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. At most academic medical centers, doctors are salaried. ” When things run well, the person with the power has it for a reason. The patient did well. But not always.

Operations 57

Operations Wellness Academics Ultrasounds 57

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

The Skeptics' Guide to EM

DECEMBER 12, 2020

She is systemically well and there is no sign of tracking, so you decide to perform incision and drainage in the ED. AEM December 2020 * Population: Patients of any age undergoing ED drainage of skin abscesses * Exclusions: Patient with abscess located on hand, foot, or face or if they required admission and/or operative intervention.

Operations 52

Operations Outcomes Research Academics 52

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. Conclusion/Recommendation ED crowding is a national patient safety issue driven by hospitals routinely operating over capacity. Academic Emergency Medicine 22.2 Click to enlarge.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 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 110

EKG/ECG Emergency Department Academics Operations 110

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

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

Dislocations 84

Dislocations Emergency Department Documentation/Coding Burns 84

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? Burnout rates have never been higher.

Hospitals 74

Hospitals Wellness Fractures Academics 74

Downeast Emergency Medicine

DECEMBER 17, 2021

Since that time, EM residencies have grown and evolved to provide academic support and training for graduating medical students interested in pursuing a career in the field. Emergency medicine (EM) was first recognized as a specialty by the American Medical Association (AMA) in 1972.

EMS 52

EMS Academics Operations Emergency Department 52

Mind The Bleep

OCTOBER 22, 2024

Research remains encouraged within cardiology, and there will be an opportunity to develop a range of academic interests. Late applications are not accepted, so checking the dates for the application year and applying well in advance is essential. This includes practical and analytical skills that you will develop during training.

Evidence-Based Practice 52

Evidence-Based Practice Academics Operations Hospitals 52

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

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 Documentation/Coding Academics 52

ACEP Now

SEPTEMBER 13, 2023

“We wanted to reach emergency physicians, nurses and others working in trauma as well as those at Health and Human Services and the Centers for Disease Control. as well as working closely on behalf of the association on projects with the White House and the Departments of Veterans Affairs, Defense, and Health and Human Services.

EMS 45

EMS Research Academics Military 45

Don't Forget the Bubbles

JANUARY 31, 2024

This was compared to a mixed reference standard that included the results of ultrasound by radiologists, intra-operative findings, and clinical follow-up. Academic Pediatrics 2024 24 1 51-58 What’s it about? The authors looked for common agents and their ability to reduce pain as well as any associated adverse events.

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

EMDocs

SEPTEMBER 25, 2023

They increase the risks of hypoxia and acidosis during the apneic period as well as hypotension and hypoperfusion caused by the abrupt transition from negative-pressure to positive-pressure ventilation (10). ” Academic Emergency Medicine 20.1 Continuing Educ Anaesth Crit Care Pain. 2013;14(3):130–5. Sakles, John C., 2013): 71-78.

Emergency Department 65

Emergency Department Soft Tissue Injuries Airway Management Operations 65

EMDocs

OCTOBER 30, 2023

Relative proportions of reported diagnostic indications versus clinical outcomes in a retrospective analysis of all CT imaging in 3 EDs over 1 year at an academic center. Some institutions developed a tier-based system for outpatient imaging as well which was updated in real-time. West J Emerg Med. 2017;18(5):835-845. 2019;70(1):13-22.

Radiology 73

Radiology Radiology Emergency Department Hospitals 73

ACEP Now

DECEMBER 10, 2023

Today Dr. Calderon is known for her research into HIV and Hepatitis C prevention, but she didn’t start off on an academic track. Her new community has a higher prevalence of Hepatitis C than HIV, so they began screening for that in the ED as well. That’s when her desire to help people was born, and that desire still motivates her.

Research 52

Research Point-of-Care Testing Burns Outcomes 52

Pediatric Emergency Playbook

MARCH 1, 2016

Adults tolerate hypotension relatively well, and is sufficient until we send them to the OR or interventional radiology suite. Fox et al in Academic Emergency Medicine found a sensitivity of 52%; with a 95% confidence interval [CI] = 31% to 73%. To avoid this, we target a MAP of 65 and look for clinical signs of sufficient perfusion.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

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

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. A 2011 meta-analysis in the journal of Academic Emergency Medicine found ESR, CRP, and PCT were not acutely useful in the diagnosis of septic arthritis due to wildly varying sensitivities and specificities between studies.

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

Don't Forget the Bubbles

MAY 3, 2023

There was no difference between the low-dose and high-dose insulin infusion groups regarding the time to resolution of hyperglycaemia, time to resolution of acidosis as well as the rate of blood glucose change. Because of the retrospective nature of the study, the decision to use the bougie was operator-dependent. Low-dose ( 0.05

CPR 52

CPR Airway Management Emergency Department Resuscitation 52

RebelEM

DECEMBER 19, 2022

While many healthcare systems across the world operate in a similar fashion, the United States does not. If you work in a tertiary academic center with a catheterization lab and/or ECMO immediately available, the application of a second defibrillator may not be immediately needed. REFERENCES: Cheskes S, et al.

EMS 52

EMS CPR Shock Resuscitation 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

EMDocs

NOVEMBER 13, 2023

2019) argue against a minimum NIHSS score to trigger the use of CTA, instead purporting that clinical suspicion of acute ischemic stroke presenting within 24 hours of the last known well was sufficient evidence to order the study. 8 The data in Mayer et al. 9 A later assessment of the VAN score in Beume et al. positivity rate on CTA for BCVI.

Stroke 87

Stroke Radiology Radiology Emergency Department 87

SheMD

NOVEMBER 2, 2023

My son Landon was two days post op his first of two neurosurgery operations the day I had a positive pregnancy test last December. A baby that would need constant medical care well beyond that of a healthy baby. Any affluent non government citizens as well. Read , our disclosure for more info.

Sexual Assault 52

Sexual Assault Ultrasounds Academics Operations 52

EM Literature of Note

JANUARY 4, 2025

Well, “yes” and “of course not” In this demonstration project, these authors set up a mobile phone video camera at the foot of patients’ beds in the emergency department. So, can AI do the same thing?

Emergency Department 88

Emergency Department Academics Operations Hospitals 88

Don't Forget the Bubbles

JANUARY 6, 2025

They all used different ultrasound devices with varying levels of operator training. If a well-child had a sudden cardiac arrest with no downtime before good CPR was started, I’m sure everyone would be doing a fairly long resuscitation effort regardless of this research. Six studies met the inclusion criteria. Salhi, Melissa A.

Dislocations 59

Dislocations CPR Ultrasounds Resuscitation 59