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. You are well prepared for this. Lead your room well. If the resuscitation does not go as well as you wanted, learn from it and move on.

Resuscitation 98

Resuscitation Risk Management Hospitals Critical Access 98

Taming the SRU

AUGUST 4, 2024

We discussed some practices to push learners outside of their comfort zone and promote learning, based on their level as well as their goals for the shift. It is better to finish early than rushing through your presentation

Emergency Department 85

Emergency Department Dislocations Documentation/Coding Burns 85

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 60

Documentation/Coding Academics Wellness 60

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. Next week I am going to show you what a well-done medical study looks like. Please do listen. Bobby is one of the smartest people in cardiology today. It is our goal.

Administration 84

Administration Outcomes Research COPD 84

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. PTSD is 2 times more prevalent in physicians (14.8%), with EM resident physicians falling in the range from 11.9%-21.5%.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

Medagadget

JUNE 12, 2023

But despite the long history of research, therapeutic electricity has also had its fair share of quackery and shams, which Adee asserts has negatively impacted the pace of research in this field, as well as its acceptance in education. But electricity wasn’t part of an accepted framework of how the body works.

Research 78

Research Academics Documentation/Coding Poisoning 78

PEMBlog

MAY 11, 2023

Injectable lidocaine, when done well, is reliable – but it can take years to master the ideal technique that doesn’t create a giant mound of subcutaneous lidocaine that can impact needle entry and landmarks. These were used by two independent reviewers to determine Neonatal Facial Coding System with pain scores.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department Academics 52

Sensible Medicine

JULY 24, 2023

But there had been two placebo-controlled drug trials that documented a 45-55 second increase in exercise time. A later re-analysis increased the time to 21 seconds, which was still well below statistical significance. You might wonder how they came up with 200 patients? This, too, was brilliant thinking. It was only 16 seconds.

Academics 90

Academics Documentation/Coding Ultrasounds Wellness 90

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

SheMD

OCTOBER 5, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. If staying in a hotel- don’t forget to use discount codes the residency program may offer. The benefits include getting a true feel for living in the city- but this can be a little riskier in cities you don’t know very well.

Research 52

Research Leadership Documentation/Coding Academics 52

RebelEM

MARCH 27, 2023

What They Did: Retrospective, observational cohort study in a single high-volume academic hospital The ED had a 5 bed area used for ongoing management and resuscitation of patients who clinically deteriorate while boarding or while actively undergo a workup in other sections of the ED. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

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

ACEP Now

MARCH 13, 2024

Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. Academic Emergency Medicine 22.2 Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

It radiated to both shoulders and both upper extremities, and there was shortness of breath and diaphoresis as well. 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.

EKG/ECG 78

EKG/ECG Outcomes Academics Documentation/Coding 78

Dr. Smith's ECG Blog

MARCH 31, 2023

I first became interested in computerized ECG interpretation in the beginning of my academic days in the early 1980s ( References to some of my work appear below — as I believe I may have been the first family physician to publish in this area ). has performed so well clinically: It has been programmed using ECG criteria put forth by Drs.

EKG/ECG 52

EKG/ECG Academics Wellness Documentation/Coding 52

SheMD

OCTOBER 8, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. Actually, I wanted to ask what supports the program has in place for parents (male and female) as well as people increasing their families, be it biologically or through adoption?” Their well-being should be considered.

Leadership 105

Leadership Best Practices Academics Documentation/Coding 105

Dr. Smith's ECG Blog

JULY 21, 2024

In both tracings — an exceedingly fast PMVT is documented. Distinction of PMVT vs VFib is an academic one in this case ). In this study — Procainamide was superior to Amiodarone for terminating monomorphic VT, as well as having fewer adverse effects than Amiodarone ( Ortiz et al — Eur Heart J 1;38 (17): 1329-1335, 2017 ).

EKG/ECG 113

EKG/ECG Shock Hospitals Sepsis 113

PulmCCM

OCTOBER 30, 2023

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. It used to be highly prevalent in U.S. Then, in 2009, the condition disappeared completely. Just kidding! In 2008, the U.S.

Sepsis 52

Sepsis Shock Hospitals 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 136

EKG/ECG Shock Academics Documentation/Coding 136

ACEP Now

JULY 6, 2023

5 Patients with acute ischemic strokes, STEMIs, and trauma, as well as many other diagnoses, have their workup largely completed, and even sometimes definitive therapy executed, before they leave the emergency department, rather than requiring inpatient units. “A In 2023 we must move beyond that title.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

EMDocs

JUNE 16, 2023

It is also important to recognize that the majority of children seeking ED care are treated at community sites rather than urban, academic institutions. It’s stressful for the ED clinical staff as well. Boarding of Mentally Ill Patients in Emergency Departments: American Psychiatric Association Resource Document. 10.1542/peds.2022-057383

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

Dr. Smith's ECG Blog

JUNE 23, 2023

The amiodarone was discontinued and the patient did well. == MY Comment , by K EN G RAUER, MD ( 6/23 /2023 ): == From an academic standpoint — I love WCT ( W ide- C omplex T achycardia ) rhythms. This likelihood of VT increases to at least 90% if the patient has documented underlying heart disease.

EKG/ECG 52

EKG/ECG Academics Documentation/Coding Wellness 52

Dr. Smith's ECG Blog

JANUARY 5, 2020

See below how this has been documented. Thus, both overdiagnosis and underdiagnosis of AF are well-recognized problems in computer interpreted electrocardiograms, and they adversely affect patient management with either inappropriate anticoagulation and/or antidysrhythmics or undertreatment [ 1 , 14 ]. Poon et al. sensitivity and 98.9%

EKG/ECG 52

EKG/ECG COPD Wellness Sepsis 52

EB Medicine

JULY 8, 2019

Jeff: Well that’s kind worrisome. Jeff: And while it’s not exactly core EM, we’re going to briefly discuss indications for bariatric surgery, as this is something we don’t often review even in academic training programs. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

ACEP Now

AUGUST 1, 2023

A rural ED staffed by a well-trained EP is an essential resource in small communities that may be otherwise lacking in readily available healthcare resources. emergency department deserves access to an emergency physician no matter their zip code. Three take home points for what I believe. Every patient in a U.S.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

The Skeptics' Guide to EM

JANUARY 28, 2023

Academic Emergency Medicine published a special contribution in December 2022 exploring the implications of this for providers of emergency healthcare. You said something specifically about documentation as well? * I interpreted that to mean, at times, men should talk less and listen more. This is one of those times.

Research 52

Research Academics Documentation/Coding Wellness 52

Dr. Smith's ECG Blog

APRIL 8, 2015

True Syncope: If, on the other hand, the patient is well, had no other serious symptoms , has a normal sinus rhythm, and normal physical exam , then you need to be certain the syncope was not due to a dangerous brady- or tachydysrhythmia that could recur. Academic Emergency Medicine., Vasovagal syncope is generally benign. Mukarram, M.,

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

ACEP Now

OCTOBER 4, 2023

Well, unfortunately my graveyard is bursting at the seams. Vot-ER has provided us with badges printed with QR codes, which patients can scan and check their voter registration in real time. We have also added a voter registration QR code to all discharge instructions printed from the emergency department.

Emergency Department 110

Emergency Department Documentation/Coding Hospitals Academics 110