EMDocs

JUNE 8, 2023

and 9 hours after onset of symptoms, with non-infarcted brain tissue, does the administration of alteplase improve functional outcome at 90 days? Subsequently reduced enrollment to 310 patients because no patients had been lost to follow-up or had insufficient data documented. Intervention: Alteplase 0.9 to 53.54, p=0.053).

Stroke 95

Stroke Administration Documentation/Coding Outcomes 95

RebelEM

JUNE 8, 2023

Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Sensible Medicine

AUGUST 21, 2023

Administrative data sets are often collected for the purpose of billing, or costing, or administrative organization, and thus are extremely vulnerable to up coding or intentional or accidental omissions. ” For example, mortality is a patient outcome—provided it can be reliably ascertained.

Administration 98

Administration Outcomes Research COPD 98

RebelEM

JANUARY 29, 2024

PMID: 37188358 Clinical Question: What is the efficacy and safety of low-dose (25mg) prolonged administration (over 6hrs) of alteplase in patients with massive PE? Reduced-Dose Systemic Fibrinolysis in Massive Pulmonary Embolism: A Pilot Study. Clin Exp Emerg Med 2023. in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47

Stroke 133

Stroke Outcomes Hospitals Administration 133

EMDocs

SEPTEMBER 30, 2024

Primary outcome: Prescription of ICS on ED discharge from the index visit Secondary outcomes: ICS prescription rates in high-risk subgroups Rates of outpatient follow-up within 30 days of an ED visit for asthma Variation in ICS prescription rates among attending ED physicians. The primary outcome was hospital admission rates.

Outcomes 101

Outcomes Academics Documentation/Coding Emergency Department 101

EMDocs

OCTOBER 10, 2024

Exam is normal except for tenderness as documented in the diagram. She never had a documented abdominal exam. I just failed to document it. The EP documented seeing the patient and agreed with the ARNP’s plan. Delay in administration of antibiotics. Temp is 98.7 and pulse 121. My pain increased when walking.

Documentation/Coding 93

Documentation/Coding Hospitals Sepsis Infectious Diseases 93

ACEP Now

DECEMBER 6, 2024

Repeat ECG following return of spontaneous circulation after administration of intravenous nitroglycerin. The decision was made to communicate directly with the on-call interventional cardiologist with specific and direct intent to discuss the administration of intravenous (IV) NTG. Click to enlarge.) What Would You Do Next?

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

Taming the SRU

MAY 11, 2024

3% HTS appears to be safe for peripheral IV administration and does not require a central line. The available data does not support any benefit of administration of hyperosmolar therapy in the setting of a TBI. When administered IM, midazolam administration appears superior in terms of time to sedation (Nobay et al.).

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

American Medical Compliance

AUGUST 7, 2024

OSHA (Occupational Safety and Health Administration) Adhering to OSHA (Occupational Safety and Health Administration) regulations is vital for ensuring safe and healthy working conditions for healthcare workers. For example, CMS requires accurate and timely documentation of patient care to ensure proper billing and reimbursement.

Hazardous Materials 105

Hazardous Materials Documentation/Coding Legal Issues Patient Safety 105

ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

RebelEM

OCTOBER 5, 2023

Secondary Outcome By day 90, mortality was 9.3% Strengths: The investigators framed a research question centered on patient outcomes, ensuring the study’s relevance and practicality. Control: Normal Saline via continuous infusion according to the same regimen used in the hydrocortisone group. in the placebo group (p = 0.006).

Research 94

Research Outcomes Administration Shock 94

Downeast Emergency Medicine

DECEMBER 1, 2021

The primary outcome was enrollment in and receiving addiction treatment at 30-days post-randomization. Additional outcomes included self-reported days of illicit opioid use, urine testing for illicit opioids, HIV risk, and use of addiction treatment services. Annals of Emergency Medicine. 2021; 78(3): 434-442.[

Emergency Department 52

Emergency Department Documentation/Coding Leadership Administration 52

Ziqitza HealthCare Ltd

JUNE 18, 2023

Ziqitza Healthcare ltd embraces precision medicine by leveraging AI to analyze genomic data, enabling the delivery of tailored therapies to patients for improved treatment outcomes. Ziqitza Limited incorporates AI-powered systems to streamline administrative tasks, allowing their staff to focus more on direct patient care.

Documentation/Coding 52

Documentation/Coding Administration Ambulance Services Outcomes 52

RebelEM

AUGUST 12, 2024

PMID: 36038001 Clinical Question: In patients undergoing cardiac surgery with cardiopulmonary bypass, does the administration of intravenous amino acid therapy lead to lower occurrence of postoperative AKI when compared to placebo? The PROTECTION trial. Contemp Clin Trials. Epub 2022 Aug 28.

Outcomes 81

Outcomes Hospitals Operations Shock 81

PulmCCM

FEBRUARY 5, 2024

You can read the document here. Also, many patients with infection won’t have fevers, and those that don’t may be at the highest risk for poor outcomes. Read the original document here. to enforce compliance with an administrative policy). What’s a Fever? °C oral measured multiple times).

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

Downeast Emergency Medicine

APRIL 26, 2021

2][3] If earlier treatment with TXA is better, would there be benefit in its administration in the prehospital setting? 4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] JAMA Neurol.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

The Skeptics' Guide to EM

FEBRUARY 23, 2019

The study by Alam et al took adult patients with a diagnosis of suspected infection and randomized them to ceftriaxone 2g IV started pre-hospital or usual care with a primary outcome of all-cause mortality at 28 days. One recommendation that they make is the rapid administration of 30ml/kg of crystalloid for hypotension.

Sepsis 52

Sepsis Administration Documentation/Coding Hospitals 52

ACEP Now

OCTOBER 10, 2024

Between deployments, Dr. McCormick earned his Master of Business Administration from National University and medical degree from Morehouse School of Medicine in Atlanta. Right now, there’s no incentive to get people out of the emergency department by hospital administrators. It may not be for everybody.

Telemedicine 105

Telemedicine Critical Access Hospitals Emergency Department 105

American Medical Compliance

APRIL 29, 2024

This course will equip caregivers and administrative staff with the necessary tools and knowledge to identify, prevent, and address these grievous issues effectively. A Framework Against Abuse and Neglect in Nursing Homes Federal Code has established regulations to safeguard nursing home residents from abuse and neglect.

Elder Abuse 52

Elder Abuse Documentation/Coding Administration Outcomes 52

Dr. Smith's ECG Blog

AUGUST 9, 2024

He had no previously documented medical problems except polysubstance use. Although recognition of OMI was not affected by administration of morphine in this case, use caution with analgesia in ongoing ACS without a definitive plan for angiography. These diagnoses were not found in his medical records nor even a baseline ECG.

EKG/ECG 108

EKG/ECG EMS Emergency Department Outcomes 108

Greater Sydney Area HEMS

AUGUST 1, 2023

When I found it, I felt the documentation (if done at all) largely tended to be the bare minimum, and certainly not reflective of the beautiful learning conversations happening in the room. And so, for this project we made the decision to look solely at process measures that reflected our interventions, as opposed to broader outcome measures.

Documentation/Coding 52

Documentation/Coding Outcomes Hospitals Administration 52

Taming the SRU

JUNE 3, 2024

CESAR Trial Published in 2009 Found that even those who didn’t get ECMO, but were transported to a tertiary care center had better outcomes No matter where you go, critical care transport will be part of your life as a sending physician, receiving physician, or both. Benefits of transport are evidenced based.

Shock 91

Shock Seizures Airway Management Stroke 91

Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

Ongoing pain noted throughout all documentation, but after nitro drip and prn morphine, "pain improved to 2/10." Long term outcome unknown but obviously bleak. Association of intravenous morphine use and outcomes in acute coronary syndromes: Results from the CRUSADE Quality Improvement Initiative. Repeat trop 150 ng/L.

EKG/ECG 79

EKG/ECG Outcomes Academics Documentation/Coding 79

PulmCCM

OCTOBER 30, 2023

If you thought administrators had a bee in their bonnet for SEP-1 before, just wait. IDSA cites multiple large observational studies showing no improvement in sepsis outcomes at many centers after SEP-1 implementation. Hospital administrators put VAP on the kill list. The stakes are going up. That was the pregame.

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? However, with ultrasonography becoming more prevalent in EDs, it may be possible that initial imaging may avoid this radiation risk and still have similar outcomes for patients. Would you be satisfied with only US and no follow-up CT?

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

ACEP Now

JULY 7, 2023

However, rapid initiation of treatment is actually patient-centered care that can both lead to better outcomes and limit ED boarding. Mental health evaluation teams can rely on documentation and interviews to understand a patient’s initial agitation level.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

Dr. Smith's ECG Blog

JULY 3, 2018

No data exists to suggest or refute that opioid administration leads to longer time to cath in patients with ongoing ACS; however, it makes logical sense that it would, since one of the qualifying factors for emergent cardiac cath is ongoing chest pain. It is unclear what, if any impact opioid administration had on the outcome of this case.

EKG/ECG 52

EKG/ECG Documentation/Coding Administration Outcomes 52

EM Updates

JUNE 15, 2021

Every patient admitted to the EDAT was followed to the conclusion of their hospital course; the development of this unit and patient outcomes resulting from its execution are presented here. Particular effort was required to keep family members, who were not allowed in the hospital for risk of contagion, apprised of their loved one’s status.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

Don't Forget the Bubbles

JUNE 10, 2024

The history of necrotising enterocolitis The earliest documented cases resembling Necrotising enterocolitis (NEC) date back to the late 19th and early 20th centuries. Let’s delve into the significant challenges posed by small bellies: big battles – the not-so-simple case of necrotising enterocolitis. Can we prevent NEC?

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Dr. Smith's ECG Blog

APRIL 8, 2016

The patient stabilized and had a good outcome. IV administration of potassium is indicated when arrhythmias are present or hypokalemia is severe (potassium level of less than 2.5 Administration of potassium may be empirical in emergent conditions. "If There is atrial fibrillation. The QT is much shorter still.

Resuscitation 52

Resuscitation EKG/ECG Hospitals Administration 52

EB Medicine

AUGUST 6, 2019

In the end, they reported similar rates of recurrence and bleeding outcomes for acute treatment. Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. Make sure to get the name, dose, and time of last administration of any DOAC. of patients per year.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

EB Medicine

MAY 3, 2019

Jeff: And finally, how many of you wish there was a clearly outlined evidence-based approach to managing such patients to improve care and outcomes? Next, schedule a follow up appointment, ideally within a week of discharge, and lastly, document the patient’s preferred follow up resources and steps taken to get them there.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

EB Medicine

OCTOBER 1, 2018

In one study, every hour of delayed abx administration was associated with an 8% increase in mortality. Nachi : I’m sure there are many trials to come in the future documenting their safety profile, but moving on to the next pressor to discuss. But this isn’t limited to the air. vasopressin. Jeff : Next we have epinephrine.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

NOVEMBER 16, 2024

Posterior – Shortened, adducted, internally rotated 5,6 Anterior – Shortened, abducted, externally rotated 5,6 As with all dislocations, perform and document distal neurovascular exam before and after management. 8 Perform and document distal neurovascular exam. 5 CT if concern for occult fracture. 2015;97(17):1386-1397.

EMS 94

EMS Dislocations Fractures Operations 94

Don't Forget the Bubbles

DECEMBER 2, 2024

This study relied on coding, and if the patient had not been coded as asthma, for example, and coded as pneumonia instead, these patients would not have been included in the study set. Most QIs focus on the care process; however, there is a lack of QIs that assess clinical outcomes. and 16.7% , respectively.

Documentation/Coding 98

Documentation/Coding Pediatrics Emergency Department Fractures 98

Don't Forget the Bubbles

JULY 3, 2023

This study supports existing evidence that the use of intranasal fentanyl improves the time to administration of analgesia for those with SCD-VOE. This data relies heavily on the coding, which we know is not standardized across healthcare sites- and, therefore may not be truly reflective. Why does it matter? Why does it matter?

Emergency Department 105

Emergency Department Hospitals Domestic Violence Pediatrics 105

RebelEM

MAY 15, 2024

Early administration of antibiotics is the only factor known to reduce this mortality. Early administration of antibiotics is the only factor known to reduce this mortality. Changing aetiology, clinical features, antimicrobial resistance, and outcomes of bloodstream infection in neutropenic cancer patients. Coding for Mucositis.

Infectious Diseases 90

Infectious Diseases Administration Sepsis Anaphylaxis 90