Sensible Medicine

DECEMBER 18, 2023

Now let’s compare the two documents. Conclusion In October 2022, while the AAP continued to recommend masking children as young as 2, the group met indoors and did not mask themselves (see pic). From their document. The USPSTF has issued draft guidance that emphasizes diet and exercise. This is Orwellian.

Pediatrics 145

Pediatrics Documentation/Coding Burns Academics 145

Dr. Smith's ECG Blog

OCTOBER 23, 2023

2022 Jul;27(4):e12939. Epub 2022 Feb 11. Macroscopic T-Wave Alternans: A Red Flag for Code Blue. I last reviewed the phenomenon of electrical alternans in My Comment at the bottom of the page in the November 28, 2022 post of Dr. Smith's ECG Blog. Ann Noninvasive Electrocardiol. doi: 10.1111/anec.12939. J Am Coll Cardiol.

EKG/ECG 134

EKG/ECG Documentation/Coding Psychiatric EMS 134

Dr. Smith's ECG Blog

APRIL 18, 2024

Emergent cath lab activation is also named after this test (code STEMI), so patients whose ECGs don’t meet STEMI criteria don’t get emergent angiograms, despite guidelines. And because there was no Code STEMI, the discharge diagnosis was “non-STEMI”, so this case will not be flagged as an opportunity for improvement. But only 6.4%

EKG/ECG 124

EKG/ECG Documentation/Coding Fractures Emergency Department 124

Dr. Smith's ECG Blog

MAY 27, 2024

Inferior hyperacute T waves, which have been added to the 2022 ACC consensus on chest pain as a “STEMI equivalent”[3] 3. Since the ECG now meets STEMI criteria, a code STEMI was activated. J Am Coll Cardiol 2022 4. But STEMI criteria is only 43% sensitive for OMI.[1] Conduction disorders in the setting of acute STEMI.

EKG/ECG 126

EKG/ECG Documentation/Coding Emergency Department 126

Stop and Think

NOVEMBER 19, 2023

In fact, the authors reported a decline in sudden cardiac death during the years 2021-2022. This was a 20-year survey in which the authors used 4 independent databases to document the incidence and causes of sudden cardiac death in NCAA athletes. They found 143 cases of sudden cardiac death over the 20 years.

Documentation/Coding 130

Documentation/Coding Wellness Resuscitation 130

EMDocs

SEPTEMBER 19, 2023

Reference: emDOCs – NCSE Journal of Emergency Medicine – Review Case 4: 52-year-0ld male brought in by EMS with “code STEMI” ECG demonstrates ST depressions with rocket like T waves in V2-V4. This document covers high sensitivity troponin, risk disposition pathways, and STEMI equivalents. J Am Coll Cardiol.

Seizures 83

Seizures Documentation/Coding EKG/ECG Emergency Department 83

EMDocs

AUGUST 22, 2024

13 Interventions may include: Ascertaining a patient’s preferred language early in the clinical encounter (during registration, for instance), and clearly documenting this preference in a place that is visible to all providers. Utilizing certified interpreters and documenting their use. Educating patients on their rights.

Documentation/Coding 94

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

Total Medical ComplianceHIPAA

DECEMBER 8, 2022

If you need assistance in determining the number of exit routes necessary for your workplace, consult current guidance under the NFPA, Life Safety Code, or International Fire Code. HIPAA: True or False: There is no way to check whether a link to a website in an email goes where it says it will go. Answer: False.

Documentation/Coding 40

Documentation/Coding 40

EMDocs

SEPTEMBER 26, 2024

An unknown EP reviews the report, determines that there is no reason to notify the patient, and documents nothing. It wasn’t, so you weren’t called, nor did the doc need to document anything. This patient’s history was either poorly taken or poorly documented. 3 : September 2022. Tyler W et al. Volume 80, no.

Radiology 87

Radiology Radiology EKG/ECG Documentation/Coding 87

ACEP Now

DECEMBER 11, 2023

A recent article documents 56 additional U.S. Published November 3, 2022. Published October 26, 2022. Published August 22, 2022. Published November 11, 2022. The wave of increasing hospital closures and service line cutbacks continues to sweep the U.S. Accessed December 8, 2023. The Atlantic website. Payerchin R.

Hospitals 98

Hospitals Administration Documentation/Coding Research 98

Sensible Medicine

AUGUST 7, 2024

In 2022 the CDC paid the AAP to form an expert working group to revise its developmental surveillance checklists. In the resulting document , the working group changed the ages at which children can be expected to reach developmental milestones. Let’s look at 1967 vs. 2022 for the DDST and the CDC: Table 2.

CDC 107

CDC Documentation/Coding Research Pediatrics 107

EB Medicine

DECEMBER 12, 2022

In this episode, Sam Ashoo, MD, and TR Eckler, MD, discuss the December 2022 Evidence-Based Urgent Care article on Influenza in Urgent Care.

Urgent Care 52

Urgent Care CDC Documentation/Coding 52

PulmCCM

JANUARY 15, 2025

In 2022, a class-action lawsuit was filed against Apple in New York alleging that the pulse oximeter on Apple Watches was inaccurate in dark-toned patients. Draft Guidance Document Wong et al. 2022 Lawsuit alleges Apple Watch's blood oxygen sensor 'racially biased'; accuracy problems reported industry-wide. January 2025.

Documentation/Coding 81

Documentation/Coding Academics Administration Research 81

EB Medicine

JANUARY 3, 2023

2) 2023 E/M coding guidelines are in effect. 2) 2023 E/M coding guidelines are in effect. Announcements: 1) The interactive Clinical Pathways have launched and they are available for free!

Shock 52

Shock Pediatrics Airway Management Sepsis 52

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

We documented that the majority of stenotic lesions had compensatory enlargement and thus exhibited remodeling. Strictly speaking — this case does not at this time qualify as MINOCA — because the negative cath and 2 normal hs-troponins done 6 hours apart failed to document infarction. (

EKG/ECG 125

EKG/ECG Ultrasounds Documentation/Coding Wellness 125

The Skeptics' Guide to EM

AUGUST 10, 2024

A code stroke is activated, and a CT head shows a left basal ganglia hemorrhage with no vascular lesions on CT angiography. The 2022 AHA/ASA guidelines give several recommendations on blood pressure lowering and coagulopathy reversal along with an algorithm. Blood Pressure Lowering:

Stroke 72

Stroke Airway Management Documentation/Coding Outcomes 72

RebelEM

NOVEMBER 6, 2024

2022 Aug 2. Acute elbow dislocation: evaluation and management. J Am Acad Orthop Surg. 1998 Jan-Feb;6(1):15-23. doi: 10.5435/00124635-199801000-00002. PMID: 9692937 Decker N, Norse A. Anterior Elbow Dislocation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. Simple elbow dislocation. Shoulder Elbow.

Dislocations 103

Dislocations Fractures Soft Tissue Injuries Outcomes 103

ALiEM

MARCH 11, 2024

In July 2022, a 32-year-old male with a past medical history of HIV (on antiretroviral therapy, CD4 390, viral load undetectable) presented to the emergency department with constitutional symptoms and a rash for 4-5 days. There is limited literature documenting eye involvement and pictographic examples of its presentation. Eye (Lond).

Documentation/Coding 56

Documentation/Coding Academics Emergency Department Hospitals 56

ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. Accessed 2022, [link]. J Safety Res.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Dr. Smith's ECG Blog

JULY 7, 2024

But because Code STEMI was cancelled on arrival and the patient had delayed angiography, the discharge diagnosis was 'non-STEMI' despite having the exact same pathology. 2022 — and — Kontos et al; 2022 ACC Expert Consensus — JACC 80(20):1925-1960, 2022 ).

EKG/ECG 69

EKG/ECG Documentation/Coding EMS Wellness 69

Mind The Bleep

JANUARY 28, 2025

First Aid Measures : Document if any initial care has been done, such as cleaning or dressing the wound. Documentation Clearly record findings, including measurements and descriptions of the wound, and consider photographic documentation if appropriate. Bleeding : Assess the extent of bleeding at the time of injury.

Documentation/Coding 52

Documentation/Coding Head Injuries Fractures Emergency Department 52

Dr. Smith's ECG Blog

OCTOBER 8, 2024

She was worked as a full code, and ROSC was achieved. For more on Precordial Swirl — See the October 15, 2022 post in Dr. Smith's ECG Blog ). Repeat ECG did not demonstrate ST elevations in the anterior leads." OMI was Missed again!! About 45 minutes after the second EKG, the patient was found in cardiac arrest.

EKG/ECG 126

EKG/ECG Documentation/Coding Resuscitation Shock 126

RebelEM

JUNE 8, 2023

2022 Sep 5. 2022 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. Am J Emerg Med.

Administration 97

Administration Emergency Department Outcomes Documentation/Coding 97

Total Medical ComplianceHIPAA

MAY 25, 2022

But there’s a twist, the malware inside the PDF is still Word document. The Word document is named “has been verified”. The pop-up message that asks the user to open the Word document says, “The file ‘has been verified’.” May 24, 2022. The user receives an email named “Remittance Invoice” with the infected PDF attached.

Documentation/Coding 52

Documentation/Coding 52

PulmCCM

MARCH 11, 2024

Societies push back on CMS’s cuts to critical care billing In 2022, the U.S. About 544,000 99292 codes were billed to CMS in 2021, according to ACCP , reportedly stable at about 10% of the total bills. Read their letter to CMS here , asking that critical care billing return to pre-2022 historical norms.

Hospice 52

Hospice Documentation/Coding Administration Hospitals 52

EB Medicine

SEPTEMBER 1, 2022

In this episode, Sam Ashoo, MD interviews Lela Bachrach, MD, MS, Larissa Truschel, MD, MPH, and Makini Chisolm-Straker, MD, MPH - the authors of the July 2022 PEMP article on Human Trafficking of Children and Adolescents: Recognition and Response in the Emergency Department. Do you find this dissuades patients form reporting?

Emergency Department 52

Emergency Department Documentation/Coding EMS Best Practices 52

Sensible Medicine

SEPTEMBER 26, 2023

According to a 2022 Pew surve y, “Trust in scientists and medical scientists, once seemingly buoyed by their central role in addressing the coronavirus outbreak, is now below pre-pandemic levels. We are living in a time of growing distrust in science and scientific institutions. Overall, 29% of U.S.

Research 121

Research Hospitals Documentation/Coding Outcomes 121

Sensible Medicine

JUNE 11, 2024

In November 2022, OpenAI launched ChatGPT-3.5. This interface shortens the time required for human-to-computer interaction by transforming an input given through natural language into almost any form, from text to images to computer code.

Documentation/Coding 87

Documentation/Coding Wellness Outcomes Research 87

PEMBlog

JUNE 14, 2023

2022-057383 Nordstrom K, Berlin JS, Nash SS, Shah SB, Schmelzer NA, Worley LLM. Boarding of Mentally Ill Patients in Emergency Departments: American Psychiatric Association Resource Document. Zima; Follow-up After Pediatric Mental Health Emergency Visits. Pediatrics March 2023; 151 (3): e2022057383. 10.1542/peds.2022-057383

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

American Medical Compliance

FEBRUARY 2, 2024

COVID-19 Prevention Requirements The Occupational Safety and Health Standards Board decided to approve COVID-19 preventative standards that are not emergency measures on December 15, 2022. Employees who are working from home. Workers covered by the legislation on Aerosol Transmissible Diseases (Cal. 8, § 5199) (section 5199).

Infectious Diseases 52

Infectious Diseases PPE Documentation/Coding Wellness 52

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

Emergency Medicine Journal

DECEMBER 30, 2024

Methods We undertook non-participant observation (162 hours, 143 pre-alerts) and semi-structured interviews with staff (n=40) in six UK EDs between August 2022 and April 2023 focusing on how ED staff respond to pre-alert calls and what influences their response. This study aimed to understand how pre-alerts influence patient care in the ED.

Emergency Department 52

Emergency Department Stroke Documentation/Coding Outcomes 52

Dr. Smith's ECG Blog

JUNE 15, 2023

I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict: You can subscribe for news and early access (via participating in our studies) to the Queen of Hearts here: [link] queen-form Then I learned that a Code STEMI was activated for concern of anterior "STEMI" in V1-V2. High sensitivity troponin I was 23 ng/L.

EKG/ECG 98

EKG/ECG Documentation/Coding Outcomes Hospitals 98

The Skeptics' Guide to EM

JULY 30, 2022

Date: July 28th, 2022 Reference: Brower et al. AEM July 2022 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Date: July 28th, 2022 Reference: Brower et al.

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

The Skeptics' Guide to EM

OCTOBER 1, 2022

Date: September 28th, 2022 Reference: Hartford et al. AEM September 2022. Date: September 28th, 2022 Reference: Hartford et al. AEM September 2022. It is not well documented, whether gaps in pain assessment and treatment exist in conditions in which opioids are not indicated, such as migraine headaches.

Pediatrics 52

Pediatrics Emergency Department Documentation/Coding Research 52

Medical Law

AUGUST 11, 2021

It is not only good for public safety — it is the law, according to Santa Barbara Municipal Code 6.08.020. Dogs who are at least four months old must be vaccinated against rabies, and owners must have a license, according to Santa Barbara Municipal Code 6.12.050. If you do need to take your dog in public, always keep it on a leash.

Documentation/Coding 75

Documentation/Coding 75

Don't Forget the Bubbles

JANUARY 1, 2024

Data from the Nurse-Family Partnership program involving 60,171 families were analysed across four cohorts, including pre-pandemic and three pandemic cohorts (from July 2022 to October 2023). 2023 Nov 23:archdischild-2022-325119. Pediatr Infect Dis J. 2023 Dec 1. Selzer A, et al. Arch Dis Child. Metz TD, et al. Pediatrics. 2023 Dec 27.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98