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

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

Sensible Medicine

NOVEMBER 3, 2023

He is otherwise well, with only hypertension, well-controlled on one medication.   I usually see people who die alone in the hospital. Some of these patients die alone in the hospital, with nobody at their bedside. .  Sensible Medicine is a reader-supported publication.

Hospice 125

Hospice Head Injuries Academics Hospitals 125

Sensible Medicine

MARCH 14, 2024

I’ve heard arguments that frame this discussion in terms of trainee wellness, physician burnout, social contract, and patient outcomes. In short, it’s a mistake to picture medical students on their wellness days off just “kicking their feet up.” The result?

Hospitals 100

Hospitals Wellness Fractures Academics 100

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

Northwestern EM Blog

MARCH 1, 2025

In this study, they found that prone positioning resulted in significant improvement in oxygenation, as well as a 50% decrease in mortality at 28 days (Guerin et. Position arms in a comfortable position, avoiding any position that could cause a brachial plexus injury, and ensure they are well-supported to avoid pressure ulcers.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

Sensible Medicine

APRIL 18, 2024

David Rind sent me this article, a thoughtful, well-argued, reply. This behavior was medically harmful and unnecessary, as well as being discriminatory. Wearing gloves for IV placement meant that you couldn’t feel veins as well. This sort of exchange has been our goal on Sensible Medicine since the beginning.

Academics 86

Academics Wellness Hospitals 86

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 98

Administration Outcomes Research COPD 98

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

Dr. Smith's ECG Blog

MARCH 14, 2024

The most recent study found a NPV of 100% of triage ECGs labeled ‘normal’ or ‘otherwise normal’ for final hospital diagnosis of ACS, and concluded that avoiding physician interruption would “alleviate interruptions in workflow and improve patient safety.” It is well known that NOMI usually has a normal ECG or nonspecific ECG.

EKG/ECG 120

EKG/ECG Documentation/Coding Patient Safety Outcomes 120

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. Patient data anonymized when presented to adjudication committee to avoid detection bias Well-balanced patient characteristics between groups. 4, 8 Paper: Dahyot-Fizelier, C.,

CDC 111

CDC Radiology Radiology Head Injuries 111

Taming the SRU

APRIL 17, 2024

3) Methods This study was a retrospective observational study at a single academic tertiary care facility in their medical intensive care unit (MICU). 1) Data comparing the accuracy between IABP and NIBP measurements are limited.

Sepsis 94

Sepsis Research Stroke Academics 94

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

ACEP Now

AUGUST 15, 2023

While there has been ample discussion of “the practice of mindfulness” in health care workers that improves mental well-being, when do we have this time? However, expressing genuine gratitude for yourself and others is powerful for your mental and physical well-being. However, they should not define our wellness. Ann Emerg Med.

Emergency Department 90

Emergency Department Military Resuscitation Wellness 90

Sensible Medicine

SEPTEMBER 12, 2024

We find the letter to be well-argued. 5 While the protocol states that academic members of an executive committee designed the study in collaboration with Novartis, the authors' disclosures raise questions about the balance between academic and industry interests in its design. Editors at JACC-HF rejected their arguments.

Academics 65

Academics Outcomes Hospitals Wellness 65

RebelEM

SEPTEMBER 14, 2023

Control: 53.4% D ECLS: 18.2% Control 8.7% Control 38.0% Majority of patients had PCI performed (96.6%) Impella CP was most common mechanical circulatory support in patients without ECLS (85.7%) Death From Any Cause at 30d ECLS: 47.8% Control: 49.0% RR 0.98; 95% CI 0.80 to 1.19; p = 0.81 vs 13.9% (RR 0.58; 95% CI 0.33 vs 22.6% (RR 1.03; 95% CI 0.88

Shock 133

Shock Outcomes Resuscitation Stroke 133

EM SIM Cases

JUNE 11, 2024

Dr Lunsford is an ER physician and Simulation Director for the Guthrie Robert Packer Hospital emergency medicine residency program in Sayre, Pennsylvania, USA. Why It Matters This case highlights an uncommon, but clinically and academically important toxidrome. This case comes from Dr Philip Lunsford.

Poisoning 52

Poisoning PPE Academics Resuscitation 52

Dr. Smith's ECG Blog

JULY 21, 2024

The patient was extubated on Day-3 of the hospital stay. The patient improved, and on Day-11 of the hospital stay — he was off inotropes and on a small dose of a ß-blocker. Distinction of PMVT vs VFib is an academic one in this case ). However, he suddenly developed a series of malignant ventricular arrhythmias.

EKG/ECG 132

EKG/ECG Shock Hospitals Sepsis 132

ALiEM

SEPTEMBER 9, 2024

Past surgical history was significant for laparoscopic ventral hernia repair with mesh and lysis of adhesions (three years ago), as well as prior appendectomy, cholecystectomy, c-section, and right nephrectomy. C); BP 110/56; HR 64; RR 16; SpO2 100% General : No acute distress, well appearing.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

The Skeptics' Guide to EM

AUGUST 22, 2020

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. Your hospital performs COVID reverse transcriptase polymerase chain reaction (rt-PCR) nasal swabs on suspected patients, so you order this test and await the results. Reference: Carpenter et al.

Emergency Department 52

Emergency Department Academics Research Administration 52

Dr. Smith's ECG Blog

OCTOBER 18, 2023

A few days into her hospital stay she developed chest discomfort and the following ECG was recorded. The ECG below was on file and was taken a few days earlier, on the day of admission to the hospital. The patient did well. She is healthy with no known cardiac disease. She was found to have a viral CNS infection.

EKG/ECG 124

EKG/ECG Hospitals Academics Outcomes 124

Stop and Think

JUNE 13, 2023

One of my colleagues, a former academic, who is now in industry, tells me I shouldn’t have this chapter. Well, the authors of the smaller trial did not choose clinical outcomes, such as heart failure or death, as the primary endpoint. The first chapter urges learners to consider what a study is for. The p-value came in at 0.049.

Outcomes 98

Outcomes Academics Shock Hospitals 98

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

ACEP Now

AUGUST 29, 2023

Our program pairs training at one of the busiest emergency departments in the country at a nationally recognized county, safety-net, Level I Trauma and Regional Burn Center (MetroHealth) with a world-renowned quaternary academic referral center (Cleveland Clinic). How should potential applicants learn more about your program?

Academics 52

Academics Burns Emergency Department Ultrasounds 52

ALiEM

JANUARY 22, 2024

The patient also complained of shortness of breath for one week associated with a dry cough, as well as an altered sensorium for one day. The patient during his hospital stay developed ARDS and was on mechanical ventilation for 20 days. Fever was documented to be 102°F and was not associated with any chills or rigors. Epub 2011 Sep 12.

Academics 64

Academics Documentation/Coding Emergency Department Hospitals 64

Sensible Medicine

MAY 31, 2024

Second guessing, also called post-call quarterbacking, is alive and well in medicine and, when done thoughtfully, can be a great way to teach and learn. percent of ER visits and 6% of hospital admissions in the US. At most academic medical centers, doctors are salaried. The patient did well. So why is it done?

Operations 77

Operations Wellness Academics Ultrasounds 77

ALiEM

OCTOBER 16, 2023

Additional Images Physical Exam Vitals : BP 115/80; HR 120; T 101°F; RR 16; O2 sat 97% General : Well appearing in no acute distress HEENT : Poor dentition, mild trismus. Treatment should include both an extended course of antibiotic therapy as well as surgical source control of abscesses. The floor of the mouth is unremarkable.

Academics 60

Academics Wellness Emergency Department Hospitals 60

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

SheMD

SEPTEMBER 21, 2023

Some of the interview information may not be relevant during the 2020-2021 academic year. Things were going well and your new love interest told you multiple times how excited they were about your first date. At first you think, “Well, maybe they’re just busy,” but the days turn into weeks. And never hear back.

Academics 52

Academics Wellness Hospitals 52

The Skeptics' Guide to EM

JANUARY 20, 2018

She has contributed to the Academic Life in Emergency Medicine and EM PharmD blogs, […] The post SGEM#203: Let Me Clear My Sore Throat with a Corticosteroid first appeared on The Skeptics Guide to Emergency Medicine. She has contributed to the Academic Life in Emergency Medicine and EM PharmD blogs, and is a part of the ALiEM Capsules Team.

Academics 52

Academics Emergency Department EMS Administration 52

The Skeptics' Guide to EM

MAY 30, 2020

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. Your hospital protocol is to give tranexamic acid (TXA) 1g IV over 10 minutes followed by a 1g infusion over eight hours. Corey Heitz is an emergency physician in Roanoke, Virginia.

Head Injuries 52

Head Injuries Academics EMS Stroke 52

Don't Forget the Bubbles

JUNE 30, 2023

And hot off the press… the international PATCH ( P rehospital A ntifibrinolytics to T rauma C oagulopathy and H aemorrhage) study (just published on 14th June 2023) compared a prehospital TXA bolus, followed by an eight-hour infusion with placebo in more than 1300 adult patients from 21 hospitals across three countries. in the placebo group).

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

EMDocs

MAY 25, 2023

Study included children, as well as adults. population at large Enrollment was terminated at an interim analysis due to predefined futility criteria that suggested that there was a 1% chance that carrying the trial to completion would demonstrate a most effect or least effective treatment. This increases applicability or ED care.

Seizures 81

Seizures Administration Anaphylaxis Outcomes 81

SheMD

SEPTEMBER 3, 2023

Some of the interview information may not be relevant during the 2020-2021 academic year. From reading applications to leading hospital tours to sitting in on med student interviews, I’ve seen the good, the bad and the ugly when it comes to interview days. Disclaimer: This post was written before the COVID-19 pandemic.

Academics 81

Academics Hospitals Wellness 81

EMDocs

DECEMBER 11, 2023

There are multiple criteria systems for diagnostic an acute myocardial infarction in this population, as well as patients with ventricular-paced rhythms. de Winter RJ, Verouden NJ, Wellens HJ, Wilde AA; Interventional Cardiology Group of the Academic Medical Center. Ann Emerg Med. 2012 Dec;60(6):766-76. N Engl J Med. PMID: 18987380.

EKG/ECG 119

EKG/ECG Emergency Department Academics Operations 119

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). She is systemically well and there is no sign of tracking, so you decide to perform incision and drainage in the ED.

Operations 52

Operations Outcomes Research Academics 52

Sensible Medicine

JULY 14, 2023

” [4] On the verge of giving up, and knowing that nobody was actually ever going to ask for my random musings, I realized that a drawing that hangs in my office pretty well summarizes four pieces of advice I’d like to give. Once he was stable enough to exercise his own will, he informed us that he was leaving the hospital.

Academics 98

Academics Hospitals Wellness Research 98