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 89

Hospitals Research Patient Safety Wellness 89

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. Only it turns out, it did help. Or could, anyway. patients infected with the Wuhan/Delta variants in 2020-2021).

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

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. There are multiple criteria systems for diagnostic an acute myocardial infarction in this population, as well as patients with ventricular-paced rhythms. PMID: 36241466.

EKG/ECG 118

EKG/ECG Emergency Department Academics Operations 118

ACEP Now

JULY 7, 2023

1 Ventricular tachycardia (VT) and ventricular fibrillation (VF) represent the most common initial rhythms for patients presenting to the ED in out-of-hospital cardiac arrest, as well as for patients who develop cardiac arrest while in the ED. Heart disease and stroke statistics-2022 update: A report from the American Heart Association.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Dr. Smith's ECG Blog

AUGUST 4, 2024

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. Also, likely different lead placement of the precordial leads. In this case, QOH V1 said Not OMI with low confidence, while V2 said Not OMI with high confidence.

EKG/ECG 120

EKG/ECG Wellness Operations Emergency Department 120

Taming the SRU

MAY 22, 2023

Use your exam to guide your initial management as well as your imaging decisions and differential diagnosis. 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].

Fractures 77

Fractures Dislocations Operations Radiology 77

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 92

EMS Dehydration Operations Hospitals 92

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. Labs can be drawn from an IO to help with rapid diagnosis in emergencies.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

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

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. CHF, in particular, lends itself well to diagnosis and treatment with PoCUS, as it readily reveals the presence of B lines. 2022 Dec;106:9-38.

Ultrasounds 122

Ultrasounds Outcomes COPD Hospitals 122

Don't Forget the Bubbles

MAY 22, 2023

These can be operated and maintained by patients and their families at home. Gemma tells you that as well as the physio, Robin’s LTV Consultant has also prescribed some oral antibiotics. Since then, he has been well in himself. Advances in technology have also led to more portable ventilators. You go to see Robin.

Radiology 98

Radiology Radiology Hospitals Wellness 98

EMDocs

JANUARY 11, 2025

Well keep it short, while you keep that EM brain sharp. Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. EMRA Antibiotic Guide.

EMS 88

EMS Sepsis Shock Fluid Resuscitation 88

RebelEM

JUNE 8, 2023

2022 Sep 5. 2022 2022 Sep 5. Prior literature primarily focused on safety and medication errors, and while this study did the same, they also assessed variables associated with PDP response. Paper: Singer S, et al. The safety and efficacy of push dose vasopressors in critically ill adults. Am J Emerg Med. Am J Emerg Med.

Administration 97

Administration Emergency Department Outcomes Documentation/Coding 97

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 98

Fractures Ultrasounds Outcomes Research 98

RebelEM

AUGUST 12, 2024

Epub 2022 Aug 28. Thus further adding to the well known safety of amino acid infusions The lack of a diversified patient population in combination with having used only one type of amino acid formulary greatly limits this study’s generalizability. Epub 2022 Aug 28. The PROTECTION trial. Contemp Clin Trials. The PROTECTION trial.

Outcomes 81

Outcomes Hospitals Operations Shock 81

ACEP Now

MAY 4, 2023

The chest X-ray showed multiple displaced right rib fractures and chest wall subcutaneous emphysema without definitive evidence of a pneumothorax, as well as right lower lobe atelectasis versus contusion (Figure 1). On hospital day 2, he was taken to the operating room for surgical rib fixation. 2022; 22(11):432-439. J Surg Res.

EMS 52

EMS Fractures Operations Ultrasounds 52

Taming the SRU

MAY 23, 2023

BACKGROUND Foot injuries are common and can have significant implications for a patient’s well-being, functional capacity, and finances. Use your exam to guide your initial management as well as your imaging decisions and differential diagnosis. Updated 2022 Nov 23]. Updated 2022 May 14]. Foot & Ankle Int.

Fractures 57

Fractures Dislocations Operations EMS 57

Medical Law

SEPTEMBER 15, 2024

California drivers should still maintain their vehicles to ensure they’re well-prepared for wet and cool conditions. Oil Changes Cooler temperatures can cause oil to thicken, which can hinder efficient engine operation. Contact our Santa Barbara car accident lawyers at (805) 962-2022 for a consultation.

Operations 52

Operations Wellness 52

EMDocs

FEBRUARY 22, 2025

Well keep it short, while you keep that EM brain sharp. 2022 Jun;45(3):1827-1845. 2022 Jun;45(3):2501. 2022 Jul;43(7):1068-1072. Epub 2022 Jun 23. 2022 Oct;74(Suppl 2):737-744. 2022 Aug;219(2):292-301. Epub 2022 Mar 9. Neurosurg Rev. doi: 10.1007/s10143-021-01641-y. Epub 2021 Sep 9.

EMS 58

EMS Fractures Operations Wellness 58

SheMD

MAY 4, 2023

Women were more likely to be first appointed to educational rather than operational roles (52.6% vs 61.2%, p=0.02) as well as to be in those roles immediately prior to first chair appointment (p=0.01). Dig Dis Sci 67, 364–366 (2022). There were no gender differences in residency type, board certification, or fellowship position.

Leadership 52

Leadership Academics Operations Administration 52

Don't Forget the Bubbles

JANUARY 1, 2024

Data from the Nurse-Family Partnership program involving 60,171 families were analysed across four cohorts, including pre-pandemic and three pandemic cohorts (from July 2022 to October 2023). However, children who had an operation experienced improvements in behaviour, symptoms, and quality of life and had lower blood pressure.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

Don't Forget the Bubbles

SEPTEMBER 23, 2023

This talk, from Clare Skinner, on music, medicine and leadership , comes from our 2022 DFTB conference in Brisbane. There is leadership operating at many levels. Just like a hospital, or a health system, an orchestra needs every player doing their thing and doing it well. In practice, though, things are more complicated.

Leadership 136

Leadership Teamwork Hospitals Emergency Department 136

Medical Law

FEBRUARY 12, 2021

Well, yes and no. While you typically won’t see an aircraft recording the speeds of passing cars, it is a possibility — and some roadways are even patrolled by drones, which can operate without a a pilot. To speak with one of our excellent legal team members, call NordstrandBlack PC, at (805) 962-2022.

Operations 59

Operations Wellness 59

ALiEM

MAY 13, 2024

They may be well-circumscribed or may have irregular borders. Well-circumscribed abscess with heterogeneous debris C. Larger abscess with well-circumscribed borders D. Superficial abscess with well-circumscribed borders Table 1. 2022 Feb 1;38(2):e674-e677. The ultrasound can only see what is scanned.

Ultrasounds 64

Ultrasounds Pediatrics Emergency Department Wellness 64

Taming the SRU

JUNE 11, 2023

Utilized in the pre-hospital setting, ICU and the Operating Room, it is a non-invasive measurement that reflects a patient’s current state of metabolism, circulation and ventilation. It’s reflection of underlying metabolism, circulation and ventilation may serve well to identify patients with early dysfunction of physiologic functions.

Hospitals 87

Hospitals Emergency Department EMS Outcomes 87

ACEP Now

DECEMBER 10, 2023

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. Multiple stakeholders emphasized the importance of sharpening the focus, as well as refining the federal and state review of training programs for nurses and long-term care workers.

Emergency Department 52

Emergency Department Leadership Hospitals Operations 52

RebelEM

AUGUST 31, 2023

CVC placement under ultrasound guidance has decreased overall complication rates and there is increased awareness of transfusion reactions, alloimmunization, acute lung injury, circulatory overload, as well as infection. Non-inferiority margin was set at 2.5% later adjusted to INR > 3.0) Median hemoglobin: 8.2 g/dl vs 8.5 ICU: 42.6%

Ultrasounds 58

Ultrasounds Outcomes Wellness Research 58

PulmCCM

APRIL 1, 2024

Both a 2019 meta-analysis and a large 2022 trial by the ANZICS group raised concerns about increased adverse events among patients receiving intensive physical therapy in the ICU. That could (and should) change if improved functional outcomes, persisting for months after hospital discharge, are ever confirmed in large, well-conducted trials.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

RebelEM

MARCH 27, 2023

First ED-based study to evaluate how operational effects such as crowding can affect patient care in the form of LPV Included ARDS criteria relating to the usage of LPV in the ED allowing evaluation as to whether patients with ARDS were more likely to receive LPV settings. 2022 Feb 8; PMID: 35156050 Higgins TL et al. N Engl J Med.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

Northwestern EM Blog

MAY 2, 2022

There is lower quality evidence for reduced myocardial infarction and mortality risk as well. Additionally, many chambers are not operated on nights and weekends, and of those available at off hours, many are unable to accommodate intubated patients. 2022, May 2). However, several factors limit HBOT use. Wessling, E.

Burns 52

Burns Poisoning EKG/ECG Operations 52

Don't Forget the Bubbles

OCTOBER 14, 2024

The government recognizes they cannot return to their country of origin owing to a well-founded fear of being persecuted for the reasons provided for in the United Nations Refugee Convention or European Convention on Human Rights (such as persecution due to race, sexuality, political opinions, or religion). Retrieved from [link] The BMJ.

Documentation/Coding 59

Documentation/Coding Hospitals Wellness Operations 59

ALiEM

AUGUST 9, 2023

F Heart Rate 138 bpm Blood Pressure 102/61 Respiratory Rate 32 Oxygen Saturation (room air) 100% He is well appearing but has increased work of breathing. The lung POCUS is also operator-dependent, and it has a steep learning curve. 2022 Jun 5;23(4):497-504. On arrival, his vital signs are: Vital Sign Finding Temperature 99.7

Ultrasounds 98

Ultrasounds Pediatrics Emergency Department Operations 98

Dr. Smith's ECG Blog

AUGUST 30, 2023

Meyers' interpretation and the High-Confidence OMI interpretation by QOH ( Q ueen O f H earts ) — I'll add the following perspective: As per Dr. Meyers — there are QS complexes in leads V1,V2,V3 ( as well as an r wave that is still of small amplitude in lead V4 ). Figure-3: Laddergram showing what blocked PACs would look like.

EKG/ECG 74

EKG/ECG Operations Wellness 74

Northwestern EM Blog

MAY 16, 2022

Follow up CT should depend on the patient and ultrasound operator. Lastly the POCUS operators were ED physicians with training “recommended by ACEP.” 2022, May 16). In this study, 40.7% of those in the POCUS group and 27% in the formal ultrasound group underwent subsequent CT. Akhentuamhen, A.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

ACEP Now

DECEMBER 10, 2023

Her new community has a higher prevalence of Hepatitis C than HIV, so they began screening for that in the ED as well. In 2022, Dr. Calderon received one of the highest honors in health care when she was elected to the National Academy of Medicine. Today, their patients can be screened for HIV, Hepatitis C and substance use disorder.

Research 52

Research Point-of-Care Testing Burns Academics 52

Taming the SRU

MARCH 14, 2023

He appears well and is triaged to an ESI 4. Ultimately, definitive management is in the operating room with revision or replacement of the VP shunt. She was doing well, but recently has had the “stomach flu” with a couple weeks of abdominal pain, nausea and vomiting. More on this below as we work through a few cases….

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

Dr. Smith's ECG Blog

DECEMBER 18, 2022

Importantly, there is also STE in aVL, as well as V1. The operative report and radiology reads do not comment specifically as to whether the dissection flap was partially or fully obstructing coronary flow, or whether it was obstructing the left main or the RCA. Intraoperative TEE noted "Type A aortic dissection arising 1.0

Ultrasounds 40

Ultrasounds EKG/ECG EMS Radiology 40