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

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. An emergent ophthalmology consult is needed to plan for operative repair. Eye (Lond).

Emergency Department 64

Emergency Department Academics Fractures Hospitals 64

ACEP Now

JANUARY 5, 2025

In a prospective study comparing clinician gestalt against systemic inflammatory response syndrome, Sequential Organ Failure Assessment (SOFA), quick SOFA, Modified Early Warning Score (MEWS), and a logistic regression machine learning model using Least Absolute Shrinkage and Selection Operator (LASSO), the obvious winner was the clinician.

Sepsis 40

Sepsis Research Airway Management Outcomes 40

Sensible Medicine

MAY 31, 2024

percent of ER visits and 6% of hospital admissions in the US. At most academic medical centers, doctors are salaried. Some of these disagreements will be critical: what drug needs to be given, does this person need to go the operating room, does JD need a chest tube? Syncope (fainting) is a common problem, responsible for 1-3.5%

Operations 76

Operations Wellness Academics Ultrasounds 76

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 99

Hospitals Wellness Academics Fractures 99

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

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. J Cardiothorac Vasc Anesth. 2023 Jul 19.

Shock 71

Shock Administration Academics Hospitals 71

Don't Forget the Bubbles

JANUARY 8, 2024

Dr Elyssia Bourke, based at Ballarat Base Hospital, is actively engaged in this area through her ongoing PhD research. Although this research is still in progress, it promises to shed light on effective strategies for managing these difficult situations. Mulraney, M., Coghill, D., Sciberras, E., and Sawyer, M.,

Research 105

Research Emergency Department Psychiatric Academics 105

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. Reference: Sceats et al.

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

ACEP Now

JUNE 7, 2023

Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. These data can be shared with hospital administration as there is mutual need to find solutions to the current ED flow challenges and very high ED walkaway rates. Patient volume losses in 2020 reversed in 2021.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 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

The Skeptics' Guide to EM

DECEMBER 12, 2020

AEM December 2020 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). Dr. Ladde is in an active academic emergency physician working at Orlando R. Date: December 10th, 2020 Reference: Ladde et al.

Operations 52

Operations Outcomes Research Academics 52

ACEP Now

MARCH 13, 2024

1 Hospital boarding is the main driver of ED crowding, with patients nearly always awaiting transfer to inpatient beds and now more commonly, to other hospitals. When considering inter-hospital transfer, the patient’s goals of care should be paramount in guiding the process.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

Taming the SRU

OCTOBER 23, 2023

At this point, the patient is taken to the operating room for a diagnostic laparoscopy. After a short period of recovery in the hospital, she is discharged home in stable condition with follow-up with OBGYN. She was taken to the operating room and found to have a right tubal ectopic pregnancy with a pseudogestational sac.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

ALiEM

SEPTEMBER 9, 2024

General surgery and neurosurgery should be consulted emergently for further operative interventions. 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. Interdisciplinary Neurosurgery, 13, 66-70.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

ACEP Now

NOVEMBER 16, 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. Academic career preparation for residents – are we on the right track?

Academics 52

Academics EMS Telemedicine Research 52

RebelEM

JUNE 8, 2023

The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. Emergency department hypotension predicts sudden unexpected in-hospital mortality: a prospective cohort study. PMID: 31270748 Maheshwari K, et al. Intensive Care Med. 2018;44(6):857–67. PMID: 29872882 Jones AE, et al. 2006;130(4):941–6.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

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. Your hospital has asked you to consider adding some advanced practice providers (APPs) instead of physician hours. Reference: Pines et al. AEM November 2020. Reference: Pines et al. AEM November 2020.

Emergency Department 52

Emergency Department Telemedicine Academics Outcomes 52

EMDocs

DECEMBER 11, 2023

In addition to a posterior ECG, the ACC’s new recommendations emphasize consideration of an emergent TTE, though lack clarity in defining who should be the operator, stating “a clinician qualified in echocardiography” is necessary, without providing specific definitions. Notably, only 0.5mm of elevation is necessary in V7-9 to meet criteria.

EKG/ECG 119

EKG/ECG Emergency Department Academics Operations 119

The Skeptics' Guide to EM

NOVEMBER 20, 2021

AEM November 2021 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). Moving the Needle on Fall Prevention: A Geriatric Emergency Care Applied Research (GEAR) Network Scoping Review and Consensus Statement.

Geriatric Emergencies 52

Geriatric Emergencies Elder Abuse Research Academics 52

Emergency Medicine Journal

MAY 23, 2023

Methods In this retrospective study, we included all adult patients who visited the ED of a single urban academic tertiary-care university hospital in South Korea for five consecutive years (1 January 2015 to 31 December 2019). The data set was randomly split into train and test sets (1:1) for internal validation.

Outcomes 40

Outcomes Emergency Department Academics Operations 40

Mind The Bleep

OCTOBER 22, 2024

Research remains encouraged within cardiology, and there will be an opportunity to develop a range of academic interests. Cardiological input is required at both district general hospitals and tertiary centres; therefore, as a consultant, you can choose where you would like to work.

Evidence-Based Practice 52

Evidence-Based Practice Academics Operations Hospitals 52

RebelEM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Consecutive enrollment avoided sampling bias Limitations: Retrospective observational study at a single academic center limits external validity (ie. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Taming the SRU

AUGUST 4, 2024

The largest retrospective cohort study to date (Beyde et al.) shows that most will improve with empiric antibiotics.

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

ACEP Now

SEPTEMBER 13, 2023

Years before, he’d started his EM career as medical director of the ER at Memphis’ public hospital and Memphis Fire EMS. Dr. Prescott, currently retired, was Chief Academic Officer of the Association of American Medical Colleges from 2008-2021 where he says he worked with “every single school of medicine in the U.S.,”

EMS 45

EMS Research Academics Military 45

Advanced Emergency Nursing from AENJ

OCTOBER 8, 2017

I can recall when a major metropolitan hospital had an unattended "First Aid Room" to which one's personal physician or a resident might be called should one come to the hospital with a problem. Academic Emergency Medicine, 10: 798–804. Schriver, J. Talmadge, R., and Hedges, J. doi:10.1197/aemj.10.7.798

Emergency Nursing 40

Emergency Nursing Emergency Department Hospitals Academics 40

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 also had no information on operators’ experience levels. In skilled hands using ultrasound, CVC complications are much lower than 3%.

Ultrasounds 40

Ultrasounds Operations Outcomes Research 40

ACEP Now

NOVEMBER 7, 2023

Dr. Bookman is professor and vice chair of operations, department of emergency medicine at the University of Colorado School of Medicine and senior director of informatics for UCHealth, in Aurora, Colo. Dr. Bissmeyer is a senior resident at Orange Park Hospital in Jacksonville, Fla. ONS Health IT website. Accessed October 11, 2023.

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

Taming the SRU

AUGUST 30, 2023

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. This finding was not significantly different among operators with different levels of experience, or between adults and children.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Advanced Emergency Nursing from AENJ

SEPTEMBER 13, 2016

It is a 11:39 minute film, by Walter Reid Army Institute of Research Production of experimental research done by Peter Safar, MD, and associates, at Baltimore City Hospital's Department of Anesthesiology. " established that exhaled air was a satisfactory gas for resuscitation. Founded first ICU that was multi-disciplinary.

Resuscitation 40

Resuscitation CPR Emergency Nursing Basic Life Support 40

Don't Forget the Bubbles

FEBRUARY 7, 2024

My first real encounter with the healthcare system took place when I was about seven years old and had to go into hospital for an orchidopexy, so I can empathize with all the young people who come through our emergency department with acute testicular pain. Urgent senior review, decision making and operation 31.3%

Pediatrics 111

Pediatrics Ultrasounds Operations Hospitals 111

Don't Forget the Bubbles

MAY 3, 2023

This single-centre academic urban institution in the United States (US) undertook a 10-year retrospective observational study of paediatric intubation and bougie use in their emergency department (ED). There were limitations to this study in that only a single academic institution was observed, and retrospective data could create data bias.

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

RebelEM

DECEMBER 19, 2022

The authors sought to answer whether double defibrillation and/or vector change defibrillation lead to a greater number of RVF patients surviving to hospital discharge when compared to standard defibrillation therapy. While many healthcare systems across the world operate in a similar fashion, the United States does not.

EMS 52

EMS CPR Shock Resuscitation 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Academic Emergency Medicine., Clinical predictors of cardiac syncope at initial evaluation in patients referred urgently to general hospital: the EGSYS score. Background: Syncope is a common, potentially serious condition accounting for many hospital admissions. Academic Emergency Medicine, 2003 Volume 10, Number 5 539-540.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EM Literature of Note

JANUARY 4, 2025

It is solely an academic exercise, though describing it as such ought not minimize the novelty of incorporating image analysis with other clinical information. Then, “admission to hospital”, while operationally interesting, is a poor surrogate for immediate clinical needs and overall acuity.

Emergency Department 88

Emergency Department Academics Operations Hospitals 88

Sensible Medicine

JANUARY 27, 2025

One would not expect this bias to be operational for mortality, which was not different between the 2 arms. This is more than an academic exercise. Yet, in the US (and Germany), procedures make hospitals and doctors lots of money. Another reason SCOT-HEART could have been positive is statistical noise. No other trial showed it.

Outcomes 121

Outcomes EKG/ECG Documentation/Coding Academics 121