Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Emergency Department (ED) crowding has dominated discourse around Emergency Medicine (EM) in recent years and is now well recognised as contributing towards patient harm. Less is known about the implications of crowded departments on staff. Because you’ve got patients in, well, everywhere.’

Emergency Department 40

Emergency Department Wellness EMS Patient Safety 40

Emergency Medicine Journal

JULY 22, 2024

Introduction Episodes of physical and verbal violence, as well as psychological humiliation, are experienced daily by ED staff. Methods We conducted a prospective observational study in the ED of Merano Hospital, Italy (52 000 ED admission in 2022) from 1 January 2022 to 31 August 2023.

Emergency Department 52

Emergency Department Hospitals Wellness 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. Out of 18 patients receiving ORT, 4 failed to respond well and were escalated to IV therapy. 2022 Sep 11;5(5):e827. Emerg Med Australas 2013;25(6):52734. AtherlyJohn et al.

Dehydration 83

Dehydration Fluid Resuscitation Administration Resuscitation 83

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

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. He returned to the emergency department, and you had the great privilege of saving his life.

Emergency Department 98

Emergency Department Psychiatric Outcomes Wellness 98

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 122

EKG/ECG Documentation/Coding Emergency Department Outcomes 122

Don't Forget the Bubbles

OCTOBER 12, 2024

doi: 10.1136/archdischild-2023-326773 Two-year-old Moyo is brought to the emergency department because her parents were concerned about noisy breathing. Most children can be discharged from the emergency department after a dose of corticosteroids and an appropriate safety net. 2022 [cited 2023 Dec 29].

Airway Management 85

Airway Management Emergency Department Administration Hospitals 85

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

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 105

Resuscitation Administration Emergency Department Ultrasounds 105

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. Treating Kratom toxicity varies based upon the clinical presentation as well as severity of symptoms. 2022 Mar 2;13:801855. Hofmeister M.

Seizures 72

Seizures Poisoning Forensics Emergency Department 72

RebelEM

JUNE 8, 2023

Am J Emerg Med. 2022 Sep 5. If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. Am J Emerg Med.

Administration 97

Administration Emergency Department Outcomes Documentation/Coding 97

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. Tilly is normally fit and well, with no significant past medical history. by her father. She is obviously uncomfortable.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

EMDocs

OCTOBER 8, 2024

Tachycardia may be present both from many medications or drugs, as well as withdrawal. Let’s use the example of the well appearing patient, without significant comorbidities. Disposition of sinus tachycardia depends on many factors, however the well-appearing asymptomatic patient does not require admission for tachycardia alone.

Shock 103

Shock Emergency Department Pediatrics EKG/ECG 103

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 98

Resuscitation Outcomes CPR Hospitals 98

Don't Forget the Bubbles

JULY 19, 2023

Olivia, a previously well 13-year-old girl, is referred to the paediatric ED from the Ophthalmology ED. 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. Clin Ophthalmol.

Pediatrics 98

Pediatrics Emergency Department Outcomes Wellness 98

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 94

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

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Heart disease and stroke statistics-2022 update: A report from the American Heart Association. Adult cardiac arrest in the emergency department – A Swedish cohort study. Published December 19, 2022.

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

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 120

EKG/ECG Wellness Operations Emergency Department 120

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 87

Emergency Department EMS Burns Wellness 87

RebelEM

NOVEMBER 25, 2024

2 Moreover, the American Society of Anesthesiologists’ 2022 Practice Guidelines for Management of the Difficult Airway recommend the use of adjuncts like bougies in anticipated difficult airways but stop short of endorsing their routine universal use. Still, most patients undergoing intubation probably have well-visualized anatomy.

Outcomes 93

Outcomes Emergency Department Operations Hospitals 93

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 93

Ultrasounds Emergency Department Pediatrics Radiology 93

The Skeptics' Guide to EM

OCTOBER 1, 2022

Date: September 28th, 2022 Reference: Hartford et al. Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference. AEM September 2022. Date: September 28th, 2022 Reference: Hartford et al. AEM September 2022. AEM September 2022.

Pediatrics 52

Pediatrics Emergency Department Documentation/Coding Research 52

EMDocs

JANUARY 25, 2025

Well keep it short, while you keep that EM brain sharp. A 45-year-old outdoor enthusiast presents to the emergency department with fever, headache, myalgias, and malaise. 10^9/L) Moderate (0.50.9 10^9/L) Severe (< 0.5 10^9/L) Generalized leukopenia (i.e. Most common causes of leukopenia Infections: 36.4% Medications: 25.6%

EMS 80

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 80

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

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

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 76

Poisoning CDC Administration Emergency Department 76

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 122

Ultrasounds Outcomes COPD Hospitals 122

Taming the SRU

MARCH 12, 2024

In the context of increasing ED and hospital crowding as well as limited ICU availability, this study aimed to evaluate the impact of a subcutaneous insulin (SQuID) protocol in the treatment of DKA on emergency department length-of-stay (EDLOS) and ICU admissions. Acad Emerg Med 2023;30(8):800–8. 10.1111/acem.14685

Operations 96

Operations Hospitals Best Practices Wellness 96

Taming the SRU

JUNE 12, 2023

Although not every person seeks health care for these injuries, the majority of those that do end up in the emergency department. In 2008, this led to greater than 316,000 emergency department (ED) visits and about 9,500 hospitalizations [1]. Annals of Emergency Medicine. Annals of Emergency Medicine.

Infectious Diseases 102

Infectious Diseases Emergency Department Administration Academics 102

Dr. Smith's ECG Blog

SEPTEMBER 8, 2023

A 50 year old presented to the emergency department of a remote rural community (where the nearest cath lab is a plane ride away) with one hour of mild chest pain radiating to the back and jaw, and an ECG labeled ‘normal’ by the computer interpretation.

EKG/ECG 133

EKG/ECG Emergency Department Wellness 133

ACEP Now

OCTOBER 3, 2023

In 2022, Spectrum Health and Beaumont Health integrated to create one system, Corewell Health. Our residency program is dedicated to producing safe, competent and qualified individuals in emergency medicine. The program works to maximize the time spent in emergency department rotations and minimize off-service rotations.

Emergency Department 52

Emergency Department Pediatrics Wellness Hospitals 52

Dr. Smith's ECG Blog

MAY 23, 2023

And they of course activated the cath lab immediately, where he was found to have acute thrombotic occlusion (TIMI 0) of the proximal LAD, as well as embolic D1 occlusion. LAD and D1 were stented, but flow unfortunately could not be well restored despite efforts (they list the post intervention TIMI flow still as 0). Am J Emerg Med.

EKG/ECG 98

EKG/ECG Wellness Emergency Department EMS 98

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

RebelEM

DECEMBER 23, 2024

There has been ongoing study about the clinical significance of these effects, as well as whether and for whom LR might provide meaningfully better clinical outcomes ( Myburgh 2013 , Self 2018 , Semler 2018 , Self 2020 ). Doing so can help avoid fundamental design errors that might otherwise limit or bias observational data ( Hernn 2022 ).

Fluid Resuscitation 121

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 121

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

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