Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Arch Dis Child.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 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

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

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. These questionable practices led to a rash of bad outcomes.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 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 Ultrasounds 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.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

RebelEM

DECEMBER 23, 2024

Within this population, over 90% of healthcare encounters are due to painful vaso-occlusive episodes (VOE) ( Kidwell 2021 ). The enrollment was multicenter, large, and adequately powered for clinically meaningful changes in outcome. Lactated Ringer (LR) and 0.9% Cross-validation was performed.

Fluid Resuscitation 123

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 123

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 126

Ultrasounds Outcomes COPD Hospitals 126

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

EM Literature of Note

JANUARY 9, 2022

The Annals of Emergency Medicine Podcast continues apace, with free monthly updates from the original research published in the journal: iTunes Link SoundCloud Link Likewise, the Annals of Emergency Medicine Journal Club has published several monthly installments: Predicting Outcomes in Pediatric Pneumonia: Are We Omnipotent or Incompetent?

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Stroke Emergency Department Outcomes 40

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Certified interpreter use can improve communication and patient outcomes. An implementation science approach improves language access in the emergency department. One cohort study in a public ED found that 84.5% 45:446-458. Taira B, et al.

Documentation/Coding 82

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 82

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 90

Emergency Department Hospitals Outcomes EMS 90

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

Don't Forget the Bubbles

JUNE 30, 2023

In 2021, Evans and colleagues (1) compared adolescent mortality rates in adult, children’s and mixed major trauma centres across the UK. In 2021, Kulvatunyou, Bauman and colleagues compared the insertion of traditional 28-32Fr chest tubes with 14Fr pigtail catheters for drainage of traumatic haemothorax. Is he going to be OK?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department.

EKG/ECG 118

EKG/ECG Documentation/Coding Emergency Department Outcomes 118

PulmCCM

NOVEMBER 6, 2023

patients infected with the Wuhan/Delta variants in 2020-2021). I recall very well my (unjustified) negative view on convalescent plasma in 2020 and 2021 — it was probably minimally effective, and I would never spontaneously offer it. The intervention took place in the emergency department, with device placement by ED physicians.

Blood Transfusions 98

Blood Transfusions Operations Infectious Diseases Resuscitation 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. The main outcome measures were ambulance transport, lumbar imaging, opioid administration and hospital admission.

Emergency Department 40

Emergency Department Administration Hospitals Outcomes 40

RebelEM

NOVEMBER 25, 2024

1 Conversely, the 2021 BOUGIE trial—a larger, multicenter randomized clinical trial conducted by the same investigators—found no significant difference in first-attempt intubation success between the bougie and an endotracheal tube with stylet among critically ill adults. Intervention: Intubation performed using a bougie. in another study).

Outcomes 76

Outcomes Emergency Department Operations Hospitals 76

RebelEM

FEBRUARY 12, 2024

There are greater than 2 million annual emergency department visits for suspected renal colic in the US, and Ct scanning is performed for more than 90% of patients who receive a diagnosis of kidney stone. Am J Emerg Med. 2021 Sep;47:70-73. Epub 2021 Mar 22. appeared first on REBEL EM - Emergency Medicine Blog.

Radiology 69

Radiology Radiology Emergency Department Ultrasounds 69

Emergency Medicine Journal

SEPTEMBER 27, 2023

Methods This cross-sectional study included parents of children <18 years old presenting to a paediatric ED in Orange County, California, USA, for a non-psychiatric complaint between 20 January 2021 and 26 March 2021. Current results may help identify families in need of additional intervention and may improve patient outcomes.

Emergency Department 40

Emergency Department Psychiatric Research Outcomes 40

ACEP Now

NOVEMBER 7, 2024

About three percent of emergency department (ED) visits are due to skin and soft tissue infections, but data are lacking on the contribution of chronic wounds to this number. Wound management in the ED is only a starting point, and appropriate referral and follow-up are key to an improved outcome. 2020;95(9):2021-2034.

Burns 97

Burns Outcomes Documentation/Coding Emergency Department 97

The Skeptics' Guide to EM

AUGUST 28, 2021

Date: August 27th, 2021 Reference: Gagnon et al. Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: Results of a randomized controlled trial. first appeared on The Skeptics Guide to Emergency Medicine. Date: August 27th, 2021 Reference: Gagnon et al.

Emergency Department 52

Emergency Department Research Outcomes 52

Don't Forget the Bubbles

JULY 22, 2024

Randomised controlled trials addressing the benefit of steroids in preschool wheeze have compared different cohorts, used different trial designs and measured different outcomes. This is a way to overcome different trial outcomes. This paper’s primary outcome was a change in wheeze severity score (WSS). What does this mean?

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

Taming the SRU

MARCH 12, 2024

In the context of increasing ED and hospital crowding as well as limited ICU availability, this study aimed to evaluate the impact of a subcutaneous insulin (SQuID) protocol in the treatment of DKA on emergency department length-of-stay (EDLOS) and ICU admissions. Secondary outcomes included fidelity to and safety of the intervention.

Operations 96

Operations Hospitals Best Practices Wellness 96

RebelEM

APRIL 29, 2024

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ). Crit Care Med. Resuscitation.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

ACEP Now

JULY 7, 2023

CASE A 30-year-old woman presents to the emergency department with left arm pain from a chronic wound. Since 2020 to 2021, the Drug Enforcement Administration has reported a sharp rise in xylazine use across the U.S., Dr. Marco is professor of emergency medicine at Penn State Health Milton S. Click to enlarge.)

Forensics 98

Forensics Airway Management Administration Emergency Department 98

EMDocs

JUNE 12, 2024

HypoCa is common in trauma patients and is associated with poor outcomes. We need RCTs to determine if Ca administration in trauma impacts mortality and other patient-centered outcomes. Am J Emerg Med. 2021 Mar;41:104-109. 2021 Feb 1;90(2):396-402. Emerg Med J. What is still needed in the literature?

Hyperthermia / Hypothermia 90

Hyperthermia / Hypothermia Resuscitation Administration Blood Transfusions 90

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.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Administration Emergency Department Research 52

The Skeptics' Guide to EM

AUGUST 24, 2024

Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle. Reference: Partyka et al.

Fractures 51

Fractures Emergency Department Ultrasounds Radiology 51

Emergency Medicine Journal

MAY 23, 2023

Background To identify the impact of enrolment onto a national pulse oximetry remote monitoring programme for COVID-19 (COVID-19 Oximetry @home; CO@h) on health service use and mortality in patients attending Emergency Departments (EDs).

Emergency Department 40

Emergency Department Outcomes Hospitals 40

The Skeptics' Guide to EM

APRIL 2, 2022

Take-Pause: Efficacy of mindfulness-based virtual reality as an intervention in the pediatric emergency department. AEM March 2022 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. Reference: Butt et al.

Pediatrics 52

Pediatrics Emergency Department Outcomes Research 52

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. He and his wife live in Boynton Beach, FL […] The post SGEM#353: At the COCA, COCA for OCHA first appeared on The Skeptics Guide to Emergency Medicine.

CPR 52

CPR Administration Outcomes Hospitals 52

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Ann Emerg Med. The management of accidental hypothermia.

Hyperthermia / Hypothermia 85

Hyperthermia / Hypothermia Resuscitation CPR EMS 85

Don't Forget the Bubbles

AUGUST 7, 2023

This prospective cohort study included patients between 0-16 years old, who presented to one of four NHS hospital sites in Greater Manchester (a large metropolitan area in the North of England), consisting of an Urgent Care Centre and three Emergency Departments. Yes Was the outcome accurately measured to minimize bias?

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

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. first appeared on The Skeptics Guide to Emergency Medicine. JAMA 2021 * Zi et al.

Urgent Care 52

Urgent Care Stroke Critical Access Outcomes 52

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. 2021 A plain abdominal X-ray shows multiple dilated loops of bo wel. 2021 These beads, once hydrated inside the body, reached considerable sizes. There have been reports of the Orbeez Challenge leading to serious outcomes. What are the risks of water beads?

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111