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). Under standard operating protocols, residual contrast materials are usually wasted, according to current CDC and JC standards.

Radiology 73

Radiology Radiology Emergency Department Hospitals 73

The Trauma Pro

JUNE 14, 2024

But without a more convincing exam, it is difficult to convince yourself to operate immediately on these patients. If the exam worsens, operate. 2022 Sep 1;157(9):771-778. There may be some “dirty mesentery”, which is contused and has a hematoma within it. doi: 10.1001/jamasurg.2022.2770. 2022.2770.

Operations 147

Operations Radiology Radiology Hospitals 147

Pediatric EM Morsels

NOVEMBER 17, 2023

2022 May 11;10:864766. 2022 Apr;29(4):406-414. Epub 2022 Jan 12. 0.41), p < 0.001. Bibl K, Pracher L, Küng E, Wagner M, Roesner I, Berger A, Hermon M, Werther T. Incidence of Post-extubation Stridor in Infants With Cuffed vs. Uncuffed Endotracheal Tube: A Retrospective Cohort Analysis. Front Pediatr. doi: 10.3389/fped.2022.864766.

Pediatrics 183

Pediatrics Emergency Department Outcomes Sepsis 183

ACEP Now

JUNE 7, 2023

The performance of EDs in 2020 and into 2021 changed abruptly, and that carried through into 2022. Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. ED patient throughput improved in 2022 in some regards, which is an incredible accomplishment in a very difficult year.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

Mount Sinai EM

DECEMBER 27, 2022

Lisfranc injury x-rays Management Depends on the severity of injury, so consult with your orthopedic surgeon to determine operative vs nonoperative management. Case study, Radiopaedia.org (Accessed on 26 Dec 2022) [link] Gaillard F, Lustosa L, Murphy A, et al. Lisfranc injury. Publisher: Elsevier. 273 – 310.

Dislocations 130

Dislocations Fractures Operations Radiology 130

Medical Law

JANUARY 12, 2023

On November 20, 2022, Renée and her two daughters participated in Mitzvah Day activities at Congregation B’nai B’rith (CBB) in Santa Barbara by making gift bags for people living in senior homes and creating holiday treats for children at the Teddy Bear Cancer Foundation. Call (805) 962-2022 to learn more today. rating from Avvo.

Operations 52

Operations 52

Pediatric EM Morsels

JUNE 16, 2023

2022) Morel-lavallee lesions – diagnosis and practical management of these troublesome injuries! Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Arch Gen Med. and Taylor, B.

Soft Tissue Injuries 152

Soft Tissue Injuries Dehydration Fractures Operations 152

Greater Sydney Area HEMS

NOVEMBER 4, 2023

In 2022, we achieved: 95% overall first pass success rate (first pass of laryngoscope into mouth results in successful intubation, from both prehospital and inter hospital cases, including cold tube and RSI. A change of operator or removal of the blade from the mouth ends the attempt). first pass success rate from RSI.

Airway Management 144

Airway Management Burns Operations Resuscitation 144

PulmCCM

NOVEMBER 17, 2023

Kenny MD [ @heart_lung ] In part 1 , right atrial pressure [P ra ] and cardiac output/venous return [CO/VR] were considered as two hemodynamic measures bound at the operating point [OP] of the circulatory system. OP is operating point. Shows what happens when Ppc, Pmsf, Rcardiac and Rvr all vary [grey operating points].

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

ACEP Now

JANUARY 5, 2025

Secondary hemorrhage occurs between days five and 14 post-operatively, peaking around days five to seven. The literature suggests that approximately 85 percent of these cases require procedural source control in the operating room, highlighting the importance of expediting transport arrangements. 2022 ;279(3):1601-1607.

Airway Management 90

Airway Management Operations Resuscitation Pediatrics 90

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. of operators being either emergency medicine residents or critical care fellows. Background More than 1.5

Operations 103

Operations Outcomes Emergency Department Academics 103

Emergency Medicine Journal

SEPTEMBER 25, 2024

Methods Prespecified analysis from a prospective, multicentre, cohort study in patients with suspected NSTE-ACS who were transported to an ED between April 2021 and December 2022 in the Netherlands. Risk stratification is performed by EMS personnel using preHEART, HEART, T-MACS and POC-troponin.

EMS 97

EMS EKG/ECG Operations Hospitals 97

ACEP Now

JUNE 21, 2023

2,3 In the 2021-2022 academic year, categorical (non-combined) EM residency lengths included 221 (80 percent) PGY 1-3 and 55 (20 percent) PGY 1-4 programs. Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. Accessed 2022-03-26. Ann Emerg Med. J Emerg Med.

EMS 114

EMS Academics Telemedicine Operations 114

Taming the SRU

MARCH 12, 2024

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. The study’s primary outcomes were the operational impacts of the SQuID protocol on EDLOS and ICU admission rates. The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics.

Operations 96

Operations Hospitals Best Practices Wellness 96

Taming the SRU

SEPTEMBER 25, 2023

Specifically, EM physicians should be able to recognize fractures that will likely require operative management and facilitate close follow up, such as a Maisonneuve fracture. Disruption of these structures yields an unstable ankle fracture, thus making close follow up for operative management imperative. 2022 May 16;10(14):4684-4690.

Fractures 100

Fractures Operations Emergency Department EMS 100

Total Medical ComplianceHIPAA

JANUARY 12, 2023

Department of Health and Human Services (HHS) Office for Civil Rights (OCR) had its busiest year with the announcement of its 22 nd enforcement settlement on December 15, 2022. Many comments to the NPRM noted that this would be an operational and compliance risk issue for providers. Last year, the U.S.

Operations 104

Operations Best Practices Documentation/Coding Administration 104

Don't Forget the Bubbles

JUNE 30, 2023

These procedures require an experienced operator. A joint statement released by the American College of Surgeons/American College of Emergency Physicians recommends that zone 1 REBOA should only be performed if the anticipated time to start the operation is less than 15 minutes. These procedures require an experienced operator.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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. In all, this 2022 update from the ACC provides diagnosis and management pathways intended to guide the approach to chest pain in the emergency department. PMID: 36241466.

EKG/ECG 110

EKG/ECG Emergency Department Academics Operations 110

RebelEM

APRIL 17, 2023

A repeat search was completed in May 2021 & November 2022. While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage. Two investigators independently assessed and screened all studies for eligibility. Ultrasound has become an extended part of our physical exam.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

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. Among 475 patients with ARDS due to Covid-19, randomized within 5 days of ventilation to receive convalescent plasma or usual care (i.e.,

Blood Transfusions 98

Blood Transfusions Operations Infectious Diseases Resuscitation 98

RebelEM

NOVEMBER 6, 2024

2022 Aug 2. 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. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. Simple elbow dislocation. Shoulder Elbow.

Dislocations 109

Dislocations Fractures Soft Tissue Injuries Outcomes 109

Ken Grauer, MD

SEPTEMBER 6, 2024

Depending on which of above considerations is operative — the differential diagnosis of the rhythm in ECG #1 will be between: i ) A reentry SVT rhythm with retrograde atrial conduction; ii ) ATach ( A trial T achycardia ) ; — or — iii ) Junctional Tachycardia. It finally responded to high-dose IV Verapamil.

EKG/ECG 245

EKG/ECG Administration Wellness Operations 245

ACEP Now

JULY 7, 2023

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. Heart disease and stroke statistics-2022 update: A report from the American Heart Association. Published December 19, 2022.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

EMDocs

FEBRUARY 7, 2024

3 Increasing Strikes and Unions Labor actions in healthcare can disrupt normal hospital operations, potentially impacting costs and threatening patient quality of care. there were 31 recorded healthcare strikes in 2021, 39 recorded healthcare strikes in 2022, and 37 healthcare strikes in 2023 as of November 3rd. months since 2022.

Hospitals 77

Hospitals Research Patient Safety Wellness 77

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., Updated 2022 Nov 23]. A comparison between pre-operative ultrasonography and surgical findings. Updated 2022 Apr 7]. Acta Radiol.

Fractures 76

Fractures Dislocations Operations Radiology 76

Emergency Medicine Journal

FEBRUARY 20, 2024

Methods This was a multicentre observational cohort study of adults attending 27 UK EDs between 26 September 2022 and 30 November 2022, with potential AAS symptoms: chest, back or abdominal pain, syncope or symptoms related to malperfusion. Reference standard was radiological or operative confirmation of AAS.

Emergency Department 52

Emergency Department Operations Radiology Radiology 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 105

Resuscitation Administration Emergency Department Ultrasounds 105

RebelEM

JANUARY 25, 2024

Point-of-care ultrasound (PoCUS) is inherently operator-dependent, which may have led to inconsistencies in the quality and findings of the ultrasound exams across different operators. 2022 Dec;106:9-38. Epub 2022 Aug 1. Published on February 28, 2022. Kok B, Wolthuis D, Bosch F, van der Hoeven H, Blans M.

Ultrasounds 126

Ultrasounds Outcomes COPD Hospitals 126

EMDocs

MAY 25, 2024

Treasure Island (FL): StatPearls Publishing; September 26, 2022. Updated 2022 Aug 8]. In: StatPearls. Insalaco LF. Ferri’s clinical advisor 2023. Sialadenitis. 01/01/2023:1391-1392.e1. doi: 10.1016/B978-0-323-75573-3.00837-4. Adhikari R, Soni A. Submandibular Sialadenitis and Sialadenosis. In: StatPearls [Internet].

EMS 80

EMS Dehydration Operations Hospitals 80

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. Reference: Brower et al. Also joining us is Dr. Andrew Goldsmith.

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

American Medical Compliance

NOVEMBER 30, 2022

In operating rooms, HAIs can cause surgical site infections, which threaten the health and safety of patients. According to the Emergency Care Research Institute, staffing shortages posed the greatest threat to patient safety in 2022. Many care providers are forced to operate without the necessary materials to do their jobs.

Patient Safety 52

Patient Safety CDC Operations Outcomes 52

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. Published May 11, 2022. 1 The Rise of the Miami BBL An entire industry has emerged around gluteal AFTs in Miami.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

Emergency Medicine Journal

FEBRUARY 20, 2024

The Chief Coroner’s annual report details the operation of the coroner’s service and does not collate PFD findings. 1 By contrast, Australia’s coronial system collates all inquest findings, informing injury prevention and health-professional education.

Emergency Department 40

Emergency Department Operations 40

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

The cut points for what constitute OMI and not OMI as well as confidence levels are calibrated to maximize sensitivity and specificity according to the receiver operating characteristic. In a large proportion of cath labs, the operator would probably have ended the case at this point. The cardiologist called this 20% stenosis.

EKG/ECG 70

EKG/ECG Operations Wellness Ultrasounds 70

Taming the SRU

NOVEMBER 3, 2023

41, 2695–2701 (2022). Broad strokes In this prospective, non-randomized study published by Kring et al in January 2022 out of Maine Medical Center, researchers compared mean pain scores at rest and during incentive spirometry before, at 15 minutes after, and then 60 minutes after treatment with a serratus anterior plane block.

Fractures 97

Fractures Ultrasounds Outcomes Research 97

RebelEM

AUGUST 12, 2024

Epub 2022 Aug 28. Epub 2022 Aug 28. Intravenous amino acid therapy for kidney protection in cardiac surgery a protocol for a multi-centre randomized blinded placebo controlled clinical trial. The PROTECTION trial. Contemp Clin Trials. The PROTECTION trial. Contemp Clin Trials. PMID: 36038001 Levi TM, et al. Rev Bras Ter Intensiva.

Outcomes 81

Outcomes Hospitals Operations Shock 81

RebelEM

MAY 27, 2024

What they did: Prospective randomized controlled trial, unblinded, multicenter study Conducted from January 2017 to December 2022 Patients with confirmed PSVT were randomly assigned to receive MVM, IV Adenosine, or combined therapy.

Outcomes 135

Outcomes Research Hospitals Operations 135