EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? 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.

Documentation/Coding 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

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

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 119

EKG/ECG Documentation/Coding Emergency Department Outcomes 119

ACEP Now

JUNE 7, 2023

ED leaders worked to develop new physician documentation and coding guidelines that needed to be implemented at the beginning of 2023. The preliminary results of the 2022 Emergency Department Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

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. Ponmani C, Nijman RG, Roland D, Barrett M, Hulse T, Whittle V, Lyttle MD on behalf of PERUKI.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. Accessed October 10, 2023. J Emerg Nurs. 2023;(3):415-424.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

ACEP Now

NOVEMBER 7, 2024

Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. Boarding of mentally ill patients in emergency departments: American Psychiatric Association resource document. West J Emerg Med. Pediatrics.

Psychiatric 59

Psychiatric Pediatrics Hospitals Emergency Department 59

PEMBlog

MARCH 4, 2025

Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEMCurrents, the Pediatric Emergency Medicine Podcast. As always, I’m your host, Brad Sobolewski, and today we’re focusing on a pathogen that has been making waves in pediatric emergency departments across the country.

Pediatrics 94

Pediatrics Military CDC Hospitals 94

ACEP Now

AUGUST 1, 2023

How does that apply to the role of the board certified emergency physician? Fundamentally, I believe every patient coming to an emergency department is best served by care delivered by board certified emergency physicians. When those same fundamentals done right achieve great success, they aren’t little at all.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

ACEP Now

MAY 5, 2023

What is your role as the emergency physician? Introduction Law enforcement officers frequently accompany emergency department (ED) trauma patients or patients who are under arrest or require assistance. Law enforcement gathering in the emergency department: Legal and ethical background and practical approaches.

Emergency Department 52

Emergency Department Documentation/Coding 52

ACEP Now

OCTOBER 26, 2023

Using Maryland state law as a guide, the American College of Emergency Physicians (ACEP) and the Emergency Department Practice Management Association (EDPMA) lobbied for passage of federal protections beginning in the mid-1990s. There were multiple interpretative letters issued by the HCFA (now CMS) to interpret BBA ’97.

Documentation/Coding 124

Documentation/Coding Hospitals Emergency Department Administration 124

ACEP Now

AUGUST 1, 2023

In late June, ACEP organized a congressional briefing with the Emergency Nurses Association (ENA) and the National Alliance on Mental Illness (NAMI) to express strong concerns to legislators about the impact of emergency department boarding on our health care safety net. Read more at acep.org/boarding-briefing.

Documentation/Coding 52

Documentation/Coding Emergency Department Emergency Nursing Research 52

EM Literature of Note

OCTOBER 9, 2024

This exploration of LLMs in the emergency department is a bit unique in its conceptualization. emergency departments are general cesspools of aggressive empiric antibiotic coverage, driven by CMS regulations – so it may in fact be the LLM displaying astute clinical judgement, here. For what its worth, of course, U.S.

Radiology 86

Radiology Radiology Emergency Department Documentation/Coding 86

PEMBlog

JUNE 14, 2023

Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. Alice Kuo and Ilene Claudius Podcast EIIC: Safe Control of the Agitated Patient Webinar Series with Dr. Zima; Follow-up After Pediatric Mental Health Emergency Visits. West J Emerg Med.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

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

ACEP Now

MARCH 9, 2025

As hospital boarding, increased emergency department (ED) volumes, and complexity of patients have increased, so have wait times. Some physicians now coin themselves waiting room medicine specialists as departments schedule a physician in triage or attempt to evaluate patients in whatever spaces might be available. J Emerg Med.

Emergency Department 90

Emergency Department Point-of-Care Testing Documentation/Coding Hospitals 90

EMDocs

SEPTEMBER 30, 2024

Inhaled Corticosteroids Rarely Prescribed at Emergency Department Discharge Despite Low Rates of Follow-Up Care. J Emerg Med. 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).

Outcomes 105

Outcomes Academics Documentation/Coding Emergency Department 105

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. I refer to My Comment in the March 4, 2023 post — in which I included a Table with ECG Findings of Acute PE.

EKG/ECG 139

EKG/ECG Emergency Department Shock Ultrasounds 139

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. But only 6.4% of such ‘high risk Non-STEMI’ patients get angiography within 2 hours.[2] Take away 1.

EKG/ECG 121

EKG/ECG Documentation/Coding Fractures Emergency Department 121

EMDocs

JUNE 9, 2023

We’re defining “protocol” here as a written document that provides oversight from the medical director about how to assess and treat patients. Reassessment and Documentation After any type of restraint is instituted, careful assessment, re-assessment, and documentation is required. Was the documentation complete?

EMS 98

EMS Documentation/Coding Pediatrics Psychiatric 98

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 74

Pediatrics Emergency Department Research Burns 74

PEMBlog

OCTOBER 18, 2024

Duchenne Muscular Dystrophy (DMD) is a complex and progressive disease requiring highly specialized care, especially in emergency situations. When patients with DMD present in the Emergency Department (ED), an understanding of the nuanced aspects of their care is essential for optimal management. Updated 2023 Jul 10].

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 52

EMDocs

JUNE 2, 2023

Document what you gave and why, as well as the impact. Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry. 2023 Mar 21:S1876-2859(23)00091-8. PMID: 30881565; PMCID: PMC6404720.

Psychiatric 93

Psychiatric Pediatrics Emergency Department Administration 93

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

Dr. Smith's ECG Blog

JANUARY 20, 2024

Written by Pendell Meyers A man in his late 30s with history of hypertension, tobacco use, and obesity presented to the Emergency Department for acute chest pain which started approximately 3 hours prior to arrival, in the setting of a very stressful situation. The pain radiated down both arms, 10/10 in severity.

EKG/ECG 121

EKG/ECG Documentation/Coding Emergency Department Hospitals 121

EB Medicine

JANUARY 3, 2023

2) 2023 E/M coding guidelines are in effect. 2) 2023 E/M coding guidelines are in effect. Announcements: 1) The interactive Clinical Pathways have launched and they are available for free!

Shock 52

Shock Pediatrics Airway Management Sepsis 52

PulmCCM

JUNE 12, 2023

Temperature management (or fever avoidance) should begin immediately after cardiac arrest (ideally in the emergency department, for out-of-hospital arrests) and continued for at least 72 hours. Read in Nature Don’t forget to register for the Hospitalist and Resuscitationist 2023 conference Sepetmber 27-30 in Montreal.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

EMDocs

MAY 26, 2023

Emerg Med Clin North Am. Structured team approach to the agitated patient in the emergency department. Emerg Med Australas. Use and avoidance of seclusion and restraint: consensus statement of the american association for emergency psychiatry project Beta seclusion and restraint workgroup. doi: 10.1016/j.emc.2009.07.003.

Pediatrics 98

Pediatrics Emergency Department Psychiatric Documentation/Coding 98

Taming the SRU

NOVEMBER 14, 2023

Chief complaints involving the ear are a common occurrence in Emergency Departments across the US and include presenting symptoms such as ear pain or fullness, hearing loss, redness, trauma, vertigo, and foreign bodies. A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

ALiEM

JANUARY 22, 2024

A 40-year-old male, tailor by occupation, was brought to the Emergency Department with complaints of high-grade fever for the past 11 days. Fever was documented to be 102°F and was not associated with any chills or rigors. Epub 2011 Sep 12. PMID: 21911554; PMCID: PMC3193135.

Academics 64

Academics Documentation/Coding Emergency Department Hospitals 64

Don't Forget the Bubbles

OCTOBER 10, 2024

2023 Mar 30;110(4):432-438. Exploring communication preferences and risk thresholds of clinicians and parents of febrile infants under 90 days presenting to the emergency department: a qualitative study. 2024 Jul 10:archdischild-2023-326727. doi: 10.1136/archdischild-2023-326727. Arch Dis Child. Arch Dis Child.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

Ultrasounds 96

Ultrasounds Documentation/Coding Wellness EMS 96

RebelEM

JULY 3, 2023

Impact of intravenous calcium with diltiazem for atrial fibrillation/flutter in the emergency department. Am J Emerg Med. What They Did: Researchers conducted a multicenter, retrospective cohort study in three community hospitals and two freestanding emergency departments. Article: Rossi N et al.

Administration 98

Administration Outcomes Documentation/Coding Emergency Department 98

Dr. Smith's ECG Blog

SEPTEMBER 5, 2023

(including Pendell and Smith) just published this article: Emergency department Code STEMI patients with initial ECG labeled ‘normal’ by computer interpretation: a 7-year retrospective review Among 394 True positive cath lab activations, 16 (4.1%) had computer "normal" ECGs. == MY Comment , by K EN G RAUER, MD ( 9/5 /2023 ): == When I first saw today’s (..)

EKG/ECG 98

EKG/ECG Documentation/Coding Emergency Department 98

ACEP Now

NOVEMBER 7, 2023

3 These regulations have led to widespread practices of EHI, such as test results and clinical documentation, being shared with patients in real time. In turn, concerns have arisen regarding when information blocking is appropriate and what ethical issues emergency department (ED) physicians must consider prior to information blocking.

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

ALiEM

MARCH 11, 2024

In July 2022, a 32-year-old male with a past medical history of HIV (on antiretroviral therapy, CD4 390, viral load undetectable) presented to the emergency department with constitutional symptoms and a rash for 4-5 days. There is limited literature documenting eye involvement and pictographic examples of its presentation.

Academics 56

Academics Documentation/Coding Emergency Department Hospitals 56

The Skeptics' Guide to EM

MARCH 31, 2023

Date: March 28, 2023 Reference: Fowler et al. Objective assessment of sleep and fatigue risk in emergency medicine physicians. You find her at […] The post SGEM#399: I’m So Tired – Emergency Medicine and Fatigue first appeared on The Skeptics Guide to Emergency Medicine. Date: March 28, 2023 Reference: Fowler et al.

Academics 52

Academics Documentation/Coding Emergency Department Outcomes 52