ACEP Now

NOVEMBER 7, 2023

Expand Your Knowledge of the Business of EM Practice Essentials, an online, asynchronous curriculum developed by ACEP and EMRA, dives into reimbursement, contracts, operations and risk management, and other topics that may not have been covered in depth during medical school or residency. Learn more at openbook.acep.org.

Leadership 98

Leadership Administration Research Risk Management 98

Pediatric EM Morsels

JULY 19, 2024

4-17% will rebleed No difference in rebleed rate between those that are treated operatively and those that are observed On average, the second bleed occurs 3-4 days after the first bleed Some bleeds are considered “ delayed post-tonsillectomy hemorrhage ” and can occur over 14 days after tonsillectomy. 2023 Aug;171:111644. 2023.111644.

Pediatrics 290

Pediatrics Airway Management Wellness Operations 290

The Trauma Pro

DECEMBER 22, 2023

Rapid placement of some kind of marker on all wounds followed by a quick image allows them to roughly predict what was hit, and assess the possibility that there might be bleeding that would drive the team straight to the operating room. 1485, Dec 2023. So yes, this is dogma.

Operations 264

Operations Outcomes 264

Don't Forget the Bubbles

MAY 17, 2023

2023 Apr 17. 2023 Apr 25;329(16):1386-1398. 2023 Apr 29. 2023 Apr 24. 2023 Apr 12. Post-operative pain in children: Comparison of pain scores between parents and children. 2023 Apr 28. 2023 Apr 25. 2023 Apr 25. 2023 Apr 25. 2023 Apr 24. 2023 Apr 18:S0890-8567(23)00185-5.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

ALiEM

OCTOBER 30, 2024

Your patient ultimately is diagnosed with a spinal epidural abscess requiring operative care. 2023 Jan 1;53(1):140-2. 2022; 06/26/2023. 2023 Jun 1;36:89-91. This month in JAAD Case Reports: August 2023: Xylazine and skin necrosis. 2023 Aug 1;89(2):231. 2023 [book]. 2023 Jun 1;36:113-5.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

Pediatric EM Morsels

JUNE 30, 2023

I know we already know this, but it especially true when you are talking about trying to obtain images on a wiggling fetus somewhere around the size of a banana.

Ultrasounds 284

Ultrasounds Pediatrics Operations EMS 284

Emergency Live

SEPTEMBER 28, 2023

FROG.PRO presents its RESCUE line: innovation and quality for emergencies In a world where unpredictable events require fast and efficient solutions, FROG.PRO, with a decade of experience in the field of military operations, lands at REAS 2023.

Military 59

Military Operations 59

Emergency Live

MAY 30, 2024

How Case Studies Can Improve Rescue Operations Some successfully handled incident case studies can serve as excellent foundations for better preparing future rescues and organizing updates and new guidelines for rescuers. Let’s analyze some.

Operations 97

Operations 97

Emergency Live

SEPTEMBER 28, 2023

Sinora Srl takes the field at the 2023 edition of REAS with the latest mission- and business-critical technology at the service of industry operators The 22nd International Emergency Exhibition is just around the corner.

Operations 105

Operations 105

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

Pediatric EM Morsels

NOVEMBER 17, 2023

2023 Apr 28;24(3):579-587. 0.41), p < 0.001. Paediatr Anaesth. 2018 Mar;28(3):210-217. doi: 10.1111/pan.13340. PMID: 29436138. Kim JH, Ahn JH, Chae YJ. Pediatric Application of Cuffed Endotracheal Tube. West J Emerg Med. doi: 10.5811/westjem.59560. PMID: 37278787; PMCID: PMC10284523. Shah A, Carlisle JB. Anaesthesia. doi: 10.1111/anae.14787.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

Date: August 30, 2023 Reference: Griffey et al. The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta. Date: August 30, 2023 Reference: Griffey et al. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta.

Diabetic Emergencies 110

Diabetic Emergencies Operations Hospitals Research 110

The Trauma Pro

JUNE 13, 2023

And even if you firmly believe you can’t be swayed, you can’t change the basic operating system in your brain. 0000000000004024, 2023. Believe it or not, these little things can change your attitude regarding their product. Your behavior will change. What if the gift is not so small? What about a research grant?

Research 189

Research Academics Operations Hospitals 189

Total Medical ComplianceHIPAA

NOVEMBER 13, 2023

They are: Health IT developers of certified health IT Entities offering certified health IT Health information exchanges Health information networks These penalties began on September 1, 2023, and OIG will not be imposing penalties for any blocking conduct that happened prior to that date. Supply appropriate personal monitoring (e.g.,

Operations 52

Operations 52

Pediatric EM Morsels

MARCH 1, 2024

Chest CT Demonstrates parenchymal disease better Allows for operative planning (if needed) Lung Abscess in Children: Management Rarity of the condition affects what is known (no randomized control trials on therapeutic options). Patients with immunocompromised conditions are at risk of Fungal infections.

Ultrasounds 173

Ultrasounds Pediatrics Operations Hospitals 173

Pediatric EM Morsels

JUNE 16, 2023

Available at: [link] (Accessed: 12 June 2023). Available at: [link] (Accessed: 12 June 2023). Shen 2013, Nickerson 2014, Scolaro 2016 ] Singh et al proposed an algorithm to guide treatment. Arch Gen Med. 1863;1:20-38, 172-200, 300-332 Sharareh, B. and Taylor, B. 2021) Morel-Lavallee lesion , Orthobullets.

Soft Tissue Injuries 154

Soft Tissue Injuries Dehydration Fractures Operations 154

RebelEM

APRIL 17, 2023

2023 Jan 10. Furthermore, another small retrospective study found that approximately 30% of patients with CT-diagnosed PTA lacked purulence on drainage attempts (Eliason 2023). While operator dependent, the dynamic ability of POCUS augments bedside diagnosis and can assist with drainage. 2023 Feb 9;15(2):e34820.

Ultrasounds 129

Ultrasounds Radiology Radiology Operations 129

ACEP Now

JUNE 21, 2023

For example, applicant interest in EM significantly declined after the EM workforce report was published resulting in a final count of 132 unfilled programs in 2023. Therefore, applicant, funding, and operational factors may influence programs to offer a particular curriculum length. Advanced Data Tables 2023 Main Residency Match.

EMS 114

EMS Academics Telemedicine Operations 114

Taming the SRU

SEPTEMBER 22, 2023

389, 418–429 (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 105

Operations Outcomes Emergency Department Academics 105

RebelEM

OCTOBER 2, 2023

The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. Acad Emerg Med 2023. No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 Acad Emerg Med 2023. Paper: Griffey RT et al. tests/hr (0.8 Traditional: 1.0

Operations 104

Operations Academics Fluid Resuscitation Outcomes 104

PulmCCM

APRIL 18, 2024

The real world success rates by operators experienced with intubation remained unknown. That uncertainty has been largely dispelled by large randomized trials in 2023 and 2024 confirming that video laryngoscopy is a superior method for obtaining first pass intubation success for patients with average risk airways.

Airway Management 98

Airway Management Operations EMS Research 98

EMDocs

NOVEMBER 1, 2023

Accessed September 30, 2023. Accessed September 30, 2023. Accessed October 1, 2023. Answer : Esophageal Perforation 1-6 Epidemiology : Most frequent etiology is iatrogenic injury from instrumentation accounting for 60% of cases (e.g. upper endoscopy, transesophageal echo, etc.). McGraw-Hill Education; 2014. Am J Emerg Med.

Operations 93

Operations Radiology Radiology Fluid Resuscitation 93

The Skeptics' Guide to EM

JUNE 15, 2024

2023 Date: June 10, 2024 Guest Skeptic: Dr. Rob Leeper is an intensivist, trauma surgeon, and general surgeon at Western University where he also serves as the director of the Royal College Surgical Foundations program. These approaches hold the possibility of enhancing our ability to save patient’s lives.

Resuscitation 120

Resuscitation Patient Safety Operations Emergency Department 120

EMDocs

MAY 25, 2024

Ferri’s clinical advisor 2023. 01/01/2023:1391-1392.e1. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Accessed June 22, 2023. Treasure Island (FL): StatPearls Publishing; September 26, 2022. Insalaco LF. Sialadenitis. doi: 10.1016/B978-0-323-75573-3.00837-4. Adhikari R, Soni A. Updated 2022 Aug 8].

EMS 98

EMS Dehydration Operations Hospitals 98

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. Date: January 9, 2025 Reference: White et al. Evidence of questionable research practices in clinical prediction models.

Research 49

Research EMS Documentation/Coding Operations 49

EMDocs

AUGUST 12, 2023

Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement. Accessed June 24, 2023. Treasure Island (FL): StatPearls Publishing; February 5, 2023. Accessed June 10, 2023. Accessed June 4, 2023. There are no extensor tendon sheaths (A) in the hand.

EMS 95

EMS Fractures Operations Ultrasounds 95

EMDocs

FEBRUARY 7, 2024

Despite a plateau in overall union membership of around 10% in 2023 1 , major labor actions shook the U.S. 3 Increasing Strikes and Unions Labor actions in healthcare can disrupt normal hospital operations, potentially impacting costs and threatening patient quality of care. October 16, 2023. 2023 October 9.

Hospitals 98

Hospitals Research Patient Safety Wellness 98

EMDocs

MAY 27, 2023

81,4 (2023): 453-465. 2023 Feb 8;S0140-6736(22)02600-9. Source The SQuID Protocol (Subcutaneous Insulin in Diabetic Ketoacidosis): Impacts on ED Operational Metrics. 2023 Feb 12. FARES also had the most favorable score for pain during reduction. Annals of emergency medicine vol. doi:10.1016/j.annemergmed.2022.10.020

Dislocations 74

Dislocations Stroke Operations 74

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

Pediatric EM Morsels

APRIL 28, 2023

In general, non-operative treatment is reserved for Type I fractures and type II. Non-operative management is appropriate if extensor mechanism is intact and the avulsed fragment is displaced less than 2 mm or able to be reduced (hyperextension at the knee) to an acceptable degree of displacement.

Fractures 130

Fractures Pediatrics Operations Wellness 130

ACEP Now

MARCH 6, 2024

The Sisyphean task remains to try to keep up—and, in that vein—here is a light round of the emergency medicine literature from 2023. 7 The operators involved in the trial were mostly emergency medicine residents or critical care fellows, but this fact does not diminish the generalizability of these observations. All bleeding stops.

Research 52

Research Airway Management Stroke Outcomes 52

PulmCCM

SEPTEMBER 4, 2024

OP is operating point, the operating point defines the cardiac output on the y-axis and Pra on the x-axis; Rcardiac is cardiac resistance (i.e., OP1 is operating point 1 at baseline. With tamponade, operating point 2 (OP2) is formed. Pmsa and Pra do not correlate (inset, upper right). cardiac function).

Ultrasounds 84

Ultrasounds Operations Research Outcomes 84

Sensible Medicine

OCTOBER 16, 2024

Today she returns to a topic that she wrote about in January 2023 , changing our organ donation laws to increase organ availability. Satel is a bit of a regular here on Sensible Medicine. Adam Cifu Sensible Medicine is a reader-supported publication. If you support our work, consider becoming a free or paid subscriber.

Operations 128

Operations Research 128

The Trauma Pro

MAY 26, 2023

Possible interventions were none, operation, angioembolization, or blood transfusion. J Trauma Nurs 30(3), 135–141, 2023. The retrospectively reviewed patients with liver or spleen injury over five years. They examined how often serial hemoglobin determinations influenced management during the study period.

Blood Transfusions 100

Blood Transfusions Operations Pediatrics Hospitals 100

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 248

EKG/ECG Administration Operations Wellness 248

RebelEM

MAY 27, 2024

mg/kg) or starting at 12 mg might be more effective for certain populations (Deck 2023, Cabalag 2010). Published 2023 Mar 10. Evidence suggests that a weight-based dosing approach (0.1 Additionally, robust evidence supports using calcium channel blockers, which may have a more favorable side effect profile (Holdgate 2006).

Outcomes 137

Outcomes Research Operations Hospitals 137

ACEP Now

SEPTEMBER 3, 2024

6,17-18 In a 2023 systematic review, no studies showed decreased costs to patients or payors, and the effect of PE ownership on quality of care measures was “mixed to harmful,” a pattern that has continued in subsequent studies. While secrecy surrounds the operations of many PE-owned groups, Envision serves as a case study.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113