Psychiatric 93

Psychiatric Emergency Department Pediatrics Administration 93

EM Literature of Note

JANUARY 9, 2022

link] Effect of Moderate vs Mild Therapeutic Hypothermia on Mortality and Neurologic Outcomes in Comatose Survivors of Out-of-Hospital Cardiac Arrest 31°C was no better than 34°C for improving neurologic outcomes following OHCA. the subsequent hospitalization rate was around 10%.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

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. emergency departments. Acad Emerg Med. How Does It Work?

Sepsis 45

Sepsis Wellness Emergency Department Research 45

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. Bacteriology - Strep is only 10-15% of hospitalized pneumonia, Viral pneumonia is about 20% (pre covid) 4. COVID-19 and antibiotics 3.

Emergency Department 52

Emergency Department Hospitals 52

RebelEM

APRIL 29, 2024

Many clinicians don’t consider IO placement while others consider it a last resort or only a pre-hospital procedure. The IO can actually be your “GO-TO” emergency line or your second choice after failed PIV access. World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4. Crit Care Med. Resusc Plus.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

RebelEM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

Ultrasounds 128

Ultrasounds Outcomes COPD Hospitals 128

Don't Forget the Bubbles

NOVEMBER 20, 2023

Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. Royal Children’s Hospital. Royal Children’s Hospital, Melbourne. April 2021 Russell F, Lowe D. DOI: 10.1016/j.joms.2006.11.039 Dermatopathology.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

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. to 1.29) than Native-English-speaking patients.

Emergency Department 40

Emergency Department Administration Hospitals Outcomes 40

ACEP Now

AUGUST 25, 2023

Intranasal Fentanyl for Sickle Cell Vaso-Occlusive Pain Case A 15-year-old female with sickle cell disease (SCD) presents to your emergency department (ED) with a vaso-occlusive pain episode (VOE) of her legs and back. She has a history of similar episodes. There are no other concerning aspects to her examination. Am J Hematol.

Administration 97

Administration Pediatrics Emergency Department Outcomes 97

EMDocs

JUNE 2, 2023

Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry. West J Emerg Med. Erratum in: West J Emerg Med. Erratum in: West J Emerg Med. Erratum in: West J Emerg Med.

Psychiatric 95

Psychiatric Pediatrics Emergency Department Administration 95

The Skeptics' Guide to EM

OCTOBER 23, 2021

Date: October 20th, 2021 Reference: Talan et al. Pathway with single-dose long-acting intravenous antibiotic reduces emergency department hospitalizations of patients with skin infections. Date: October 20th, 2021 Reference: Talan et al. The mortality rate for hospitalized patients with SSTI is <0.05% [3, 4].

Emergency Department 52

Emergency Department Sepsis Hospitals Research 52

Don't Forget the Bubbles

MARCH 19, 2024

This has coincided with a widespread shortage of specialist placements for children facing behavioural, psychiatric, and child protection challenges, leading to an over-reliance on the placement of these children in hospitals. A paediatric social admission is one where a child is admitted to the hospital but not for a medical reason.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

PEMBlog

MAY 17, 2023

Most children who present to Pediatric Emergency Departments these days with mental health concerns – including agitation – have a known psychiatric problem or diagnosis. Pediatrics 2021; 147. Diagnostic yield of head CT in pediatric emergency department patients with acute psychosis or hallucinations.

Psychiatric 80

Psychiatric Pediatrics Emergency Department Best Practices 80

Taming the SRU

MARCH 12, 2024

ED visits per 1000 adults with diabetes based on 2018 data resulting in over 500,000 annual hospital days. This amounts to annual hospital costs of $5.1 Acad Emerg Med 2023;30(8):800–8. DKA accounts for approximately 223,000 ED visits annually or 8.9 10.1111/acem.14685

Operations 98

Operations Hospitals Best Practices Wellness 98

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. She had a low-grade fever and an episode of vomiting before coming to the hospital. Hospital Admitted Patient Care Activity.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 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

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. with acetaminophen) until temperatures reached 37.8 °C who then received external cooling to maintain a target temperature of 37.5 °C.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 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. The patient was discharged on hospital day 5. 2021; 9:e04871. No free intraperitoneal air. Clin Case Rep.

Ultrasounds 99

Ultrasounds Emergency Department Wellness Operations 99

EMDocs

DECEMBER 11, 2023

As we all know, a critical concern for emergency physicians is identifying patients with heart tissue-threatening ischemia that could benefit from percutaneous catheterization via stent deployment by an interventional cardiologist. J Emerg Med. 2021 Mar;60(3):273-284. He underwent serial ECGs, which are shown below.

EKG/ECG 120

EKG/ECG Emergency Department Academics Operations 120