Pediatric EM Morsels

JUNE 2, 2023

Today we are talking about a rare disease called FPIES (food protein induced enterocolitis syndrome) and how you might encounter these patients in the Pediatric Emergency Department. Allergy Asthma Clin Immunol 18, 54 (2022). You may not make the diagnosis, but detecting the clues is important for the family!

Dehydration 193

Dehydration Shock Pediatrics Emergency Department 193

Pediatric EM Morsels

OCTOBER 27, 2023

Most emergency drugs except for amiodarone and succinylcholine are based on ideal body weight [Emergency Medical Services for Children, Luten 2007] Epinephrine, dopamine, fentanyl, ketamine based on what child should weigh. PAWPER [Wells 2013, Silvagni 2022] Takes into account body habitus. Published 2022 Sep 15.

Pediatrics 271

Pediatrics Resuscitation Documentation/Coding Wellness 271

ACEP Now

JUNE 7, 2023

The role of emergency physicians has been made dramatically more important due to the pandemic. The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. Commercial payers aggressively abused the No Surprises Act as a method to delay, downcode, and deny payment for emergency services.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

ACEP Now

DECEMBER 8, 2024

The Centers for Disease Control and Prevention (CDC) estimates of emergency department (ED) visits for 2022 were recently released. ED visit estimates and utilization rates for 2018 to 2022 are shown in Figure 1. Estimates of Emergency Department Visits in the United States, 2016-2022. Augustine JJ.

CDC 52

CDC Emergency Department Hospitals 52

Taming the SRU

DECEMBER 17, 2024

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. 2022 Sep 11;5(5):e827. sodium chloride therapy does not reduce length of stay of alcoholintoxicated patients in the emergency department: A randomised controlled trial.

Dehydration 84

Dehydration Fluid Resuscitation Administration Resuscitation 84

Pediatric EM Morsels

JULY 19, 2024

If bleeding, the only lab that is needed in the Emergency Department is a type and cross. 2022 Sep-Oct;43(5):103582. Epub 2022 Aug 6. Am J Emerg Med. 2022 Mar 4;14(3):e22857. CBC, coagulation panels, von Willebrand factor etc are less useful. Am J Otolaryngol. doi: 10.1016/j.amjoto.2022.103582. 2022.103582.

Pediatrics 290

Pediatrics Airway Management Wellness Operations 290

ALiEM

FEBRUARY 9, 2024

The 2022 American College of Cardiology (ACC) pathway provides timely guidance [1]. Intermediate-risk patients may be further stratified based on recent stress testing or coronary angiogram findings plus a modified HEART or Emergency Department Assessment of Chest Pain (EDACS) score. Time to know your hs-cTn better.

EKG/ECG 110

EKG/ECG Emergency Department Burns Wellness 110

Don't Forget the Bubbles

MAY 10, 2023

In May 2022, Holly and Joe, two students on the joint QMUL and DFTB PEM MSc , created video presentations on human factors. You’re in the paediatric emergency department, typing some notes for the child you’ve just discharged. Promoting hot debriefing in an emergency department. Scand J Trauma Resusc Emerg Med.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

ACEP Now

NOVEMBER 8, 2024

First, research suggests a higher number of emergency department visits among individuals with ASD. About 30 percent of children with ASD need treatment in an emergency department, and this number increases to nearly 70 percent for those aged 15–18. Seeing the unseen: neurodiversity in the emergency department.

Emergency Department 52

Emergency Department Leadership Research 52

Emergency Medicine Journal

JANUARY 21, 2025

Methods After preliminary evaluation of an M-LFD (SureScreen) with laboratory-grown virus and PCR-negative clinical samples, it was evaluated in a real-world setting at the ED of St Thomas’ Hospital (London, UK) from 1 December 2022 to 21 April 2023.

Emergency Department 52

Emergency Department Hospitals 52

RebelEM

MAY 11, 2023

Background: The emergency department is frequently visited by patients suffering from symptomatic alcohol withdrawal, and the traditional management has been dominated by repeated doses of benzodiazepines. Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal.

Emergency Department 95

Emergency Department Administration Hospitals Academics 95

Emergency Medicine Journal

JULY 24, 2023

Given increasing demand and constraints in ED staffing, pharmacists are a potential resource to expand the Children’s Emergency Department (CED) workforce. We determined whether a pharmacist in the CED could independently safely discharge eligible patients and whether the role would be acceptable to families.

Emergency Department 75

Emergency Department Hospitals 75

RebelEM

NOVEMBER 6, 2024

2022 Aug 2. Elbow Dislocations in the Emergency Department: A Review of Reduction Techniques. J Emerg Med. 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. Shoulder Elbow.

Dislocations 114

Dislocations Fractures Soft Tissue Injuries Outcomes 114

Emergency Medicine Journal

AUGUST 21, 2024

It was performed in our non-academic ED in the Netherlands from July 2021 to April 2022. This study evaluated if a package of noise-reducing interventions altered workload, physical complaints, productivity and room acoustics. Methods This was an observational pre-post implementation study.

Wellness 98

Wellness Emergency Department Academics 98

EM Ottawa

JULY 4, 2023

2022 Sep;24(6):636-640. Findings: Monthly average BUN ordering declined from 1905 to 448, and BUN test to […] The post Reduction of urea test ordering in the emergency department: multicomponent intervention including education, electronic ordering, and data feedback appeared first on EMOttawa Blog. Methodology: 2.5/5

Emergency Department 75

Emergency Department 75

Northwestern EM Blog

FEBRUARY 4, 2025

The patient was ultimately discharged from the Emergency Department with primary care and neurology referrals along with seizure precautions and advised to abstain from Kratom use. 2022 Mar 2;13:801855. Treating Kratom toxicity varies based upon the clinical presentation as well as severity of symptoms. Hofmeister M.

Seizures 72

Seizures Poisoning Forensics Emergency Department 72

The Skeptics' Guide to EM

FEBRUARY 22, 2025

Clinical Chemistry and Laboratory Medicine 2022; 60(5):786-792 Clin Chem Lab Med. 2022 Date: February 21, 2025 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Vice Chair of Critical Care Medicine at Mayo Clinic Arizona.

Sepsis 61

Sepsis Infectious Diseases Emergency Department Pediatrics 61

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. 2022 May 11;10:864766. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

Emergency Medicine Journal

AUGUST 23, 2023

Background High emergency department (ED) usage by older individuals for non-emergencies is a global concern. The evaluation took place between September 2021 and September 2022. ED avoidance initiatives have proven effective in addressing this issue. This study assessed the acceptability of the service among its users.

Emergency Department 75

Emergency Department Urgent Care Hospitals 75

Pediatric EM Morsels

JULY 21, 2023

Jain 2022] Now used for critically ill trauma and medical patients in >75 countries. Jain 2022] Now used for critically ill trauma and medical patients in >75 countries. Jain 2022] Glasgow Coma Scale in Children – How do you perform it correctly?

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Pediatric EM Morsels

AUGUST 23, 2024

Concussions are commonly encountered in the Emergency Department. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. We have previously discussed an approach to the question of when a patient “ can return to sport.” Br J Sports Med.

Seizures 281

Seizures Pediatrics Academics Emergency Department 281

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. Thus, the survey included data for about one-third of all patients seen in US ED’s in 2022. percent in 2022. percent in 2021, 2.8

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. 2022 Dec 27;14(12):e33009.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

Northwestern EM Blog

MARCH 1, 2025

This maneuver improves oxygenation and gas exchange via three main mechanisms (Malhotra, 2022): 1. It is the distending force of the lungs, opposing the innate inward elastic recoil of the lung parenchyma (Neupane and Jamil, 2022). What are the physiologic effects of proning? What are the contraindications to proning?

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

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. 2023 May 17:archdischild-2022-325280. doi: 10.1136/archdischild-2022-325280. Arch Dis Child. Why was the DIMPLES study needed?

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

EMDocs

NOVEMBER 19, 2024

Movement Disorder Emergencies. Published 2022. J Emerg Crit Care Med Vol 6 (October 30, 2022) J Emerg Crit Care Med. His roommate found an empty pill bottle on the floor next to him. Accessed October 23, 2023. Stiff and Twisted. Life In The Fast Lane. Published 2020. Accessed October 23, 2023. Hum Exp Toxicol.

Poisoning 111

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 111

ACEP Now

MAY 9, 2024

Unfortunately, at least 13 deaths were subsequently reported in Miami-Dade County from 2019–2022, the three years immediately following the implementation of the subcutaneous injection regulation. 6 Theoretically, ultrasound guidance should decrease this risk, which formed the basis for the 2022 Florida Medical Board regulation.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 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 in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes. Annals of emergency medicine, 82(1), 3746. Stercoral Colitis.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

EMDocs

JANUARY 25, 2025

A 45-year-old outdoor enthusiast presents to the emergency department with fever, headache, myalgias, and malaise. Philadelphia, PA: Elsevier; 2022:1-11. 101,33 (2022): e30116. Updated 2022 Nov 14]. Disposition is based on overall clinical presentation, inciting etiology, and consultant evaluation. doi:10.1097/MOH.0000000000000305

EMS 96

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 96

Broome Docs

DECEMBER 9, 2023

Overnight Stay in the Emergency Department and Mortality in Older Patients. Risk of Radiation Exposure to Emergency Department Personnel From Portable Radiographs. J Emerg Med. 2022 Nov;63(5):645-650. Epub 2022 Oct 12. Droperidol versus ondansetron for nausea treatment within the emergency department.

Infectious Diseases 114

Infectious Diseases Emergency Department Stroke Pediatrics 114

ACEP Now

MAY 5, 2023

What is your role as the emergency physician? Introduction Law enforcement officers frequently accompany emergency department (ED) trauma patients or patients who are under arrest or require assistance. Law enforcement gathering in the emergency department: Legal and ethical background and practical approaches.

Emergency Department 52

Emergency Department Documentation/Coding 52

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. He is the founder and host of the Emergency Medicine Cases podcast and website. 2022 ;279(3):1601-1607. Emerg Med Clin North Am. and youre three hours from the nearest tertiary care center. Wall JJ, Tay KY.

Airway Management 98

Airway Management Operations Resuscitation Pediatrics 98

RebelEM

APRIL 3, 2024

Monica Saxena is a practicing emergency physician and assistant professor at Stanford University School of Medicine. Her research focuses on reproductive justice and women’s health in the emergency department setting.

Emergency Department 121

Emergency Department EMS Research Hospitals 121

RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. 2022 Feb 8; PMID: 35156050 Higgins TL et al. 2022 Feb 24;7(1):29603. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Broome Docs

OCTOBER 31, 2022

Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. 2022 Jan;48(1):78-91. 2022 Sep;21(9):781-791. 2022 Sep 15;387(11):989-1000. Emerg Med Australas. 2022 Sep 18. 2022 Aug;41(4):101096. Epub 2022 Apr 28. 2022 Aug 3;11:100284. Emerg Med J.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

The Trauma Pro

OCTOBER 18, 2024

Bottom line: I have visited a number of hospitals that successfully use the Nelson score to assist with admission service decision-making while the patient is still in the emergency department. Am Surg, 88(7), 1537-1540, 2022. The only gray zone is the score of 4 or 5. Journal of Trauma Nursing, 25 (3), 192-195, 2018.

Documentation/Coding 147

Documentation/Coding Emergency Department Hospitals 147

RebelEM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.

Emergency Department 52

Emergency Department Administration EMS Dehydration 52