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). Front Pediatr.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

Dr. Smith's ECG Blog

MARCH 10, 2025

They concluded, "Our findings increase confidence in the normal automated GE Marquette 12 SL ECG software interpretation to predict a benign outcome. Smith comment: this is a very stupid outcome measure) What if we use that methodology for the ECG above? What is the gold standard for ECG interpretation: patient outcome!!!

EKG/ECG 89

EKG/ECG Outcomes Documentation/Coding Emergency Department 89

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

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 97

Emergency Department Administration Hospitals Academics 97

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

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. What outcomes did they look at? Arch Dis Child.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

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

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. In StatPearls.

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. 0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. Philadelphia, PA: Elsevier; 2022:1-11. 101,33 (2022): e30116. Updated 2022 Nov 14].

EMS 95

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 95

ACEP Now

MAY 9, 2024

These questionable practices led to a rash of bad outcomes. When seven South Florida gluteal AFT patients died tragically in one year alone, the Florida Board of Medicine issued an emergency regulation restricting fat injection to the subcutaneous space rather than injecting into muscle. units per patient.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

Case: It is a steady Saturday afternoon in your rural emergency department (ED). Tessa Davis covered the FORCE trial on SGEM #372 which looked at buckle fractures and compared immobilization in a cast or splint vs. a soft bandage and they found no difference in pain scores or functional outcomes. Reference: Snelling et al.

Fractures 139

Fractures Ultrasounds Pediatrics Outcomes 139

ALiEM

OCTOBER 30, 2024

Bupe Allergy Buprenorphine induction has been the mainstay of emergency department treatment of opioid use disorder for more than a decade [11, 12]. Drug Checking Quarterly Report (Q3 2022). 2022; 06/26/2023. 2022 May;14(5). Xylazine (veterinary sedative) use in Puerto Rico. 2011 Dec;6:1-4. 2017 Jun;32:660-6.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. This is a critical error that leads to poorer outcomes for patients in need of critical care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Don't Forget the Bubbles

MARCH 31, 2025

The value of white blood cell count in predicting serious bacterial infections in children presenting to the emergency department: a multicentre observational study Archives of Disease in Childhood 2025;110:191196. This was a secondary analysis of the Management and Outcome of Fever in Children in Europe (MOFICHE) study.

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

RebelEM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

Ultrasounds 129

Ultrasounds Outcomes COPD Hospitals 129

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 Dehydration EMS 52

The Skeptics' Guide to EM

AUGUST 10, 2024

He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Case: A 65-year-old man is brought into the emergency department (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table.

Stroke 90

Stroke Airway Management Documentation/Coding Outcomes 90

ACEP Now

JULY 11, 2024

2 Although the opiate epidemic is certainly worthy of attention, it accounts for only about half of the number of deaths annually and only around a quarter of the number of emergency department visits annually relative to alcohol use. This medication has limited outcomes data and multiple contraindications. West J Emerg Med.

Emergency Department 98

Emergency Department Psychiatric Outcomes Wellness 98

Taming the SRU

SEPTEMBER 22, 2023

Several single-center and moderately-sized studies have compared the outcomes of these two methods with varying results. Trial personnel reviewed the medical record to collect each patient's baseline characteristics, periprocedural care, and clinical outcomes. BMI was around 26.5 for both groups.

Operations 105

Operations Outcomes Emergency Department Academics 105

ACEP Now

OCTOBER 10, 2023

A 76-year-old female presents to the emergency department obtunded with left hemiplegia. Both INTERACT-2 and ATACH-2 showed no statistical difference in their primary outcome between intensively lowering the BP and a less-intensive strategy. 1,2 The 2022 AHA/ASA Guidelines give several recommendations on this topic.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

Broome Docs

OCTOBER 6, 2024

Can acutely ill patients predict their outcomes? Emerg Med J. doi: 10.1136/emermed-2022-213000. PMID: 39025092 Is early CT actually 100% sensitivity for SAH (Of course not) Roberts et al, Subarachnoid haemorrhage in the emergency department (SHED): a prospective, observational, multicentre cohort study.

Emergency Department 102

Emergency Department EMS Research Outcomes 102

RebelEM

JUNE 8, 2023

Am J Emerg Med. 2022 Sep 5. Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose. Paper: Singer S, et al. The safety and efficacy of push dose vasopressors in critically ill adults.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Certified interpreter use can improve communication and patient outcomes. An implementation science approach improves language access in the emergency department. One cohort study in a public ED found that 84.5% 45:446-458. Taira B, et al.

Documentation/Coding 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department.

EKG/ECG 119

EKG/ECG Documentation/Coding Emergency Department Outcomes 119

Don't Forget the Bubbles

OCTOBER 2, 2023

doi: 10.1136/bmjpo-2022-001842 What’s it about? The reported prevalence of undiagnosed hypoglycaemia disorders among children seen in the emergency department (ED) for any reason ranges between 10% and 28%. doi: 10.1136/archdischild-2022-325230 What’s it about? doi: 10.1136/archdischild-2022-325011 What’s it about?

Outcomes 138

Outcomes Research Wellness Emergency Department 138

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Research in the Emergency Department needs to be delivered in real time, within a specific clinical time-frame, and on a wide variety of conditions and states of emergency, on participants presenting in an unscheduled manner at any time.

Emergency Department 40

Emergency Department Research Outcomes Hospitals 40

Taming the SRU

MARCH 27, 2024

The parent trial was conducted from October 2020 to July 2022 in the capital region of Denmark. The primary outcome was cumulative norepinephrine use during the first 48 hours of admission. That said, outcomes for these patients are generally poor and the use of steroids as a one-time dose likely has little risk. Hill, J.

Resuscitation 99

Resuscitation CPR Outcomes Hospitals 99

RebelEM

JULY 24, 2023

This approach has been shown to benefit patients when agents like propofol and midazolam are used. ( Russotto 2022 , Choi 2004 ). Population: Patients > 14 years of age who underwent RSI with either etomidate or ketamine from the National Emergency Airway Registry (NEAR). Emerg Med J. Paper: Driver BE et al. mg/kg 1.33

Resuscitation 98

Resuscitation Outcomes Emergency Department EMS 98

EMDocs

SEPTEMBER 26, 2024

This story, while unlikely to reflect the standards of most readers, has a somewhat surprising outcome. References : System-Level Process Change Improves Communication and Follow-Up for Emergency Department Patients With Incidental Radiology Findings. 3 : September 2022. What role do discharge instructions play?

Radiology 97

Radiology Radiology EKG/ECG Documentation/Coding 97

Emergency Medicine Journal

JUNE 20, 2024

Emergency departments (ED) represent a promising setting to address preventive health measures like CRC screening. We enrolled ED patients, 45–75 years old, in the Greater Rochester, NY region into a randomised controlled pilot from January to May 2022. The primary outcome was patient CRC screening or scheduling.

Emergency Department 40

Emergency Department Documentation/Coding Outcomes 40

EMDocs

SEPTEMBER 27, 2023

Additionally, a 2022 study in JAMA found no association between MIPS measures and any meaningful clinical outcomes and moreover physicians who cared for the most medically and socially vulnerable were more likely to receive worse scores (8). link] Bond, A. ” JAMA 328 (21): 2136-2146.

Emergency Department 88

Emergency Department Research Outcomes Hospitals 88

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. 2022 May 16;10(14):4684-4690. screws for medial malleolus. References 1. World J Clin Cases.

Fractures 101

Fractures Operations Emergency Department EMS 101

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. 2,3 In general, patients who develop cardiac arrest with an initial rhythm of VT or VF tend to have favorable outcomes compared to patients who develop cardiac arrest from either asystole or pulseless electrical activity.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives In recent years there has been a large increase in demand for emergency care across the country, particularly during winter. This study utilised 12 months’ of routinely collected data from Emergency Departments (EDs) and acute Admitted Patient Care Episodes (APCs) to understand trends in demand for emergency care.

Emergency Department 40

Emergency Department Hospitals Outcomes Research 40

RebelEM

APRIL 29, 2024

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ). 2022 PMID: 35206981 2.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Ann Emerg Med. doi: 10.1097/MAT.0000000000001518

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

Don't Forget the Bubbles

JULY 19, 2023

Trends and Clinical Characteristics of Pediatric Patients Presenting to an Ophthalmology Emergency Department with an Initial Diagnosis of Optic Nerve Head Elevation. 2022 May 18;16:1525-1528. 2022 [cited 2023 May 14];16:1525–8. Outcome of pediatric patients referred for papilledema. Clin Ophthalmol.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98