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 77

Hospitals Research Wellness Patient Safety 77

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

Pediatric EM Morsels

APRIL 28, 2023

Has undergone many modifications as well to include up to 5 types. In general, non-operative treatment is reserved for Type I fractures and type II. The Athlete is at risk of both Osgood Schlatter’s disease as well as Tibial Tubercle Avulsion Fracture. Anterior knee pain is not always Osgood Schlatter’s.

Fractures 130

Fractures Pediatrics Operations Wellness 130

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., Accessed March 5, 2023.

Fractures 75

Fractures Dislocations Operations Radiology 75

RebelEM

APRIL 17, 2023

However, It is unclear how well POCUS performs in ruling in or ruling out the diagnosis of PTA. 2023 Jan 10. Question: How well does the US perform in diagnosing PTA compared to CT, needle aspiration, or Incision and Drainage? 2023 Feb 9;15(2):e34820. Article: Kim DJ et al. Acad Emerg Med. Epub ahead of print.

Ultrasounds 123

Ultrasounds Radiology Radiology Operations 123

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

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

EMDocs

AUGUST 12, 2023

He presented to the emergency department because he is having numbness distal to the site of injury, as well as constant bleeding and some difficulty with flexing his finger. Management consists of intravenous antibiotics , and hand surgery should be consulted to consider operative debridement.

EMS 69

EMS Fractures Operations Ultrasounds 69

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 2023 Apr 22]. Updated 2023 Mar 30]. Updated 2023, Apr 14].

Fractures 57

Fractures Dislocations Operations EMS 57

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 98

EKG/ECG Wellness Emergency Department Operations 98

PulmCCM

APRIL 1, 2024

That could (and should) change if improved functional outcomes, persisting for months after hospital discharge, are ever confirmed in large, well-conducted trials. Authors included 130 studies published 2015-2023, “to ensure that included studies were representative of current medical practices, including ultrasonography guidance.”

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

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. World J Emerg Surg 2023 PMID: 36918947 3. 2023 PMID: 37502742 11 Schwalbach KT et al. Healthcare.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

RebelEM

AUGUST 7, 2023

This helps relieve agitation/pain while maintaining spontaneous breathing and airway reflexes allowing for adequate pre-oxygenation as well as facilitates other resuscitation interventions including IV access, vasopressors, fluids, etc. Anesth Analg 2023. Anesth Analg 2023.

Head Injuries 98

Head Injuries Outcomes Airway Management Burns 98

ACEP Now

MARCH 14, 2024

These can be delayed, up to weeks later, so it’s important to educate patients on the importance of follow-up with burn care well-versed with electrical injuries or neurology if they have or develop these symptoms. In the operating room, there was minimal urinary output and the bladder pressures were 35 mmHg under sedation and analgesia.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Dr. Smith's ECG Blog

OCTOBER 16, 2023

With the good image, she got it with HIGH confidence. == MY Comment , by K EN G RAUER, MD ( 10/17 /2023 ): == QOH ( Q ueen O f H earts ) — is an amazing AI application. This last reflection was borne out in the October 13, 2023 post — in which Dr. Smith disagreed with the QOH prediction — and Dr. Smith's interpretation was correct.

EKG/ECG 60

EKG/ECG Operations Wellness 60

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. Paper: van Baarle FLF et al. Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia. N Engl J Med.

Ultrasounds 55

Ultrasounds Outcomes Wellness Research 55

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

ACEP Now

SEPTEMBER 5, 2024

Creation of an accurate database of emergency physicians living and working within a state, as well as a network of each states’ EM groups and ED medical directors would help chapter leaders disseminate relevant information, strengthen advocacy efforts, and plan regional solutions summits to focus on unique challenges.

Leadership 52

Leadership PPE EMS Wellness 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

Unfortunately, we do not have those images for review, but the operators described a ruptured LAD plaque and they stented this area, which ensures the stability of the plaque. The patient did well afterward without any recurrence of symptoms. Fortunately, that is exactly what happened. His echocardiogram showed normal wall motion.

EKG/ECG 122

EKG/ECG EMS Wellness Operations 122

RebelEM

JUNE 19, 2023

Demographics were well balanced in the two groups. We should expect TXA to help in immediate stabilization and allow trauma teams the time to intervene (whether that be continued resuscitation, interventional or operative procedures). The PATCH-trauma researchers sought to address this critique.

Outcomes 102

Outcomes Blood Transfusions Administration Hyperthermia / Hypothermia 102

EMDocs

SEPTEMBER 9, 2023

Accessed June 24, 2023. Accessed June 8, 2023. Accessed June 6, 2023. Accessed June 7, 2023. Results of primary extensor tendon repair in relation to the zone of injury and pre-operative outcome estimation. Accessed June 9, 2023. Accessed June 7, 2023. Tendon Lacerations. McGraw Hill; 2021.

EMS 78

EMS Fractures Soft Tissue Injuries Ultrasounds 78

ALiEM

OCTOBER 30, 2023

The same goes for clinical operations and research – interesting, but there hasn’t been any “a ha” moment to illuminate her calling. Well, instead of passively waiting for Godot, you can seize the initiative and bend the arc of your career into alignment with your values, strengths, and passions, and, by extension, toward fulfillment.

Academics 64

Academics Leadership Wellness Research 64

Pediatric EM Morsels

AUGUST 4, 2023

Oka, 2023) Female to male predominance with a ratio of 3:2. Oka, 2023) It has various other names but one is Cast Syndrome due to a slight increased risk with patients in hip spica casts. Oka, 2023) Always consider SMA syndrome in patients with eating disorders who present with nausea and bilious vomiting. Record, 2015).

Pediatrics 246

Pediatrics Burns Operations Ultrasounds 246

Don't Forget the Bubbles

MAY 24, 2023

Crouzon syndrome, Pierre-Robin sequence, Down syndrome, Beckwith-Wiedemann syndrome) I njuries to the face, mandible, pharynx, or neck S leeping issues such as snoring due to adenotonsillar hypertrophy It’s essential to have a well-planned approach to managing the difficult airway. cited 2023 Feb 19]. Why is it important? Br J Anaesth.

Airway Management 98

Airway Management Teamwork Pediatrics Emergency Department 98

Pediatric EM Morsels

NOVEMBER 3, 2023

This allowed US hospitals to stock the drug to ensure quick treatment of suspected severe cases, rather than having to ship it from the CDC under the prior expanded-access protocol (Thomas 2023). Both have a range of detection limits, which can be greatly dependent on operator.

Seizures 277

Seizures Pediatrics CDC Infectious Diseases 277

Don't Forget the Bubbles

MARCH 11, 2024

There are many causes, and it is less well understood than plagiocephaly. Craniosynostosis needs urgent referral and is usually corrected operatively before a child’s first birthday. Craniosynostosis Craniosynostosis is rare. It is due to the premature closure of the sutures rather than positional changes to an otherwise normal skull.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

Intensive Blog

AUGUST 17, 2023

Retrieved August 16, 2023, from [link] Arachchillage, D.J., The many causes of anaemia include: Decreased production Malnutrition Bone marrow suppression (e.g., Cannula site bleeding. J Cardiothorac Vasc Anesth. 2021 Apr;35(4):1192-1202. doi: 10.1053/j.jvca.2020.08.068. 2020.08.068. Epub 2020 Sep 10. PMID: 33046363.

Blood Transfusions 52

Blood Transfusions Operations Wellness 52

Dr. Smith's ECG Blog

AUGUST 30, 2023

link] == MY Comment , by K EN G RAUER, MD ( 8/16 /2023 ): == The 2 Key Questions regarding today’s presentation are the following: Question #1: Is the ECG in Figure-1 likely to represent an ongoing or recent OMI in need of prompt cath and PCI? It is not yet available, but this is your way to get on the list.

EKG/ECG 75

EKG/ECG Wellness Operations 75

Don't Forget the Bubbles

JANUARY 17, 2024

Point-of-care ultrasound may show well-demarcated, round, and hypoechoic material in the stomach and first part of the duodenum, though it can underestimate the number of beads present. They passed away a few days after a second operation. From Mullens et al., Unfortunately, the anastomosis broke down. It’s beads, too!

Pediatrics 111

Pediatrics Poisoning Ultrasounds Dehydration 111

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. What is happening in today's case is different.

EKG/ECG 252

EKG/ECG Administration Wellness Operations 252

Taming the SRU

MARCH 11, 2024

It is also important for the emergency physician to ask about previous surgeries on the affected knee, as well as anticoagulation status. She continues to do well post operatively with her rehabilitation program. He works in both the emergency department as well as the sports medicine clinic. An abnormal ABI (<0.9)

Dislocations 106

Dislocations Emergency Department Fractures Operations 106

ACEP Now

AUGUST 28, 2024

So far, they are communicating well. John’s emergency department, including about 43 doctors, nurse practitioners, and physician assistants not working as supervisors or residents, nearly unanimously voted to form a union in 2023. One, American Physician Partners closed entirely on July 31, 2023 (see ACEP Now , Sept.

Emergency Department 85

Emergency Department Hospitals Patient Safety Leadership 85

RebelEM

AUGUST 22, 2024

1,2 Intra-arterial (IA) tPA has also shown benefit but is less well studied. Moreover, there are multiple operational and patient-specific barriers rendering timely thrombolytic administration difficult. Patients whose last known well (LKW) time was within 24 hours of presentation. Paper: Lema GMC, De Leacy R, Fara MG, et al.

Stroke 80

Stroke Administration Outcomes Documentation/Coding 80

RebelEM

JULY 31, 2023

Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults [published online ahead of print, 2023 Jun 16]. Operators had performed a median of 50 previous tracheal intubations (Range 25 to 92) The median proportion of previous intubation operators performed with VL was 0.69. N Engl J Med. PMID: 37326325.

Operations 98

Operations Outcomes Emergency Department Airway Management 98

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

Regarding my Systematic assessment of ECG #1: There is significant baseline artifact , as well as baseline wander. There are many ways to estimate the QTc ( ie, I illustrate a user-friendly method I developed and have used for decades in the October 25, 2023 post). To determine the QTc — We need to correct this 450 msec.

Seizures 106

Seizures EKG/ECG EMS Documentation/Coding 106

EMDocs

JUNE 3, 2023

4 This is the framework the ED resuscitationist should be operating under, as hemodynamically unstable pelvic trauma patients require a different approach compared to stable patients who will undergo CT, routine pelvic fixation, and definitive surgical repair. Figure 5: Pelvic binding with a sheet.

Fractures 54

Fractures Resuscitation Operations EMS 54

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i]. Its use in the prehospital environment is not well known or studied and may be an interesting area for future research. [i] October 2023. [vi] i] Leibowitz A, Oren-Grinberg A, Matyal R.

Ultrasounds 98

Ultrasounds Shock Research Emergency Department 98