Pediatric EM Morsels

OCTOBER 27, 2023

Taking care of a critically ill child can be nerve-racking to say the least, and downright petrifying for those who don’t do it frequently, even if they are well-trained and brilliant clinicians. Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Broselow does not.

Pediatrics 268

Pediatrics Resuscitation Documentation/Coding Wellness 268

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

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

ALiEM

NOVEMBER 17, 2023

A 4-year-old female with no significant past medical history is brought to the Emergency Department by her grandmother for concern for two days of progressive vaginal bleeding. kg General : Well-appearing 4-year-old female acting appropriately with grandmother and mother at the bedside. Accessed January 5, 2022.

Pediatrics 100

Pediatrics Emergency Department Academics OB/GYN 100

EMDocs

JULY 9, 2024

The emergency department takes care of some of the highest risk patients with the worst access to health care and social services Over the past 20 years, many researchers have created and validated social needs screeners Some examples: iHELP, WE CARE, SEEK, USDA 2-item food insecurity questionnaire Does screening make a difference?

Pediatrics 71

Pediatrics Emergency Department Research Burns 71

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

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors. Providers should respect and utilize this mode of communication, as well as document the patient’s request for a non-certified interpreter.

Documentation/Coding 82

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 82

Taming the SRU

SEPTEMBER 16, 2024

In the era of modern medicine, blood transfusions are commonplace, especially in the emergency department. While they are a lifesaving staple of medicine, they also come with risks that emergency providers must be aware of. 10, 19 May 2022, p. 2, July 2022, pp. 2859, [link] Afroz, Tamanna, et al.

Blood Transfusions 60

Blood Transfusions Anaphylaxis Emergency Department Sepsis 60

ACEP Now

MARCH 12, 2024

30 to discuss violence in the emergency department and encourage elected officials to pass the SAVE Act , bipartisan legislation that ACEP helped develop and strongly supports to protect physicians and health care professionals in the workplace. This is a daily situation in emergency departments across the country.”

Leadership 52

Leadership Emergency Department Pediatrics Research 52

EMDocs

AUGUST 15, 2023

Published April 15, 2022. Accessed May 7, 2022. StatPearls Publishing; 2022. Accessed May 17, 2022. Accessed May 7, 2022. Accessed May 7, 2022. Accessed May 7, 2022. Accessed May 7, 2022. His father confirmed the snake was a copperhead. Treatment of snakebite poisoning. Am J Hosp Pharm.

Poisoning 82

Poisoning Administration CDC EMS 82

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.

Emergency Department 52

Emergency Department Leadership Hospitals Administration 52

Pediatric EM Morsels

FEBRUARY 2, 2024

In one ED study, ALL cases of missed travel-related illness did not have a documented travel history in their ED note , whereas 90% of the identified travel-related illnesses had a provider documented travel history (Greenky 2022) Those who are visiting friends and relatives (VFR) are typically at highest risk. Am J Emerg Med.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Written by Pendell Meyers A teenager was involved in a motor vehicle collision and presented to the Emergency Department via EMS altered and potentially critically ill. Systolic function normal by visual assessment only, unable to visualize well for further characterization. The patient did well and was discharged.

EKG/ECG 109

EKG/ECG Wellness Fractures Hospitals 109

The Skeptics' Guide to EM

DECEMBER 10, 2022

Date: November 30th, 2022 Reference: Johnson et al. Date: November 30th, 2022 Reference: Johnson et al. Bone Joint J 2022 Guest Skeptic: Dr.Matt Schmitz is an Orthopaedic Surgeon specializing in Adolescent Sports Medicine and Young Adult Hip Preservation. We mentioned x-rays were unreliable as well to rule-out a scaphoid injury.

Operations 52

Operations Fractures Military Emergency Department 52

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. Am J Emerg Med.

EKG/ECG 121

EKG/ECG Documentation/Coding Emergency Department Outcomes 121

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. 2022 PMID: 35206981 2. World J Emerg Surg 2023 PMID: 36918947 3. Healthcare. Crit Care Med.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

The Skeptics' Guide to EM

MAY 14, 2022

Date: May 13th, 2022 Reference: Abril et al. J Emerg Med 2022 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. Date: May 13th, 2022 Reference: Abril et al. An Analysis of Data From Randomized Studies.

Emergency Department 52

Emergency Department Research Wellness 52

ALiEM

OCTOBER 20, 2023

A 50-year-old Caucasian female with a history of hypertension, coronary artery disease, and insulin-dependent diabetes mellitus presents to the emergency department with a complaint of painful sores on the top of her left foot. Updated 2022 Dec 1]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

Academics 64

Academics Emergency Department Wellness Research 64

ALiEM

NOVEMBER 29, 2023

In patients with skin changes, consider topical wound care as well as further evaluation of deep tissue infections, osteomyelitis, and ischemia. Journal of Addiction Medicine 16(5):p 595-598, 9/10 2022. Published 2022 Aug 19. Opioid overdoses involving xylazine in emergency department patients: a multicenter study.

Forensics 67

Forensics Administration Poisoning Emergency Department 67

Taming the SRU

MARCH 27, 2024

The parent trial was conducted from October 2020 to July 2022 in the capital region of Denmark. In this study, the authors aim to assess the hemodynamic effects of prehospital high-dose glucocorticoid treatment in resuscitated comatose OHCA patients. Hill, J.

Resuscitation 96

Resuscitation Outcomes CPR Hospitals 96

Northwestern EM Blog

MAY 9, 2022

There is no gold standard with respect to its definition, and it requires a medication history (which we typically don't do very well in the emergency department). Accessed February 11, 2022. Goldfrank's Toxicologic Emergencies, 11e. Accessed February 11, 2022. 2022, May 9). 12 March 2015.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Administration 52

Northwestern EM Blog

SEPTEMBER 26, 2022

Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The Emergency Department is a challenging work environment for a variety of reasons.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

The Skeptics' Guide to EM

FEBRUARY 5, 2022

Date: February 7th, 2022 Reference: Williams et al. JAMA Pediatrics 2022 Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine fellow at Children’s National Hospital in Washington, DC. Date: February 7th, 2022 Reference: Williams et al. Things were much simpler when I started my pediatric training.

Pediatrics 52

Pediatrics Emergency Department Hospitals Outcomes 52

ALiEM

APRIL 12, 2023

The thin alcohol layer serves to eliminate any air bubbles under the adhesive cover as well as minimizes residual adhesive material sticking to the probe when removing the cover. 2022 Jan 6;8(1):42. emDOCs.net – Emergency Medicine Education. Accessed April 5, 2023 Afzal S, Zahid M, Rehan ZA, et al. Hemmings, Talmage D.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103

The Skeptics' Guide to EM

NOVEMBER 12, 2022

Date: November 10th, 2022 Reference: de-Madaria E et al. Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University. Date: November 10th, 2022 Reference: de-Madaria E et al.

Fluid Resuscitation 52

Fluid Resuscitation Resuscitation Emergency Department Shock 52

EMDocs

SEPTEMBER 7, 2023

DGA concentrates in the kidney tissue and causes nephrotoxicity, as well as neurotoxicity. Elimination half-life data is not well established but increases in larger overdoses and as renal injury begins to occur. Accessed August 2022. FDA Consumer Magazine , June 1981, [link] Accessed August 2022. Accessed August 2022.

Poisoning 66

Poisoning CDC Administration Emergency Department 66

Taming the SRU

JULY 21, 2023

Eye Pathology Now let’s dive back into some common eye disease processes you may see on a typical day in the emergency department. Accessed April 15, 2022. Accessed April 15, 2022. Accessed April 15, 2022. Patients will often have objective visual acuity impairment as well as a fever or leukocytosis.

Emergency Department 86

Emergency Department EMS Burns Wellness 86

Taming the SRU

APRIL 14, 2024

You may place cold packs or ice packs to the hernia site to help reduce inflammation and swelling, as well as to assist in local analgesia. Symptoms include persistent tenderness in the area, as well as symptoms of obstruction including nausea, vomiting, and pain, despite reduction. (2) The Journal of Emergency Medicine , vol.

Ultrasounds 91

Ultrasounds Emergency Department Pediatrics Radiology 91

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. They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. Pediatr Emerg Care. PMID: 34398861.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

The Skeptics' Guide to EM

DECEMBER 31, 2022

Date: Dec 15, 2022 Reference: Mahajan et al. Date: Dec 15, 2022 Reference: Mahajan et al. October 2022 Guest Skeptic: Dr. Brian Lee is a pediatric emergency medicine attending at the Children’s Hospital of Philadelphia and Assistant Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania.

Pediatrics 40

Pediatrics Research Emergency Department Hospitals 40

PulmCCM

NOVEMBER 6, 2023

Intuitively, plasma seemed even less likely to help the very sickest of the sick— those mechanically ventilated with ARDS from Covid-19, whose mortality rate was well over 50% at many centers. The intervention took place in the emergency department, with device placement by ED physicians. Only it turns out, it did help.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

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 patient did well. == MY Comment , by K EN G RAUER, MD ( 8/4 /2024 ): == I thought today's case by Dr. Meyers is an important one for emergency providers for a number of reasons. Pericarditis maybe."

EKG/ECG 98

EKG/ECG Wellness Emergency Department Operations 98

The Skeptics' Guide to EM

MARCH 12, 2022

Date: March 3rd, 2022 Reference: Macnow et al. JAMA Pediatrics 2021 Guest Skeptic: Dr. Catherine Varner is an Assistant Professor and Clinician Investigator in the Department of Family and Community Medicine at the University of Toronto. first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 40

Emergency Department Head Injuries Pediatrics Research 40

ALiEM

MAY 19, 2023

A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU.

Emergency Department 98

Emergency Department Ultrasounds Wellness EMS 98

ALiEM

DECEMBER 8, 2023

A 45-year-old male status-post right nephrectomy secondary to a renal mass presented to the emergency department with right-sided flank pain. Major risk factors for their development include prior abdominal surgeries that weaken the musculature as well as cardiovascular co-morbidities. 2022 Dec 19. Strangulated Hernia.

Academics 60

Academics Emergency Department Outcomes Wellness 60

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. The kidney will have a different axis as well as level of lie, so care should be taken to scan broadly if the renal cortex is not immediately apparent. 2022 Nov 28. 2022 Sep 26:1–19.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

Don't Forget the Bubbles

DECEMBER 27, 2023

Sonia Twigg gave this talk at our 2022 DFTB conference in Brisbane. Dr. Sonia Twigg, a pediatric Emergency Physician, shares insights into the significance of debriefing, particularly focusing on “hot debriefs.”

Wellness 52

Wellness Emergency Department Pediatrics 52