Sensible Medicine

FEBRUARY 16, 2024

Bill had coded and died overnight. A nurse had a needlestick during the code. ” David Rind is an academic primary care physician at Beth Israel Deaconess Medical Center and Chief Medical Officer of the Institute for Clinical and Economic Review.

Documentation/Coding 108

Documentation/Coding Academics Shock Research 108

PulmCCM

JUNE 12, 2023

Read in JAMA In The News Journal editors walk off the job: Forty leading scientists—the entire academic board of the journal NeuroImage —resigned to protest publisher Elsevier’s practice of charging academic authors over $3300 per paper to publish in the prestigious journal.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

Dr. Smith's ECG Blog

JUNE 13, 2024

Her first set of vitals were documented: BP 116/57 Pulse 94bpm Respiratory rate 24/min O2 sat 90% on room air Temp 97F She had been cleaning a Jeep in the sun, and was sunburned. The physician documented “normal sinus rhythm”. The physician documented that she was “improved” and the patient was discharged.

EKG/ECG 89

EKG/ECG Documentation/Coding EMS Burns 89

Stop and Think

JULY 17, 2024

Reading only the guidelines is not enough, because guideline documents are merely one group’s take of the seminal trials. We enlisted the help of Mohammed Ruzieh, a trainee of Foy, and now an academic cardiologist at the University of Florida.

Wellness 74

Wellness Documentation/Coding Academics 74

RCEM Learning

MAY 20, 2022

Author: Rick Body / Editor: Govind Oliver / Code: / Published: 06/02/2020 In 2017 the National Institute for Health Research (NIHR) published its Training Review. The NIHR Incubator for EC will support academic training within the field of EC, under the governance and direction of the NIHR Academy. What are NIHR Incubators?

Documentation/Coding 52

Documentation/Coding Academics Research Hospitals 52

Sensible Medicine

FEBRUARY 6, 2024

First, their qualifications are spectacular: academic accolades, research, publications, clinical medicine experiences prior to residency, even real-life professional experiences. Two things are clear about the internal medicine residents I get to work with. Require applicants to do tasks that predict whether they will succeed.

Military 102

Military Documentation/Coding Free Clinics Academics 102

PulmCCM

APRIL 29, 2024

ICUs, and a popular research focus for academics, generating a steady stream of papers. And maybe, noticing all the fuss, some clinicians might have started coding for VAP slightly less often in equivocal cases. You don’t hear much about ventilator-associated pneumonia (VAP) anymore. It used to be highly prevalent in U.S.

Documentation/Coding 52

Documentation/Coding Academics Administration Research 52

ALiEM

JANUARY 26, 2024

Ciprofloxacin has been documented as a cause of IgA vasculitis. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. Case Question: What are common triggers for this diagnosis? Dermatol Ther.

Documentation/Coding 73

Documentation/Coding Academics EMS Hospitals 73

PulmCCM

JANUARY 15, 2025

That task—requiring simultaneous measurements of oxygen saturation from pulse oximetry and arterial blood gases in hundreds or thousands of patients—will likely fall to academic clinicians, who were the first to identify and report the potential scale of the problem. Draft Guidance Document Wong et al. January 2025.

Documentation/Coding 81

Documentation/Coding Academics Administration Research 81

The Skeptics' Guide to EM

MAY 11, 2019

His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation. His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation.

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

ALiEM

JANUARY 22, 2024

Fever was documented to be 102°F and was not associated with any chills or rigors. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. Eschar: a clue to scrub typhus. 2011 Oct 18;183(15):E1152.

Documentation/Coding 64

Documentation/Coding Academics Emergency Department Hospitals 64

Medagadget

JUNE 12, 2023

Scott Jung, Medgadget: Can you share a little bit about your background and how you ended up writing about the body’s electric code? I began to read academic papers I had never heard of, about electrical signalling in development and wound healing – not in niche publications but places like Nature.

Research 78

Research Academics Documentation/Coding Poisoning 78

EMDocs

SEPTEMBER 30, 2024

5 urban academic EDs, attending charts. Among patients with a primary provider documented in the chart, 30-day outpatient follow-up rate was 21.3% (n = 313). Clinical question: In adult patients with asthma discharged from the ED, what are prescription rates for ICS? 4000 visits amount 3000 patients.

Outcomes 83

Outcomes Documentation/Coding Academics Administration 83

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 77

EMS Documentation/Coding Pediatrics Psychiatric 77

Taming the SRU

AUGUST 4, 2024

Know your audience, and tailor your presentation to them in terms of humor, pop culture references, and dress code Err on the side of making your presentation slightly shorter than the alloted time to allow room for questions. It is better to finish early than rushing through your presentation

Dislocations 84

Dislocations Emergency Department Documentation/Coding Burns 84

The Injectable Orange

APRIL 4, 2017

Quite simply, document your intended personal learning objective; identify a high quality resource that addresses this (article, workshop, conference); document a reflection on your achieved personal learning outcome. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine , 21 (10), 1069–1082.

Emergency Department 52

Emergency Department Evidence-Based Practice Documentation/Coding Academics 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. Academic Emergency Medicine. Commercial payers aggressively abused the No Surprises Act as a method to delay, downcode, and deny payment for emergency services. Maame Y, et al. 2020;27:600–611.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

ACEP Now

JULY 7, 2024

My current practice is a hybrid of academic and community sites, and I have worked in myriad community hospitals from busy ones to single coverage critical access hospitals. Sometimes there is a risk management staff member on call to support you in navigating challenging outcomes, including your immediate documentation.

Resuscitation 98

Resuscitation Risk Management Hospitals Critical Access 98

ALiEM

JANUARY 10, 2025

Other documented pharmacological causes of anisocoria include nebulized ipratropium bromide and scopolamine (14-19). Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. 1990;70(5):569-570.

Pediatrics 64

Pediatrics Documentation/Coding Academics Administration 64

SheMD

JULY 27, 2023

Unequal distribution of domestic responsibility has been documented as a factor in the underrepresentation in female physicians in leadership roles in academic medicine as well as contributing to career satisfaction. How does this apply to us?

Academics 52

Academics Leadership Documentation/Coding Research 52

The Skeptics' Guide to EM

NOVEMBER 21, 2020

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. The American College of Emergency Physicians ( ACEP ) has a number of documents discussing APPs in the ED. Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia.

Emergency Department 52

Emergency Department Telemedicine Academics Outcomes 52

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. Training opportunities for documentation best practices should be employed. Code of federal regulations eCFR website. substance use disorder” rather than “drug addict”).

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

RebelEM

JUNE 8, 2023

PMID: 36108346 Clinical Question: What is the efficacy and safety of peripherally administered push dose pressors for the treatment of acute hypotension?

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Sensible Medicine

MAY 25, 2023

“The Centers for Medicare and Medicaid Services should make establishing payment codes for products involving women’s heart disease a priority to prompt private insurers to cover new service lines.” The authors continued, “Calcium deposits in breast arteries can indicate a problem.”

Documentation/Coding 57

Documentation/Coding Academics Wellness 57

The Skeptics' Guide to EM

MARCH 31, 2023

You find her at the desk, asleep with her face on the keyboard, patient documentation half finished. AEM March 2023 * Population: A convenience sample of emergency physicians from a single academic emergency department. As she tries to wipe the drool out of the keyboard, you ask how she has been sleeping recently.

Academics 52

Academics Documentation/Coding Emergency Department Outcomes 52

ALiEM

MARCH 11, 2024

There is limited literature documenting eye involvement and pictographic examples of its presentation. Copyright Images and cases from the Society of Academic Emergency Medicine (SAEM) Clinical Images Exhibit at the 2023 SAEM Annual Meeting | Copyrighted by SAEM 2023 – all rights reserved. ” N Engl J Med. Epub 2022 Jul 21.

Documentation/Coding 56

Documentation/Coding Academics Emergency Department Hospitals 56

Sensible Medicine

JULY 24, 2023

But there had been two placebo-controlled drug trials that documented a 45-55 second increase in exercise time. In one of the most candid and entertaining pieces of academic writing that I have read, two ORBITA authors swatted these concerns away—often with good doses of British ridicule. This, too, was brilliant thinking.

Documentation/Coding 82

Documentation/Coding Academics Ultrasounds Wellness 82

Sensible Medicine

AUGUST 21, 2023

On yesterday’s podcast , I talked with Bobby Yeh, an academic cardiologist who made a compelling case for enhancing credibility of observational research. Please do listen. Bobby is one of the smartest people in cardiology today.

Administration 76

Administration Outcomes Research COPD 76

Dr. Smith's ECG Blog

AUGUST 26, 2009

Published in Academic Emergency Medicine, vol. Methods : We searched the catheterization laboratory database for all cases coded as acute Inferior STEMI from January 2002 through March 2008. Also, remember the value of lead aVL: see this post. And this one Click here for a great case of developing inferior MI with hyperacute T-waves.

EKG/ECG 52

EKG/ECG Documentation/Coding Research Academics 52

PEMBlog

MAY 11, 2023

These were used by two independent reviewers to determine Neonatal Facial Coding System with pain scores. Acad Emerg Med, 2017 This was a single-center (one academic Pediatric Emergency Department) randomized double-blind trial of J-Tip versus EMLA – topical anesthetic (TA) cream for pain relief in 66 infant LPs.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department Outcomes 52

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Definitive diagnosis that ECG #1 is in fact VT is more than academic. As I discussed and documented in Lesson 1 of My Comment at the bottom of the page in the April 2, 2022 post of Dr. Smith's ECG Blog — certain patients may remain in sustained VT not only for hours — but even for days!

EKG/ECG 134

EKG/ECG Shock Documentation/Coding Academics 134

Don't Forget the Bubbles

MAY 6, 2024

of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) The study included academic NICUs, which may reduce the generalisability of the results. Data collected were the worst values documented within the same calendar day as the blood cultures were obtained. Of the 74.9%

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

PulmCCM

JANUARY 6, 2025

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. This led the authors to speculate that qSOFA parameters were being documented more diligently on the wards randomized to screening.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

Northwestern EM Blog

SEPTEMBER 26, 2022

It is well-documented that ED physicians have historically high rates of burnout compared to other specialties as well as a high incidence of post-traumatic stress disorder (PTSD) compared to the general population. STOP5: a hot debrief model for resuscitation cases in the emergency department.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

SheMD

OCTOBER 8, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. And if you worry about reporting a program because of retaliation, document all of it and submit after match or anonymously. Disclaimer: This post was written before the COVID-19 pandemic. This post contains affiliate links.

Leadership 105

Leadership Best Practices Documentation/Coding Academics 105

Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

Ongoing pain noted throughout all documentation, but after nitro drip and prn morphine, "pain improved to 2/10." Academic Emergency Medicine 27(S1): S220; May 2020. Setting – large, academic, suburban ED. Repeat ECG: New developing Q waves in V2 and V3, further confirming evolving OMI. CT aorta negative for dissection.

EKG/ECG 82

EKG/ECG Outcomes Academics Documentation/Coding 82

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Triage documented a complaint of left shoulder pain. Academic Emergency Medicine 27(S1): S220; May 2020. The neighbor recorded a systolic blood pressure again above 200 mm Hg and advised her to come to the ED to address her symptoms. The patient presented to triage at around 10 PM. The patient said, "I just don't feel good."

EKG/ECG 122

EKG/ECG Outcomes Documentation/Coding Academics 122