EMDocs

JANUARY 11, 2025

A) Administration of IV morphine for pain control B) Admission to general surgery for IV antibiotics C) Discharge home on lactulose D) Emergent surgical consultation for exploratory laparotomy E) Manual disimpaction Correct answer: E Although uncommon, stercoral colitis is a potentially life-threatening complication of chronic constipation.

EMS 97

EMS Sepsis Shock Fluid Resuscitation 97

RebelEM

JANUARY 18, 2024

Time to antibiotic therapy (from triage, not from onset of infection) has become a quality metric to improve the time to administration of these medications. Prehospital Administration of Broad-Spectrum Antibiotics for Sepsis Patients: A Systematic Review and Meta-Analysis. Health Sci Rep 2022. Health Sci Rep 2022.

Sepsis 132

Sepsis Hospitals Administration Outcomes 132

ACEP Now

JANUARY 5, 2025

Fibrinogen levels should also be obtained, where available, if severe hemorrhage suggests the potential need for administration of fibrinogen concentrate. 2022 ;279(3):1601-1607. Hemoglobin, type and screen, and crossmatch should be prioritized for significant blood loss and potential transfusion requirements. Wall JJ, Tay KY.

Airway Management 98

Airway Management Operations Resuscitation Pediatrics 98

RebelEM

SEPTEMBER 29, 2022

to 6.8L) WATERFALL Trial Fluid Administration Critical Findings: The trial was stopped early due to an interim analysis demonstrating a high incidence of fluid overload with no significant difference in the primary outcome. The aggressive fluid administration arm is far less aggressive than what was historically recommended for pancreatitis.

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

ACEP Now

JUNE 7, 2023

The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. The preliminary results of the 2022 Emergency Department Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding. Patient volume losses in 2020 reversed in 2021.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

RebelEM

JUNE 8, 2023

2022 Sep 5. Prior literature primarily focused on safety and medication errors, and while this study did the same, they also assessed variables associated with PDP response. Paper: Singer S, et al. The safety and efficacy of push dose vasopressors in critically ill adults. Am J Emerg Med.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

ACEP Now

DECEMBER 11, 2023

Published November 3, 2022. Published October 26, 2022. Published August 22, 2022. Published November 11, 2022. Conditions in the Workplace Over 20 percent of our health care workforce left health care in the last two years, and 10 percent of all practicing U.S. physicians quit in 2021 alone. workplace professions.

Hospitals 98

Hospitals Administration Documentation/Coding Research 98

Ken Grauer, MD

SEPTEMBER 6, 2024

Additional easier-to-read links — Cadogan — Life-In-The-Fast-Lane, 2022 — and — Hafeez and Armstrong — StatPearls, 2023. == The C ASE C ontinues: The rhythm in today's case was treated with Adenosine. Figure-4: Rhythm strips recorded after administration of IV Adenosine to today's patient.

EKG/ECG 242

EKG/ECG Administration Operations Wellness 242

RebelEM

APRIL 29, 2024

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. 2022 PMID: 35206981 2. Intravenous vs intraosseous adrenaline administration in cardiac arrest: A protocol for systematic review and meta-analysis. Labs can be drawn from an IO to help with rapid diagnosis in emergencies.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

RebelEM

FEBRUARY 1, 2024

Tenecteplase, a modified version of alteplase, is being increasingly utilized for AIS due to its favorable pharmacological profile, ease of administration, and cost effectiveness. Earlier studies looking at tenecteplase dosing began in 2005 and have largely settled on a dose of 0.25 mg/kg at this time for the potential treatment of AIS.

Stroke 134

Stroke Blood Transfusions Outcomes EMS 134

Pediatric EM Morsels

JUNE 9, 2023

Castillo, 2019 ] Somatostatin (or its analogues, like Octreotide) Guidelines do recommend this… There is great variability in its administration, though. Epub 2022 Dec 26. Gana, 2011 ] Endoscopy and other procedures Currently still debated, but reasonable to discuss additional options with your friendly Pediatric GI team.

Pediatrics 154

Pediatrics Head Injuries Airway Management Resuscitation 154

RebelEM

SEPTEMBER 7, 2023

About 30% of patients experience early seizures within seven days following the onset of a stroke ( Peter-Derex 2022 ). Lancet Neurology 2022; 21:781-91. 2022 Feb;36(1):248-258. Lancet Neurology 2022; 21:781-91. Ongoing debates persist regarding the drug’s effectiveness, optimal dosage, and potential side effects.

Seizures 130

Seizures Stroke Outcomes Research 130

EMDocs

AUGUST 31, 2023

Approximately 12 hours following F(ab’) 2 antivenom administration, the child is noted to have progressive swelling, firmness, tension, and pain of the right calf. Accessed May 7, 2022. Accessed May 7, 2022. doi:10.1080/19420862.2015.1111497 Antivenom administration North American Crotalinae snakebites – UpToDate.

Allergic Reactions 96

Allergic Reactions Anaphylaxis Poisoning EMS 96

Don't Forget the Bubbles

OCTOBER 18, 2024

Midlines are preferred over routine peripheral cannulas for IV drug administration lasting more than four days. They are not suitable for CT contrast administration. 2022 Oct 31;12(4):814-823. Ensure the guide wire is removed before the line is fixed and sharps are disposed of appropriately. doi: 10.3390/nursrep12040079.

Administration 89

Administration Pediatrics Ultrasounds Burns 89

Don't Forget the Bubbles

OCTOBER 12, 2024

When comparing corticosteroids to a placebo, children who received corticosteroids had a more significant reduction in croup scores between 2 and 12 hours of administration. Five studies explored different routes of dexamethasone administration. 2022 [cited 2023 Dec 29]. How should we give the corticosteroids? mg/kg to 0.6

Airway Management 85

Airway Management Emergency Department Administration Hospitals 85

Core Medical Group

OCTOBER 20, 2022

Travel nurses advance their skills and their life experience every day, but if you're someone who is interested in moving to a managerial or administrative role someday, you may want to stay at one facility longer than travel nursing contracts generally allow. Conversely, as you travel from place to place, you’re expanding your network.

Administration 52

Administration Research 52

PEMBlog

MAY 31, 2023

Marianne Gausche-Hill New England EMSC: New England Regional Behavioral Health Toolkit Disclaimer The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. 2022 May 11;12(5):e059876. doi: 10.1136/bmjopen-2021-059876.

Psychiatric 93

Psychiatric Emergency Department Pediatrics Administration 93

EMDocs

JULY 1, 2023

This is the only situation in which aspirin is recommended for administration in children, as the benefits outweigh the risks of Reye syndrome. UpToDate;2022. Accessed December 31, 2022. Accessed December 31, 2022. UpToDate;2022. Accessed December 31, 2022. UpToDate;2022. Accessed December 31, 2022.

EMS 91

EMS Infectious Diseases Pediatrics Research 91

ALiEM

SEPTEMBER 11, 2023

Timely administration of antibiotic drops and ophthalmology evaluation is crucial to prevent progression to corneal ulcer and the need for corneal transplant. Food and Drug Administration. 2022, August 16). Case Discussion Take-Home Points Corneal abrasions can occur in both eyes at once. Cont Lens Anterior Eye. 2021.02.010.

Administration 60

Administration Academics Emergency Department 60

RebelEM

NOVEMBER 6, 2023

ug/kg/min of norepinephrine equivalent at time of hydroxocobalamin or methylene blue administration Exclusion Criteria: Administration of hydroxocobalamin or methylene blue for non-VS indications Hydroxocobalamin or methylene blue given > 48 hours after CPB Pre-intervention cardiac index < 2.0 2022 Aug 22.

Shock 71

Shock Administration Academics Hospitals 71

ALiEM

FEBRUARY 20, 2024

Here is the patient’s EKG after administration of a 300 mEq sodium bicarbonate showing significant improvement of the cardiac sodium channel blockade as evidenced by a narrower QRS complex. 2022 Jun;56:394.e1-394.e4. Epub 2022 Mar 9. What are other agents that block cardiac socium channels? Am J Emerg Med. doi: 10.1016/j.ajem.2022.03.006.

Shock 73

Shock EKG/ECG Poisoning Burns 73

ACEP Now

JUNE 5, 2023

Finally, on the legislative side, we are working with our Congressional allies to put pressure on the Administration to address these significant implementation issues. For now, that guidance still stands, even though the administration is not enforcing it. ACEP submitted amicus briefs for both earlier this year. What’s Next?

Administration 59

Administration Radiology Radiology 59

PEMBlog

JUNE 14, 2023

Marianne Gausche-Hill New England EMSC: New England Regional Behavioral Health Toolkit Disclaimer The Emergency Medical Services for Children Innovation and Improvement Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. 2022-057383 Nordstrom K, Berlin JS, Nash SS, Shah SB, Schmelzer NA, Worley LLM.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

Total Medical ComplianceHIPAA

JANUARY 12, 2023

Department of Health and Human Services (HHS) Office for Civil Rights (OCR) had its busiest year with the announcement of its 22 nd enforcement settlement on December 15, 2022. Last year, the U.S. All indicators show no intention of this slowing down, either. The very first enforcement of the new year was announced on January 3 rd.

Operations 104

Operations Best Practices Documentation/Coding Administration 104

ACEP Now

JANUARY 11, 2024

Published November 3, 2022. Published October 26, 2022. Published August 22, 2022. Published November 11, 2022. Conditions in the Workplace More than 20 percent of our health care workforce left health care in the last two years, and 10 percent of all practicing U.S. physicians quit in 2021 alone. workplace professions.

Hospitals 52

Hospitals Administration Documentation/Coding Research 52

The Skeptics' Guide to EM

DECEMBER 23, 2023

Nov 7, 2023 Guest Skeptic: Dr. Mahaleh Mekalai Kumanan attended Dalhousie University for her undergraduate studies, Master of Health Administration degree and medical school before completing her residency at the University of Western Ontario. More Than Four Million Ontarians Will Be Without a Family Doctor by 2026. million in 2018.

Administration 61

Administration Research Wellness 61

The Skeptics' Guide to EM

FEBRUARY 26, 2022

Date: February 21st 2022 Reference: Kim et al. AEM February 2022. Date: February 21st 2022 Reference: Kim et al. AEM February 2022. AEM February 2022. Emergency psychiatric assessment, treatment, and healing (EmPATH) unit decreases hospital admission for patients presenting with suicidal ideation in rural America.

Psychiatric 52

Psychiatric Hospitals Academics Research 52

Mind The Bleep

APRIL 10, 2025

AI can book appointments and perform other administrative tasks, for instance, retrieving medical information and billing. Digital Health Volume 9 : 1-5 Dranove, David, and Craig Garthwaite 2022). AI can respond to patient questions this is an example of natural language processing. Will AI Eventually Replace Doctors?

Documentation/Coding 52

Documentation/Coding Research Outcomes Administration 52

Northwestern EM Blog

OCTOBER 31, 2022

2022, Oct 31). Michael Schmidt, MD Chief of Staff Department of Emergency Medicine Northwestern Memorial Hospital How To Cite This Post: [Peer-Reviewed, Web Publication] Tandlich, M. Expert Commentary by Schmidt, M]. Retrieved from [link] Other Posts You May Enjoy

Emergency Department 52

Emergency Department Administration Documentation/Coding Hospitals 52

The Skeptics' Guide to EM

JUNE 12, 2022

Date: June 12th, 2022 Reference: Finfer et al. Date: June 12th, 2022 Reference: Finfer et al. saline, that may be partly driven by kidney injury associated with the administration of high-chloride content IV fluids. Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults. Reference: Finfer et al.

Fluid Resuscitation 53

Fluid Resuscitation Resuscitation Outcomes Administration 53

American Medical Compliance

JUNE 17, 2022

In March of 2022, the US Health and Human Services Office of Civil Rights (HHS OCR) released four new enforcement actions. An administrative hearing occurred, leading to a settlement agreement. Reference: Policy & Medicine (2022, April 24). HIPAA Violations in Dental Settings. Retrieved from: [link].

Psychiatric 52

Psychiatric Administration 52

RebelEM

MAY 11, 2023

3, 4 Much of the appeal of phenobarbital lies in its ability to stave off severe alcohol withdrawal symptoms days after administration, without the necessity of daily redosing. J Med Toxicol 2022. 5 Paper: Lebin J et al.

Emergency Department 95

Emergency Department Administration Hospitals Academics 95

The Skeptics' Guide to EM

FEBRUARY 25, 2023

2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Pediatric Crit Care Med.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

ACEP Now

NOVEMBER 7, 2024

At a recent meeting at Red Cross headquarters, a DHA leader reported that their decision to switch saved the MHS more than $23 million in 2022 and $25 million in 2023. Even more important, the transition saved 830,000 student and instructor training hours in 2022 and nearly one million hours in 2023.

Advances Cardiac Life Support (ACLS) 74

Advances Cardiac Life Support (ACLS) Military CPR Basic Life Support 74

PulmCCM

NOVEMBER 17, 2023

shows blood administration with a direct linear relationship between Pra and CO/VR; only Pmsf is varied here. Ultrasound J 2022, 14(1):36. OP is operating point. See text for details. shows inspiratory holds with inverse, linear relationship between Pra and CO/VR; only Ppc is varied here. Critical care medicine 1984, 12(2):107-112.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

Dr. Smith's ECG Blog

JUNE 28, 2023

He underwent an EP study 5/10/2022 for evaluation of pre-excitation/accessory tract which found a left sided accessory pathway - he is currently in the EP study now. EP note: "He had wide-complex monomorphic tachycardia with extreme axis concerning for VT.

EKG/ECG 98

EKG/ECG Ultrasounds Administration EMS 98

RebelEM

FEBRUARY 2, 2023

Unfortunately, the exact dose and time of administration of first line medications was not reported before a second line medication was given. 2022 Sep 7. However, digoxin is known for its rate-control properties and its direct vagal effect on the atrioventricular node. Paper: Mason JM, et al. Am J Emerg Med. Am J Emerg Med.

Emergency Department 52

Emergency Department Administration Dehydration EMS 52