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. Well… sometimes it starts again. Am J Otolaryngol. 2022.103582.

Pediatrics 285

Pediatrics Airway Management Wellness Administration 285

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Chest drains are commonly inserted in the Emergency Department (ED) with a complication rate of 30-40%. Training in chest drain insertion is essential in Emergency Medicine (EM) as approximately 25,000 patients undergo in England and Wales undergo this procedure annually.

Emergency Department 40

Emergency Department EMS Research Operations 40

Taming the SRU

SEPTEMBER 25, 2023

Musculoskeletal injuries are a common occurrence, representing a substantial number of Emergency Department visits on an annual basis. 1) Oftentimes, Emergency Physicians are the first provider patients encounter after an injury. Thus, treatment of Maisonneuve fractures often involves operative repair. (5) References 1.

Fractures 99

Fractures Emergency Department Operations EMS 99

EMDocs

DECEMBER 11, 2023

In October 2022, the American College of Cardiology released an updated expert consensus decision regarding the evaluation of chest pain in the emergency department. This included the addition several new STEMI equivalents [4] on ECG that warrant “prompt evaluation for emergency coronary angiography.” J Am Coll Cardiol.

EKG/ECG 110

EKG/ECG Emergency Department Academics Operations 110

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

PulmCCM

NOVEMBER 6, 2023

open label) at 17 sites in Belgium in 2020-2022, 35% of those receiving plasma died at 28 days, vs. 45% of the usual care patients — a number needed to treat of 10 to save one life. The intervention took place in the emergency department, with device placement by ED physicians.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 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. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals.

Ultrasounds 52

Ultrasounds Operations Outcomes Documentation/Coding 52

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. 2022 PMID: 35206981 2.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

The Skeptics' Guide to EM

DECEMBER 3, 2022

Date: November 16th, 2022 Reference: Lipsett SC, Monuteaux MC, Shanahan KH, et al. Pediatrics 2022 Guest Skeptic: Dr. Angelica DesPain is an Assistant Professor of Pediatrics and a pediatric emergency medicine physician at the Baylor College of Medicine Children’s Hospital of San Antonio in San Antonio, TX.

Pediatrics 40

Pediatrics Operations Ultrasounds Emergency Department 40

ACEP Now

DECEMBER 10, 2023

Boarding in the emergency department is a systemic crisis with emergency physicians at the center. ACEP said as much to the White House by writing a powerful letter in November 2022 supported by 34 organizations to show how serious the issue has become. This can be prevented.”

Emergency Department 52

Emergency Department Leadership Hospitals Administration 52

The Skeptics' Guide to EM

APRIL 16, 2022

Date: April 16th, 2022 Reference: Blom et al. It’s Not Always Hammer Time first appeared on The Skeptics Guide to Emergency Medicine. Date: April 16th, 2022 Reference: Blom et al. Case: A 55-year-old man comes into the emergency department (ED) for increasing knee pain and decrease in function.

Military 40

Military Operations Emergency Department Pediatrics 40

SheMD

MAY 4, 2023

Article Summary What they looked at: This article aimed to look at career trajectory differences between genders in faculty who have attained academic chair roles in emergency medicine. Women were more likely to be first appointed to educational rather than operational roles (52.6% Dig Dis Sci 67, 364–366 (2022). JAMA Netw Open.

Leadership 52

Leadership Academics Operations Administration 52

Mind The Bleep

JUNE 21, 2024

This will not be an issue if oil is used, though this will require another operation to be removed and gain full visual potential. Laser/cryotherapy is applied to seal the break intra-operatively. Note: vitrectomy is associated with a very rapid post-operative progression/development of a cataract which will then necessitate surgery.

Operations 52

Operations Emergency Department Ultrasounds 52

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., Most frequent reasons for emergency department visits, 2018. Updated 2022 Nov 23]. Updated 2022 Apr 7]. Int J Emerg Med.

Fractures 75

Fractures Dislocations Operations Radiology 75

ACEP Now

MAY 4, 2023

A 58-year-old male with a history of alcohol abuse presented to the emergency department (ED) as a category 2 trauma for a fall with a reported flail chest. On hospital day 2, he was taken to the operating room for surgical rib fixation. 2022; 22(11):432-439. 2022; 276:221-234. Click to enlarge.) BJA Education.

EMS 52

EMS Fractures Operations Ultrasounds 52

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. Ann Emerg Med.

EMS 69

EMS Fractures Operations Ultrasounds 69

Taming the SRU

MAY 23, 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., Updated 2022 Nov 23]. Foot injuries in the emergency department. Updated 2022 May 14]. Foot & Ankle Int. 2015 Apr 28].

Fractures 57

Fractures Dislocations Operations EMS 57

Taming the SRU

APRIL 5, 2023

THE CASE An elderly female patient presents to the emergency department (ED) with 1 week of generalized weakness leading to numerous falls. Operators should take care to obtain clear images of the upper renal poles with the understanding that inferior pole evaluation will be limited from the isthmus. 2022 Nov 28.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

Dr. Smith's ECG Blog

AUGUST 4, 2024

Context: a man in his 40s presented to the emergency department with 1 day of sudden onset chest pain. The ST/T wave ratio ( ie, the ratio of ST elevation compared to T wave amplitude ) in lead V6 is well over 0.24 ( See My Comment in the June 8, 2022 post for more on this Ratio ). Pericarditis maybe." Spodick sign is present.

EKG/ECG 98

EKG/ECG Wellness Emergency Department Operations 98

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. In the operating room, there was minimal urinary output and the bladder pressures were 35 mmHg under sedation and analgesia.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

EMDocs

DECEMBER 2, 2023

Updated 2022 Jul 4]. Available from: [link] yousef, CC BY-SA 4.0 <[link] via Wikimedia Commons The post EM@3AM: Oculomotor Nerve Palsy appeared first on emDOCs.net - Emergency Medicine Education. He has no known medical history and has never been to the doctor. Risk factors for ischemic ocular motor nerve palsies.

EMS 67

EMS Operations Pediatrics Emergency Department 67

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Unsuspected Critical Illness Among Emergency Department Patients Presenting for Acute Alcohol Intoxication. Annals of Emergency Medicine. 2022 Jul;46(7):1306-1312. J Emerg Med.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

EMDocs

SEPTEMBER 9, 2023

Treasure Island (FL): StatPearls Publishing; November 15, 2022. Dec 21, 2022. 2021.0052 Emergency Department Management of Extensor Tendon Lacerations – Page 3 of 4. Ann Emerg Med. Emergency Medicine Residents’ Association; 2022:10-11. Extensor tendon repair in the emergency department.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

ALiEM

MAY 13, 2024

Case Introduction: Child with abdominal pain Wendy is a 7-year-old girl who comes into the emergency department with redness, swelling, and pain on her left calf. 63M with an Erythematous Abdomen Limitations of POCUS As with all ultrasound applications, soft tissue POCUS is operator dependent. Pediatr Emerg Care.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Taming the SRU

MARCH 14, 2023

Case 1 Fussy 1 month old A 1-month-old (ex-34 week premature) infant comes to your emergency department for fussiness. Case 2 19 year old seizure A 19-year-old male is brought into your emergency department via EMS for witnessed seizure-like activity. More on this below as we work through a few cases….

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

ALiEM

AUGUST 9, 2023

Child with Cough and Fever: Case Introduction A 6-year-old boy presents to the emergency department complaining of cough for 3 days and fever for the last day. The lung POCUS is also operator-dependent, and it has a steep learning curve. West J Emerg Med. 2022 Jun 5;23(4):497-504. 2011 Oct;140(4):859-866.

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Don't Forget the Bubbles

MAY 22, 2023

You’ve just started working in the Children’s Emergency Department (CED). These can be operated and maintained by patients and their families at home. The triage nurse comes to let you know about Robin. He is eight years old, with a background of cerebral palsy and severe scoliosis. You go to see Robin.

Radiology 98

Radiology Radiology Hospitals Wellness 98

Taming the SRU

JANUARY 29, 2024

She was concerned that this was not improving and decided to come to the emergency department (ED). Hospital Course The patient was initiated on a therapeutic heparin drip in the emergency department with vascular surgery consultation. 2022 Apr 26. She had not had any blood clots previously. Clin Exp Med.

Emergency Department 91

Emergency Department Fractures Hospitals Operations 91

Don't Forget the Bubbles

JANUARY 17, 2024

Curious Ken is brought into your emergency department. They passed away a few days after a second operation. Pediatric Emergency Care, 31 (8), pp.605-607. Journal of The Korean Society of Emergency Medicine , 33 (1), pp.134-138. What are the risks of water beads? Unfortunately, the anastomosis broke down.

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

EMDocs

OCTOBER 30, 2023

” – Musings of an American ED resident in July 2022 when US healthcare was affected simultaneously by supply chain issues from GE Healthcare (contrast media) and Abbott Laboratories (Similac baby formula). A baby formula milk shortage for adults.” 11 Table 1.

Radiology 73

Radiology Radiology Emergency Department Hospitals 73

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. More pertinent and relevant takeaway messages have to do with staffing and operations.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

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 183

Pediatrics Emergency Department Outcomes Sepsis 183

SheMD

JULY 23, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. Therefore, he worked with the primary care innovation department and learned hospital administration and clinical operations during his residency. Disclaimer: This post was written before the COVID-19 pandemic.

Research 98

Research Academics Hospitals Administration 98

RebelEM

JULY 31, 2023

11 medical centers in the United States enrolled 1417 patients from 17 sites, including 7 emergency departments and 10 intensive care units. of intubations were performed in the emergency department. An emergency medicine resident or critical care fellow performed 91.5% 1420 patients were enrolled. of intubations.

Operations 98

Operations Outcomes Emergency Department Airway Management 98

Taming the SRU

SEPTEMBER 22, 2023

million adults undergo tracheal intubation outside of the operating room each year in the United States. The operator reported a subjective assessment of the anticipated difficulty. Most intubations (69.7%) were performed in the emergency department, with the remainder occurring in an intensive care unit.

Operations 103

Operations Outcomes Emergency Department Academics 103

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

The fire department, who operate at an EMT level in this municipality, arrived before us and administered 324 mg of baby aspirin to the patient due to concern for ACS. Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

EKG/ECG 52

EKG/ECG Emergency Department Ultrasounds Hospitals 52

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. One operator should perform defibrillation in the anterolateral position, followed by another operator providing a second shock in the anteroposterior position after a delay of less than one second.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98