RebelEM

JUNE 29, 2023

Back on June 1 st , 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? REBEL EM Blog, June 1, 2023. Resus 2023. Back on June 1st, 2023, Swami wrote a blog post on REBEL EM titled, The CT FIRST Trial, Should We Pan-CT After ROSC? Available at: HERE Branch KHR et al.

CPR 145

CPR EMS Documentation/Coding Outcomes 145

Total Medical ComplianceHIPAA

APRIL 14, 2023

On April 11, 2023, the HHS published a notice on upcoming new rules to add greater protection to reproductive health care because of new state laws passed due to the outcome of the Supreme Court ruling on Roe v. You can even call and talk to your patient and document this. New HIPAA rules proposed by Health and Human Services (HHS).

Documentation/Coding 83

Documentation/Coding Outcomes Wellness 83

PulmCCM

JANUARY 15, 2025

According to a 2023 analysis of applications for FDA approval , as late as 2020 manufacturers were complying with a minimum of effort—e.g., Draft Guidance Document Wong et al. JAMA Network Open 2023. In 2013, FDA issued a suggestion that manufacturers test devices on patients “with a range of skin pigmentations.”

Academics 81

Academics Documentation/Coding Administration Research 81

Ken Grauer, MD

JULY 29, 2023

The "good news" — is that we clearly see sinus P waves in ECG #1 , that document conversion to sinus rhythm ( ie, upright P waves in lead II that precede each QRS complex with a constant and normal PR interval ). A DDENDUM ( 7/29/2023 ) : I summarize KEY features regarding Idiopathic VT in Figure-4.

EKG/ECG 370

EKG/ECG Resuscitation Documentation/Coding Hospitals 370

EMDocs

JUNE 13, 2024

We just don’t document it. If we don’t use printed instructions, document our verbal instructions regarding the most common side effects of the drug(s) being prescribed. Documenting our warnings should be standard care. State regulations and codes may place that responsibility on our shoulders. Updated: Jun 7, 2023.

Documentation/Coding 98

Documentation/Coding Patient Safety Emergency Department Hospitals 98

Dr. Smith's ECG Blog

NOVEMBER 27, 2023

link] == MY Comment , by K EN G RAUER, MD ( 11/26 /2023 ): == Superb commentary by Dr. McLaren — that addresses a number of truly challenging aspects regarding ECG assessment of patients who present with new chest pain. It is not yet available, but this is your way to get on the list. I'd add the following to Dr.

EKG/ECG 110

EKG/ECG Documentation/Coding Wellness 110

EMDocs

MAY 4, 2024

. #1: Emergent Cath Lab Activations with “Normal” Computer ECG Interpretations Spoon Feed A significant minority of code STEMI patients have an initial normal computer ECG interpretation. Epub 2023 Sep 17. Acad Emerg Med. 2024 Mar;31(3):296-300. doi: 10.1111/acem.14795. PMID: 37620163. #2:

Documentation/Coding 98

Documentation/Coding Stroke Emergency Department Pediatrics 98

Dr. Smith's ECG Blog

MARCH 4, 2024

link] Or use the QR code: 10 Cases: Case 1 Do you want to be interrupted to view what the computer calls normal or nonspecific ECGs? Smith, Meyers and Herman ( in the December 5, 2023 post of Dr. Smith's ECG Blog ) — many of which are summarized in Figure-1 — and, all of which are routinely discussed in cases presented on this ECG Blog.

EKG/ECG 128

EKG/ECG Documentation/Coding Wellness Resuscitation 128

Emergency Medicine Journal

DECEMBER 30, 2024

Methods We undertook non-participant observation (162 hours, 143 pre-alerts) and semi-structured interviews with staff (n=40) in six UK EDs between August 2022 and April 2023 focusing on how ED staff respond to pre-alert calls and what influences their response. This study aimed to understand how pre-alerts influence patient care in the ED.

Emergency Department 52

Emergency Department Stroke Documentation/Coding Outcomes 52

EMDocs

AUGUST 22, 2024

13 Interventions may include: Ascertaining a patient’s preferred language early in the clinical encounter (during registration, for instance), and clearly documenting this preference in a place that is visible to all providers. Utilizing certified interpreters and documenting their use. Educating patients on their rights.

Documentation/Coding 105

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 105

Dr. Smith's ECG Blog

OCTOBER 18, 2023

4,5] We have now formally studied this question: Emergency department Code STEMI patients with initial electrocardiogram labeled ‘normal’ by computer interpretation: a 7-year retrospective review.[6] have published a number of warnings about the previous reassuring studies.[4,5] Am J Emerg Med. 2022 ; 55 : 180 - 182 6.

EKG/ECG 119

EKG/ECG Documentation/Coding Emergency Department Outcomes 119

ACEP Now

AUGUST 1, 2023

2023 CPT Documentation Guidelines FAQ Updated, Expanded ACEP has updated its 2023 CPT Documentation Guidelines, expanding from 39 to 70 questions. The letter followed ACEP’s participation in a June 29 roundtable hosted by the Committee. Read more at acep.org/NSA-HELP-letter.

Documentation/Coding 52

Documentation/Coding Emergency Department Emergency Nursing Research 52

ACEP Now

OCTOBER 26, 2023

One of the HCFA letters, written by then Medicaid Director Tim Westmoreland (the Westmoreland Letter) specifically cited that the CPT 9928X codes should be reimbursed under federal PLP unless the Medicaid plan believed there were program integrity issues with the claim. ACEP, state chapters, and EDPMA respond with litigation.

Documentation/Coding 124

Documentation/Coding Hospitals Emergency Department Administration 124

Dr. Smith's ECG Blog

JANUARY 2, 2025

In the middle of the night, a "code" was called, and multiple rhythms like this were recorded. For more on Torsades de Pointes vs PMVT See My Comment in the October 18, 2023 post and the September 2, 2024 post in Dr. Smith's ECG Blog ). LBBB, ventricular pacing, etc.)." CASE CONTINUED She was admitted to the ICU.

EKG/ECG 116

EKG/ECG Sepsis Wellness Documentation/Coding 116

Pediatric EM Morsels

MAY 5, 2023

2023 Feb 12. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. J Am Diet Assoc 2001;101:661–9. doi:10.1016/S0002-8223(01)00167-5. Qudsiya Z, De Jesus O. Subacute Combined Degeneration of the Spinal Cord. In: StatPearls [Internet]. PMID: 32644742. Sanders TA. Growth and development of British vegan children. Am J Clin Nutr.

Pediatrics 130

Pediatrics Documentation/Coding EMS 130

ACEP Now

DECEMBER 11, 2023

A recent article documents 56 additional U.S. Published September 15, 2023. Accessed December 8, 2023. Accessed December 8, 2023. Accessed December 8, 2023. Accessed December 8, 2023. Published July 21, 2023. Accessed December 8, 2023. Published April 19, 2023. Accessed December 8, 2023.

Hospitals 98

Hospitals Administration Documentation/Coding Research 98

PEMBlog

MARCH 4, 2025

After a lull during the COVID 19 pandemic, cases reemerged in 2023 and continued to climb into 2024. Studies supporting antibiotic treatment of documented mycoplasma pneumoniae in children are limited. So mycoplasma pneumonia infections have been on the rise, especially in children.

Pediatrics 94

Pediatrics Military CDC Hospitals 94

ACEP Now

AUGUST 1, 2023

emergency department deserves access to an emergency physician no matter their zip code. The post 2023 ACEP Elections Preview: Meet the President-Elect and Council Officer Candidates appeared first on ACEP Now. Three take home points for what I believe. There is no substitution for the physician led team. Every patient in a U.S.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

Dr. Smith's ECG Blog

APRIL 18, 2024

Emergent cath lab activation is also named after this test (code STEMI), so patients whose ECGs don’t meet STEMI criteria don’t get emergent angiograms, despite guidelines. And because there was no Code STEMI, the discharge diagnosis was “non-STEMI”, so this case will not be flagged as an opportunity for improvement. But only 6.4%

EKG/ECG 121

EKG/ECG Documentation/Coding Fractures Emergency Department 121

Dr. Smith's ECG Blog

MAY 26, 2023

Severely ill patients from any etiology can have very abnormal ECGs = My Comment by K EN G RAUER, MD ( 5/26 /2023 ): = There are more questions than answers in today's case. A NSWER : In Figure-3 — I have color-coded P waves in the long lead II rhythm strip of ECG #2. How Are the P Waves Color-Coded?

Shock 98

Shock EKG/ECG Documentation/Coding Resuscitation 98

Total Medical ComplianceHIPAA

FEBRUARY 15, 2023

Among many other documents offered to our clients, TMC also provides access to Federal and State posters in the client portal. Each employer shall take steps to insure that such notices are not altered, defaced, or covered by other material.” The posters must be at least 8½ inches by 14 inches, with a font size of at least 10.

Documentation/Coding 52

Documentation/Coding 52

Don't Forget the Bubbles

DECEMBER 16, 2024

A Decline in Vaccination Coverage: A Global Issue In 2023, the World Health Organisation (WHO) reported that worldwide immunization rates for key vaccines, including the diphtheria-tetanus-pertussis (DTP3) series, had dropped to 84% from pre-pandemic rates of 86%. 2023 UK Government. have completed their preschool DTaP/IPV booster.

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59

Pediatric EM Morsels

JULY 28, 2023

A critical MORSEL is that every child you treat for DKA needs to have an initial thorough neuro exam including cranial nerves and then frequent neuro reassessments … and document it ( so your colleagues who take over care for the kid can know if there has been a change )!

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

EMDocs

SEPTEMBER 30, 2024

2023 May;64(5):555-563. Among patients with a primary provider documented in the chart, 30-day outpatient follow-up rate was 21.3% (n = 313). Guidelines – Global Initiative for Asthma (GINA) 2023 The 2019 Global Initiative for Asthma (GINA) guidelines recommend that all patients with asthma be prescribed ICS. J Emerg Med.

Outcomes 105

Outcomes Academics Documentation/Coding Emergency Department 105

Don't Forget the Bubbles

MAY 31, 2023

2023 May 17:archdischild-2022-325280. D., & Paediatric Emergency Research United Kingdom and Ireland (PERUKI) (2023). Available at [link] (Accessed: May 22 2023). Arch Dis Child. doi: 10.1136/archdischild-2022-325280. Why was the DIMPLES study needed? PLoS medicine, 19(8), e1003974. link] Ponmani, C., Nijman, R. Barrett, M.,

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

The Skeptics' Guide to EM

JANUARY 25, 2025

BMC Med 2023 Guest Skeptic: Dr. Jestin Carlson is the Program Director for the AHN-Saint Vincent EM Residency in Erie Pennsylvania. P-hacking is not exclusive to AUC but is a well-documented problem in broader research, particularly surrounding the 0.05 Date: January 9, 2025 Reference: White et al. p-value significance threshold.

Research 49

Research EMS Documentation/Coding Operations 49

ACEP Now

NOVEMBER 7, 2024

Boarding of mentally ill patients in emergency departments: American Psychiatric Association resource document. link] Published September 25, 2023. Maura Kelly , a health writer, is a special contributor to Annals of Emergency Medicine. Reference Nordstrom K, Berlin JS, Nash SS, et al. West J Emerg Med. 2019;20(5):690-695. Pediatrics.

Psychiatric 59

Psychiatric Pediatrics Hospitals Emergency Department 59

Total Medical ComplianceHIPAA

OCTOBER 7, 2023

According to the HHS Office for Civil Rights data breach portal , healthcare data breaches impacted over 39 million people in the United States so far in 2023. Here are a few key concepts: Data Encryption: Converting your data into a code to prevent unauthorized access.

Documentation/Coding 99

Documentation/Coding 99

PulmCCM

JUNE 5, 2023

Read in AJRCCM In The News The Hospitalist and the Resuscitationist 2023 Conference will take place September 27-30 in Montreal. Check out the preliminary program , and use code PULMCCM15 to get 15% off the attendance fees. Patients with secondary pneumothoraces (e.g., iatrogenic or hospital-acquired) were excluded.

Advances Cardiac Life Support (ACLS) 96

Advances Cardiac Life Support (ACLS) Documentation/Coding CPR Shock 96

PulmCCM

JANUARY 6, 2025

A follow-up study in 2023 showed the Epic model performed badly in complex patients. This was despite a higher intensity of care in the visible-alert patients, who had more rapid responses, ICU transfers, code blues, intubations, and initiation of dialysis. 2023 Jun 1;183(6):611-612. But for whom, and to what end?

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

ACEP Now

JUNE 7, 2023

The example provided illustrates both the potential and current limitations of the technology, presently requiring careful review to ensure spurious extrapolations have not been inserted into the medical documentation. Published March 20, 2023. Last revised April 12, 2023. Accessed May 15, 2023. Published March 29, 2023.

Documentation/Coding 78

Documentation/Coding Wellness Administration Research 78

Dr. Smith's ECG Blog

MARCH 10, 2025

Weve also published the largest study on this question: Emergency Department Code STEMI patients with initial electrocardiogram labeled normal by computer interpretation: a 7-year retrospective review. This underestimates computer false normal ECGs because we only included code STEMIs, not Non-STEMIs with OMI.

EKG/ECG 89

EKG/ECG Outcomes Documentation/Coding Emergency Department 89

PulmCCM

FEBRUARY 8, 2024

ATS and ESICM each separately issued its own updated ARDS guideline in 2023, and SCCM did not lend its name to either. You can read the document for all the caveats. Neither document commented on treating ARDS patients with statins, which seemed very likely to have benefited some patients with hyperinflammatory ARDS in past trials.

Research 52

Research Documentation/Coding Fractures Outcomes 52

Dr. Smith's ECG Blog

JANUARY 20, 2024

Here you will sign up for the Queen of Hearts on the Telegram app: [link] Or, you can get the PM Cardio app with Queen of Hearts function through this QR code. When you register on the app, you need to say you are from a supported country in the EU. You will get 5 free reports. de Winter et al in N Engl J Med 359:2071-2073, 2008.

EKG/ECG 121

EKG/ECG Documentation/Coding Emergency Department Hospitals 121

PulmCCM

JANUARY 29, 2024

AHA Updates its Cardiac Arrest Guidelines In December 2023, the American Heart Association published a “focused update” to its landmark guidelines for the management of cardiac arrest. Read the document for all the details (it’s not long). PulmCCM is not affiliated with the American Heart Association.

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

EM Literature of Note

OCTOBER 9, 2024

Before even considering the results, there are multiple fundamental considerations taking this published exploration into the realm of curiosity rather than insightfulness: This communication was submitted in Oct 2023 – meaning the LLMs used, while modern at the time, are debatably becoming obsolete.

Radiology 86

Radiology Radiology Emergency Department Documentation/Coding 86

Mind The Bleep

OCTOBER 29, 2024

Provide detailed documentation of the initial assessment, treatment provided, and the patient’s response to interventions. Updated 2023 Jul 17]. Updated 2023 Jul 17]. Preparation for Transfer Ensure the patient is hemodynamically stable before transfer. Chemical Burns. In: StatPearls [Internet]. 1982 May;22(5):420-3.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52