Emergency Medicine Journal

MAY 28, 2024

Methods Adult patients brought by ambulance to the ED at both locations of the Amsterdam UMC, a level 1 trauma centre, were prospectively included between 11 March and 28 October 2021. Accuracy in predicting critical illness was assessed using the area under the receiver operating characteristics curve (AUROC).

Operations 52

Operations 52

ACEP Now

JUNE 7, 2023

The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. Patient volume losses in 2020 reversed in 2021. EDs weathered attacks from a variety of sources in recent years.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

JournalFeed

OCTOBER 23, 2021

It’s the JournalFeed Podcast for the week of October 18-22, 2021. We cover intubating angioedema patients, inhaled steroids for COVID-19, non-operative management of appendicitis, part-time physician outcomes, and ECG diagnosis of wide complex tachycardia.

Operations 52

Operations EKG/ECG Outcomes 52

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 trial is impressive for having been conducted at all.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Pediatric EM Morsels

APRIL 28, 2023

In general, non-operative treatment is reserved for Type I fractures and type II. Non-operative management is appropriate if extensor mechanism is intact and the avulsed fragment is displaced less than 2 mm or able to be reduced (hyperextension at the knee) to an acceptable degree of displacement. October 26, 2021.

Fractures 130

Fractures Pediatrics Operations Wellness 130

RebelEM

APRIL 17, 2023

A repeat search was completed in May 2021 & November 2022. While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage. 2021 May 12:34894211015590. Published on October 25, 2021. Accessed on December 3, 2021. AJR Am J Roentgenol. 2015 May;204(5):1064-8.

Ultrasounds 123

Ultrasounds Radiology Radiology Operations 123

Emergency Medicine Journal

MAY 23, 2023

Methods Traditional and grey-literature searches were performed on 1 June 2021. We report overall sensitivity, specificity, positive and negative predictive values, and the hierarchical summary receiver operating characteristic curve for LUS. Meta-analysis was carried out using established open-source packages in R.

Ultrasounds 52

Ultrasounds Operations Research Hospitals 52

PulmCCM

SEPTEMBER 4, 2024

OP is operating point, the operating point defines the cardiac output on the y-axis and Pra on the x-axis; Rcardiac is cardiac resistance (i.e., OP1 is operating point 1 at baseline. With tamponade, operating point 2 (OP2) is formed. Argaiz ER, (2021) VExUS Nexus: Bedside Assessment of Venous Congestion.

Ultrasounds 83

Ultrasounds Operations Research Outcomes 83

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. Aesthetic Plastic Surgery National Databank Statistics 2020–2021. These questionable practices led to a rash of bad outcomes.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

The Skeptics' Guide to EM

APRIL 16, 2022

BMJ 2021 Guest Skeptic: Dr. Matt Schmitz, Pediatric Orthopedics, Adolescent Sports Medicine and Young Adult Hip Preservation Surgeon at San Antonio Military Medical Center in Texas. Clinical Question: What is the effectiveness of common elective orthopaedic procedures compared with no treatment, placebo, or non-operative care?

Military 40

Military Operations Emergency Department Pediatrics 40

ACEP Now

DECEMBER 11, 2023

Most Important Data Trends for Emergency Physicians and ED Leaders Large losses (around 14 percent) in ED volume in 2020 reversed in 2021 and volumes increased further during 2022. The overall length of stay for all ED patients increased to 211 minutes in 2022, up from 194 minutes in 2021, 184 minutes in 2020, and 182 minutes in 2019.

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

EMDocs

FEBRUARY 7, 2024

3 Increasing Strikes and Unions Labor actions in healthcare can disrupt normal hospital operations, potentially impacting costs and threatening patient quality of care. there were 31 recorded healthcare strikes in 2021, 39 recorded healthcare strikes in 2022, and 37 healthcare strikes in 2023 as of November 3rd. Frequency : In the U.S.,

Hospitals 76

Hospitals Research Wellness Patient Safety 76

EB Medicine

NOVEMBER 1, 2021

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

Fractures 52

Fractures Documentation/Coding Operations Emergency Department 52

Don't Forget the Bubbles

APRIL 22, 2024

Occasionally, lacrimal probing does not work, and an operation is needed. 2021 Jan 2;40(1):18-23. 2021 Dec;21(1):1-7. 2021 Feb 15;37(5):482-7. After applying a topical anaesthetic, a small probe is inserted into the lower punctum of the lacrimal canal to relieve the obstruction. Isaza G, Arora S. 2013 Jun 1:E158-62.

Infectious Diseases 71

Infectious Diseases Sepsis Pediatrics Operations 71

PulmCCM

APRIL 18, 2024

The real world success rates by operators experienced with intubation remained unknown. In the relatively few studies comparing video to direct laryngoscopy, intubations were usually performed by inexperienced trainees, and sample sizes were small.

Airway Management 98

Airway Management Operations EMS Research 98

ACEP Now

JUNE 21, 2023

2,3 In the 2021-2022 academic year, categorical (non-combined) EM residency lengths included 221 (80 percent) PGY 1-3 and 55 (20 percent) PGY 1-4 programs. Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. 1 Curricula with non-EM internships (i.e., Ann Emerg Med.

EMS 114

EMS Academics Telemedicine Research 114

Broome Docs

APRIL 30, 2024

Video Laryngoscopy vs Direct Laryngoscopy for Endotracheal Intubation in the Operating Room: A Cluster Randomized Clinical Trial. 2021 Oct;38(10):446-448. 2024 Mar 18:e240762. doi: 10.1001/jama.2024.0762. PMID: 38497992 Preventing poison ivy? Why is there so much I never knew Stibich AS, Yagan M, Sharma V, Herndon B, Montgomery C.

Poisoning 70

Poisoning Dislocations Operations Ultrasounds 70

ACEP Now

MARCH 13, 2024

Unfortunately, many tertiary hospitals routinely operate at censuses of greater than 100 percent capacity, due to factors including insufficient acute care bed capacity, a shortage of nursing care, and misaligned incentive structures for health care more generally. Published online 2021:26. Click to enlarge. 2015):157-165.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

Total Medical ComplianceHIPAA

JANUARY 12, 2023

The NPRM was published in 2021 for public comments. Many comments to the NPRM noted that this would be an operational and compliance risk issue for providers. The new year will most certainly bring the finalization of the Proposed Rule that will make changes to the HIPAA Privacy Rule (“NPRM”).

Operations 104

Operations Best Practices Documentation/Coding Administration 104

Dr. No

DECEMBER 1, 2021

A week ago , the familiar high profile double humped weekly deaths chart got disappeared, perhaps because the 2021 line was misbehaving. The chart at the top of this post does just that, for summer and autumn 2020 and 2021, based on ONS weekly deaths data. The counts are WYSIWYG – what you see is what you got.

Forensics 52

Forensics Wellness Operations 52

Taming the SRU

OCTOBER 23, 2023

At this point, the patient is taken to the operating room for a diagnostic laparoscopy. She was taken to the operating room and found to have a right tubal ectopic pregnancy with a pseudogestational sac. 2021 Nov;49:226-232. Epub 2021 Jun 9. In this same population, free fluid in the hepatorenal recess had a 99.5%

Ultrasounds 92

Ultrasounds Operations Radiology Radiology 92

EMDocs

AUGUST 12, 2023

Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. McGraw Hill; 2021. November 9, 2021. Inoculation usually occurs by penetrating injury , which seeds the tendon sheath. Unrecognized or persistent infection can lead to necrosis of the tendon. In: StatPearls.

EMS 69

EMS Fractures Operations Ultrasounds 69

Don't Forget the Bubbles

JANUARY 17, 2024

2021 A plain abdominal X-ray shows multiple dilated loops of bo wel. 2021 These beads, once hydrated inside the body, reached considerable sizes. They passed away a few days after a second operation. By 2 AM, he had begun to vomit , and his parents, remembering your advice, brought him straight back. From Mullens et al.,

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

EMDocs

MAY 25, 2024

McGraw Hill; 2021. Am Fam Physician. 2014;89(11):882-888. Jauch EC, Hall G, Knoop KJ. Sialadenitis. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. Accessed June 22, 2023. link] Haidar H, Menon A, Al Duhirat E. Diseases of the salivary glands. In: Textbook of Clinical Otolaryngology.

EMS 80

EMS Dehydration Operations Hospitals 80

Downeast Emergency Medicine

DECEMBER 17, 2021

Since its early days of small and scattered residency programs, EM has burgeoned to nearly 3,000 residency positions according to the 2021 Report on Residents published by the Association of American Medical Colleges (AAMC). Retrieved October 30, 2021, from [link]. Association of American Medical Schools 2021 Report on Residents.

EMS 52

EMS Academics Operations Emergency Department 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.

Research 52

Research Poisoning Documentation/Coding Outcomes 52

Don't Forget the Bubbles

MAY 24, 2023

Airway complications are also more likely to occur in the emergency department (ED) than in the operating theatre. It can also able to be applied in multiple scenarios, not just the operating theatre, and it more accurately depicts real-world practice. doi:10.1136/archdischild-2021-322520 Kennedy CC, Cannon EK, Warner DO, Cook DA.

Airway Management 98

Airway Management Teamwork Pediatrics Emergency Department 98

Taming the SRU

MAY 22, 2023

weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge: Counsel on expected course of injury, supportive care (e.g., A comparison between pre-operative ultrasonography and surgical findings. RICE), and symptomatic management (e.g., Foot & Ankle Specialist.

Fractures 72

Fractures Dislocations Operations Radiology 72

PulmCCM

APRIL 1, 2024

Read in Lancet Respiratory Medicine Higher vs. lower oxygenation targets in Covid-19 (HOT-COVID trial) Published in January 2021, the HOT-ICU trial found no difference in mortality (42.9% Authors also had no information on operators’ experience levels. In skilled hands using ultrasound, CVC complications are much lower than 3%.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

The Skeptics' Guide to EM

MARCH 5, 2022

AEM 2021 Guest Skeptic: Professor Daniel Fatovich is an emergency physician and clinical researcher based at Royal Perth Hospital, Western Australia. AEM 2021 Guest Skeptic: Professor Daniel Fatovich is an emergency physician and clinical researcher based at Royal Perth Hospital, Western Australia.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Research Pediatrics Outcomes 40

ACEP Now

NOVEMBER 16, 2023

2,3 In the 2021-2022 academic year, categorical (non-combined) EM residency lengths included 221 (80 percent) PGY 1-3 and 55 (20 percent) PGY 1-4 programs. Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. 1 Curricula with non-EM internships (i.e., government.

Academics 52

Academics EMS Research Telemedicine 52

EMDocs

JULY 17, 2023

7 While post-operative adhesive disease is also a risk factor, it is far less commonly implicated in LBO compared to SBO. Pearls -LBO is often associated with a serious underlying condition such as CRC and is not usually successfully managed with non-operative measures. -A Published 2021 Apr 22. Cancers (Basel ). 2018;13:36.

Operations 77

Operations EMS Fluid Resuscitation Resuscitation 77

Don't Forget the Bubbles

MAY 10, 2023

A study in Denmark in 2021 explored barriers to effective resuscitation in over 900 in-hospital resuscitations across six hospitals in Denmark. Then the patient is rapidly moved to the operating theatre. 2021; 164: 70-78. StatPearls Publishing, Treasure Island (FL) ; 2021. But crowd control can still be an issue.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

PulmCCM

NOVEMBER 11, 2023

Additionally, this model clarifies that the dependent variable is the ‘operating point’ [OP] which is composed of both CO and P ra , simultaneously. The dependent variable is the operating point [i.e., Adv Chronic Kidney Dis 2021, 28(3):252-261. the mean systemic filling pressure; 2.) Crit Care 2023, 27(1):205.

Ultrasounds 87

Ultrasounds Operations Shock 87

33 Charts

SEPTEMBER 21, 2021

And uncertainty is the new core operating condition for healthcare leaders. As doctors and healthcare leaders we have traditionally operated in a field of relative certainty. We’ve got to operate in dynamic state where we are willing to move with the unknowns and change our views on a regular basis.

Leadership 57

Leadership Operations Hospitals Wellness 57

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. 2021; 9:e04871. No free intraperitoneal air. World J Emerg Surg 13, 22 (2018). Clin Case Rep. Monsomboon, A.,

Ultrasounds 91

Ultrasounds Emergency Department Wellness Operations 91

Taming the SRU

JANUARY 29, 2024

Variations in sensitivity are thought to be related to operator technique, patient habitus, and difficulty evaluating the subclavian vein beneath the clavicle. [12] 2021 Oct;76:601.e7-601.e11. Epub 2021 Jun 25. 2021 Jun;36(5):392-400. Epub ahead of print. Zhang J, Wang Y, Du Y, Zhao L. Ann Vasc Surg. J Int Med Res.

Emergency Department 86

Emergency Department Fractures Hospitals Operations 86