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

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

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 83

Ultrasounds Operations Research Outcomes 83

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 285

Pediatrics Airway Management Wellness Administration 285

Emergency Live

JANUARY 8, 2024

Structure and Sizes of Civil Protection Units in Key European Countries Introduction In 2023, the importance of civil protection forces, including firefighters, healthcare personnel, and ambulance operators, became increasingly evident in Europe.

Operations 52

Operations 52

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 240

Operations Outcomes 240

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.

Operations 82

Operations Diabetic Emergencies Hospitals Research 82

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

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

ACEP Now

JULY 7, 2024

2,3 In this case, aortic dissection was visualized neither on initial bedside nor on repeat inpatient TTE, despite operator knowledge of a known lesion and extensive operator training. Her orthopedic injury was managed non-operatively until her aortic repair could be performed. Published 2023 Apr 17. Click to enlarge.)

Operations 59

Operations Hospitals Administration Outcomes 59

Broome Docs

APRIL 30, 2024

2023 Feb 8:S0735-6757(23)00066-9. 2023 Mar 6;5(3):e0855. Video Laryngoscopy vs Direct Laryngoscopy for Endotracheal Intubation in the Operating Room: A Cluster Randomized Clinical Trial. 2023 Aug 17;389(7):e12. Epub 2023 Aug 12. J Trauma Acute Care Surg. 2022 Aug 1;93(2):157-165. doi: 10.1097/TA.0000000000003554.

Poisoning 70

Poisoning Dislocations Operations Ultrasounds 70

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.

Pediatrics 169

Pediatrics Ultrasounds Operations Hospitals 169

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., Accessed March 5, 2023. Updated 2023 Apr 22]. A comparison between pre-operative ultrasonography and surgical findings. 9(1):31-36.

Fractures 72

Fractures Dislocations Operations Radiology 72

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 57

Dislocations Stroke Operations 57

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 Research 114

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 80

EMS Dehydration Operations Hospitals 80

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 67

Operations Radiology Radiology Fluid Resuscitation 67

JournalFeed

APRIL 15, 2023

The JournalFeed podcast for the week of April 10-14, 2023. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Academics 52

Academics Pediatrics Administration Operations 52

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 152

Soft Tissue Injuries Dehydration Fractures Operations 152

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 76

Hospitals Research Wellness Patient Safety 76

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 242

Research Academics Operations Hospitals 242

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 123

Ultrasounds Radiology Radiology Operations 123

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 91

Resuscitation Patient Safety Operations Emergency Department 91

Taming the SRU

MAY 23, 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 2023 Apr 22]. Updated 2023 Mar 30]. Updated 2023, Apr 14]. Updated 2023 Feb 3]. PMID: 24971221; PMCID: PMC4071746.

Fractures 55

Fractures Dislocations Operations EMS 55

ACEP Now

APRIL 5, 2024

There was no analysis of operator experience or expertise. As with any procedural device, operator expertise is an important component of its successful use. 2023: online ahead of print. Published December 19, 2023. Some important limitations of this analysis should be recognized. Anaesthesia. Accessed March 26, 2024.

Airway Management 73

Airway Management Operations Emergency Department Research 73

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 69

EMS Fractures Operations Ultrasounds 69

ACEP Now

JUNE 14, 2024

Two years ago, an ACEP Now article covered the issue of transfer challenges resulting from early pandemic operations. 1 As fresh challenges of the pandemic and hospital operations changed emergency medicine practice, one of the more challenging areas was the movement of admitted patients out of the first emergency department (ED).

Emergency Department 52

Emergency Department Hospitals Operations Leadership 52

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. Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. Executive Summary of ED Operations in 2022 Volume was up from 2021.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

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 130

Blood Transfusions Operations Pediatrics Hospitals 130

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 258

Ultrasounds Pediatrics Operations EMS 258

Mind The Bleep

JUNE 21, 2024

This will not be an issue if oil is used, though this will require another operation to be removed and gain full visual potential. Laser/cryotherapy is applied to seal the break intra-operatively. Note: vitrectomy is associated with a very rapid post-operative progression/development of a cataract which will then necessitate surgery.

Operations 52

Operations Emergency Department Ultrasounds 52

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

American Medical Compliance

AUGUST 10, 2023

It is of the upmost priority for Prospect Medical Holdings to not only resolve this investigation, but also address patient concerns regarding information security and modify operations so this does not occur in the future. The FBI has also announced a separate investigation into the cybersecurity incident.

Hospitals 52

Hospitals Ambulance Services Administration Operations 52

ALiEM

NOVEMBER 27, 2023

One case report published in 1993 used RUQ abdominal ultrasound to identify septations (violin-string adhesions) and ascites to ultimately diagnose FHCS, later confirmed by serologic and operative evidence [2]. Eur J Obstet Gynecol Reprod Biol. 1993 Jul;50(2):159-62. doi: 10.1016/0028-2243(93)90181-b. PMID: 8405645.

Ultrasounds 64

Ultrasounds Academics Operations OB/GYN 64

EMDocs

SEPTEMBER 7, 2024

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 58

EMS Fluid Resuscitation Resuscitation Radiology 58

ACEP Now

DECEMBER 11, 2023

In 2023, ED volumes are approaching those seen pre-pandemic at 66 percent. Patients who require inpatient boarding remain a significant challenge to ed operations. Published August 1, 2023. Accessed November 29, 2023. Accessed November 29, 2023. These numbers have been trending higher and 2022 was no exception.

Emergency Department 52

Emergency Department Hospitals EMS Operations 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. 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