ACEP Now

NOVEMBER 14, 2023

In 1901, UVA opened its first hospital with 25 beds and three operating rooms. But inside these charming historic walls is a research-driven, quaternary-care, academic, medical center. While most academic EDs have lost pediatric volume, the UVA ED continues to see almost 20 percent pediatric patients.

Academics 52

Academics Emergency Department Leadership Operations 52

Don't Forget the Bubbles

JANUARY 31, 2024

As a Trauma Unit within the Thames Valley Trauma Network, Wexham Park Hospital hosts trainees from across the spectrum of acute specialties. Two really important patient groups were excluded – those who were admitted to hospital and families who were not fluent in English. Academic Pediatrics 2024 24 1 51-58 What’s it about?

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

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. Nature (news). January 2024. Fawzy et al. Ferryman et al.

Academics 81

Academics Documentation/Coding Administration Research 81

Sensible Medicine

JUNE 28, 2024

A 76-year-old woman presents to a community hospital after waking with garbled speech and right-sided weakness. If I had it all to do again, there is no doubt that I would choose medicine in general and academic general internal medicine in particular, but occasionally we all have a bad week. The hospital does an excellent job.

Stroke 105

Stroke Academics EKG/ECG Hospitals 105

The Trauma Pro

JUNE 13, 2023

Ever wonder why your hospital won’t let pharma representatives sponsor lunches anymore? These can significantly improve one’s academic rank, job security, financial status, and more. .” Psychological research has demonstrated time and time again that human behavior is easily influenced. Or even give you a pen?

Research 189

Research Academics Operations Hospitals 189

ACEP Now

JUNE 21, 2023

2,3 In the 2021-2022 academic year, categorical (non-combined) EM residency lengths included 221 (80 percent) PGY 1-3 and 55 (20 percent) PGY 1-4 programs. A fourth year of EM training offers additional supervised clinical and academic experience. Residency length has varied since the inception of the specialty of emergency medicine.

EMS 114

EMS Academics Telemedicine Operations 114

ACEP Now

MARCH 10, 2025

9 Furthermore, meaningful work is a cornerstone in the longevity of career academic physicians. Dr. Koo is faculty and an emergency physician at MedStar Washington Hospital Center in Washington, D.C., Marys Hospital in Leonardtown, Maryland. A sense of purpose is an integral part of well-being. References Nyanchama V.

Academics 52

Academics Wellness CPR Hospitals 52

RebelEM

OCTOBER 2, 2023

Mild to moderate DKA represents a subgroup of patients that often require admission to the ICU due to hospital policies not allowing insulin infusions outside of this clinical setting. However, it is unclear if all degrees (mild, moderate, severe) of DKA require the same intensive treatment. tests/hr (0.8 Traditional: 1.0 tests/hr (0.8

Operations 97

Operations Academics Fluid Resuscitation Outcomes 97

PulmCCM

JUNE 12, 2023

Temperature management (or fever avoidance) should begin immediately after cardiac arrest (ideally in the emergency department, for out-of-hospital arrests) and continued for at least 72 hours. with acetaminophen) until temperatures reached 37.8 °C who then received external cooling to maintain a target temperature of 37.5 °C.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

ACEP Now

AUGUST 22, 2023

In an environment in which patients may have their entire work-up in the waiting room, or attend a critical access hospital staffed by non-emergency physicians, or lack the financial support to follow up with an appropriate specialist, a pragmatic approach to care is required. References Society for Academic Emergency Medicine.

Emergency Department 98

Emergency Department Academics Critical Access Research 98

PulmCCM

JANUARY 6, 2025

With financial penalties coming for noncompliance with the new rule, hospital administrators rapidly deployed the alerts to fire on all eligible inpatients. The SCREEN Trial SCREEN was a stepped-wedge cluster randomized trial of an EMR alert for organ failure, conducted at 45 wards of 5 hospitals in Saudi Arabia from 2019 to 2021.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

Pediatric EM Morsels

JULY 21, 2023

Academic emergency medicine 12.9 Acad Emerg Med. 2016 Aug;23(8):878-84. doi: 10.1111/acem.13014. Epub 2016 Aug 1. PMID: 27197686. Holmes, James F et al. Performance of the Pediatric Glasgow Coma Scale in Children with Blunt Head Trauma.” 2005): 814–819. Chung CY, Chen CL, Cheng PT, See LC, Tang SF, Wong AM.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Sensible Medicine

FEBRUARY 12, 2024

Academic medicine sometimes gets it right. Along with a team of researchers at numerous hospitals, they randomized ≈1000 patients who had had stroke of unknown cause and evidence of atrial cardiopathy to either treatment with an oral anticoagulant (apixaban) vs aspirin. This is a positive story about a negative trial.

Wellness 133

Wellness Stroke EKG/ECG Academics 133

EMDocs

SEPTEMBER 30, 2024

5 urban academic EDs, attending charts. The primary outcome was hospital admission rates. For the primary comparison, ICS + SCS reduced the risk of hospital admission compared with SCS; fixed-effects odds ratio (95% confidence interval) 0.73 (0.57-0.94). Excluded admitted, transferred, or expired patients during their ED visit.

Outcomes 101

Outcomes Academics Documentation/Coding Emergency Department 101

Dr. Smith's ECG Blog

MAY 3, 2024

In fact, most do not make it to the hospital alive, which explains why only a tiny percent of OMI are due to full LM occlusion. Today's patient did make it to the hospital — but was in cardiogenic shock, and despite valiant attempt at treatment, succumbed soon after. Moreover, left main occlusion often presents near death.

Shock 128

Shock EKG/ECG Hospitals EMS 128

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. If applicants are more impressive on paper, but no more impressive in the clinics and hospitals, aren’t we doing something wrong?

Military 129

Military Free Clinics Documentation/Coding Academics 129

Dr. Smith's ECG Blog

SEPTEMBER 27, 2023

The hospital stay was complicated by aspiration pneumonia, recurring ventricular tachycardia and a mural thrombus. Of academic interest — are the arrhythmias that developed. Is there OMI? How did the PM Cardio Queen of Hearts perform: OMI with high confidence. ECG#5 There was acute 100% occlusion of the proximal LAD.

EKG/ECG 134

EKG/ECG Resuscitation Academics EMS 134

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. Academic Emergency Medicine. Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. Academic Emergency Medicine. vs. 18.0%, p<0.001) and improved survival to hospital admission (10.9%

CPR 52

CPR Academics Resuscitation Hospitals 52

Stop and Think

OCTOBER 8, 2024

Consider heart failure hospitalization. The problem is that in some trials, hospitalization for heart failure represents only a small fraction of total hospitalizations. Yes, hospitalizations for heart failure are 29% lower with the drug. Yes, hospitalizations for heart failure are 29% lower with the drug.

Hospitals 73

Hospitals Academics Outcomes 73

ACEP Now

JANUARY 5, 2025

Finally, in what serves as a bit of idle academic curiosity, a re-examination of the rate of intracranial hemorrhage after thrombolysis found starkly different statistics than those typically used in discussions with patients. Automated identification of adults at risk for in-hospital clinical deterioration. Ann Emerg Med.

Sepsis 40

Sepsis Research Airway Management Stroke 40

Sensible Medicine

SEPTEMBER 1, 2024

Finally, Adam Cifu weighs in in favor of physician political involvement but cautions that academic medical centers should not take political stances and that physicians should be careful not to allow politics to interfere with the doctor patient relationship. I suggest that this view of medicine and politics confuses the nature of both.

Academics 120

Academics Operations Hospitals Wellness 120

Dr. Smith's ECG Blog

JUNE 13, 2024

After being transferred to an academic center, she was taken to the cath lab: Proximal RCA occlusion (causing inferior and RV OMI) Unfortunately, she continued to decline despite aggressive measures. The family filed a lawsuit against the physician and the hospital. The hospital and doctor reached confidential settlements.

EKG/ECG 93

EKG/ECG Documentation/Coding EMS Burns 93

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. Stratified by center (different hospital practices may affect results) and GCS (<8 or ≥8) (higher VAP risk inherent to lower GCS). 4, 8 Paper: Dahyot-Fizelier, C.,

CDC 111

CDC Radiology Radiology Head Injuries 111

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. If you have a difficult outcome, it is helpful to know what risk management support you have at your hospital. The past is the past.

Resuscitation 98

Resuscitation Risk Management Hospitals Critical Access 98

SheMD

JULY 23, 2023

Some of the interview information may not be relevant during the 2020-2021 & 2021-2022 academic years. One individual I knew wanted to run his own clinic or hospital. Therefore, he worked with the primary care innovation department and learned hospital administration and clinical operations during his residency.

Research 98

Research Academics Hospitals Operations 98

Sensible Medicine

FEBRUARY 16, 2024

I learned from the nursing staff that Bill’s family was in his hospital room, hoping to speak with someone about what had gone wrong. ” 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 135

Documentation/Coding Academics Shock Research 135

PulmCCM

APRIL 29, 2024

ICUs, and a popular research focus for academics, generating a steady stream of papers. government proposed adding VAP to its “hospital-acquired conditions” list—the ones that it won’t pay for. Hospital administrators put VAP on the kill list. It used to be highly prevalent in U.S. Just kidding!

Documentation/Coding 52

Documentation/Coding Academics Administration Research 52

The Skeptics' Guide to EM

APRIL 8, 2023

2023 Apr Guest Skeptics: Dr. Louella Vaugh is an internist practising as a hospitalist physician at an academic centre in London, UK with a special interest in smaller, rural and remote healthcare. The main outcome was the adjusted odds ratio for in-hospital mortality and hazard ratio for 30-day mortality with some pre-specified subgroups.

Stroke 56

Stroke Emergency Department COPD Academics 56

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. He had no other complaints and denied any other trauma or loss of consciousness during the event.

Emergency Department 64

Emergency Department Fractures Academics Hospitals 64

Sensible Medicine

NOVEMBER 3, 2023

  I usually see people who die alone in the hospital. Some of these patients die alone in the hospital, with nobody at their bedside. She had tried to convince herself that his slips were just senior moments of an already eccentric academic. .  They say that there is nothing worse than dying alone.

Hospice 125

Hospice Head Injuries Academics Hospitals 125

RCEM Learning

MAY 20, 2022

In that document, the NIHR proposed that, to build research capacity in key areas, it would develop a small number of networking structures, to be called “NIHR Incubators” The Incubators would support capacity building and multidisciplinary career development in priority areas with a low critical mass of clinical academics.

Documentation/Coding 52

Documentation/Coding Academics Research Hospitals 52

EMDocs

OCTOBER 30, 2023

1 The shortage in supply posed difficulties for hospitals that significantly depend on GE Healthcare as their supplier, which encompassed approximately 50% of hospitals in the United States (US). Preparation 9 Hospitals had to prepare for the impending contrast shortage as soon as potential shortage news occurred. 11 Table 1.

Radiology 92

Radiology Radiology Emergency Department Hospitals 92

EMDocs

JUNE 9, 2023

How do we manage the agitated child in the pre-hospital environment? After listening to this episode you will be able to: Identify unique aspects of the pre-hospital environment that impact assessment and treatment of agitated children Describe the role of EMS personnel and EMS director in the care of agitated children. mg/kg IN; 0.1-0.15

EMS 95

EMS Documentation/Coding Pediatrics Psychiatric 95

Sensible Medicine

MARCH 14, 2024

The analogy of a physical hospital expanding from its original isolated ward to become an interconnected quaternary care center may help. Like a disorganized hospital metropolis connected by haphazard networks of tunnels, skywalks, and parking garages, we cannot effectively navigate our day without becoming facile in each mode of connection.

Hospitals 100

Hospitals Wellness Fractures Academics 100

Emergency Medicine Cases

APRIL 9, 2019

In anticipation of EM Cases Episode 123 Pediatric UTI Myths and Misconceptions, Dr. Olivia Ostrow, Pediatric Emergency Physician at Hospital for Sick Children, Assistant professor at the University of Toronto and a Medical Safety Leader with an academic focus in quality improvement, discusses a case that exemplifies how indiscriminate work up of pediatric (..)

Pediatrics 52

Pediatrics Academics EMS Outcomes 52

PulmCCM

JUNE 3, 2024

The ASTER Trial Ware et al conducted a phase 2b randomized trial from 2021 to 2023 among 447 patients admitted with sepsis and organ failure at 40 US academic hospitals. Patients received either 1 g of acetaminophen IV every six hours or placebo for five days.

Sepsis 52

Sepsis Outcomes Academics Hospitals 52

RebelEM

NOVEMBER 6, 2023

So with yet another confounding variable added (sicker patients at baseline in methylene blue group), the comparison of these two medications is yet again even more difficult There was no difference in ICU and hospital length of stays or hospital mortality between the two groups.

Shock 71

Shock Administration Academics Hospitals 71