Downeast Emergency Medicine

DECEMBER 1, 2021

While the ongoing COVID-19 pandemic has contributed to overdose deaths and taxed constrained Emergency Department (ED) resources, it has also clarified the important role that emergency physicians have in expanding access to life-saving medications to treat opioid use disorder. Annals of Emergency Medicine. Hawk, et al.

Emergency Department 52

Emergency Department Documentation/Coding Leadership Hospitals 52

EB Medicine

JUNE 12, 2024

Eckler, MD interview Corey Hazekamp, MD, MS, one of authors of the June 2024 Emergency Medicine Practice article, Managing Emergency Department Patients With Opioid Use Disorder Current State of Opioid Epidemic Overview of overdose deaths and trends. Anecdotal insights on changing naloxone administration dosages.

Emergency Department 81

Emergency Department Administration EMS Research 81

Emergency Medicine Journal

NOVEMBER 28, 2023

Patients assessed by an Emergency Department (ED) based Frailty Intervention Team (FIT) are routinely asked ‘What Matters To You’ (WMTY). Data was routinely collected from Comprehensive Geriatric Assessments, and entered prospectively onto Excel by a trained administrator.

Emergency Department 40

Emergency Department Documentation/Coding Administration Hospitals 40

The Skeptics' Guide to EM

AUGUST 27, 2022

He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. […] The post SGEM#374: Bad Habits – Medications for Opioid Use Disorder in the Emergency Department first appeared on The Skeptics Guide to Emergency Medicine. Date: August 23rd, 2022 Reference: Schoenfeld et al.

Emergency Department 40

Emergency Department Research Administration Resuscitation 40

JournalFeed

JUNE 29, 2024

Thursday Spoon Feed : Ketamine has been shown to be efficacious in managing acute pain conditions in the emergency department (ED), and this study showed equal efficacy between nebulized and intravenous administration of sub-dissociative ketamine (IV-SDK).

Administration 52

Administration Emergency Department 52

JournalFeed

JULY 20, 2024

Tuesday Spoon Feed : In a cohort of septic children, delays in antibiotic administration 330 minutes or longer from arrival to the emergency department led to an increase in mortality. For access to more, please visit JournalFeed.org for details about becoming a member. in the control group.

Administration 52

Administration Emergency Department 52

ACEP Now

AUGUST 25, 2023

Intranasal Fentanyl for Sickle Cell Vaso-Occlusive Pain Case A 15-year-old female with sickle cell disease (SCD) presents to your emergency department (ED) with a vaso-occlusive pain episode (VOE) of her legs and back. Two interesting findings were time to parenteral opioid administration and total dose of opioid morphine equivalents.

Administration 97

Administration Pediatrics Emergency Department Outcomes 97

EMDocs

JUNE 29, 2024

. #2: Nebulized vs IV Sub-dissociative Ketamine for Pain Spoon Feed Ketamine has been shown to be efficacious in managing acute pain conditions in the emergency department (ED), and this study showed equal efficacy between nebulized and intravenous administration of sub-dissociative ketamine (IV-SDK).

Shock 69

Shock Emergency Department Administration Resuscitation 69

ALiEM

JULY 22, 2023

You can not seem to find your pressure infusion cuff to squeeze the IV bag and accelerate fluid administration. Note that conventional pressure bags may not be readily available in emergency departments and could blow the line you worked hard to secure. In the unused port, attach a 10 or 20 cc syringe.

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Emergency Department Administration 96

The Skeptics' Guide to EM

AUGUST 24, 2024

Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle. Reference: Partyka et al.

Fractures 50

Fractures Emergency Department Ultrasounds Radiology 50

The Skeptics' Guide to EM

JUNE 17, 2023

Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Date: June 15, 2023 Reference: Rees CA et al. Date: June 15, 2023 Reference: Rees CA et al. Reference: Rees CA et al.

Emergency Department 71

Emergency Department Pediatrics Administration Head Injuries 71

ACEP Now

OCTOBER 13, 2023

The CHRISTUS Health-Texas A&M Spohn Emergency Medicine Residency Program announced Friday that its program will close in June 2026 after the current emergency medicine residents complete their training. We feel that this decision was made without adequate assessment of the negative impacts this WILL have on our patients.

Patient Safety 132

Patient Safety Administration Emergency Department EMS 132

Emergency Medicine Journal

APRIL 22, 2024

The randomised controlled trial by Pope et al reported in this issue of the Emergency Medicine Journal, adds to a growing literature on the use of e-cigarettes as a smoking cessation intervention, providing evidence in a novel, pragmatic setting—emergency departments (EDs).

Administration 52

Administration Emergency Department 52

The Trauma Pro

JUNE 30, 2023

Typically, hospital administrators pressure trauma programs to adopt an eTFS at some point after implementing the hospital-wide use of an electronic health record (EHR). Epic Systems became the first, and hospital administrators eventually became aware of it. The biggest question is, why does your hospital want you to use it?

Hospitals 130

Hospitals Administration Resuscitation Best Practices 130

EB Medicine

JANUARY 10, 2020

Show Notes Please click here and take our listener survey Emergency Department management of Non-St Segment Elevation Myocardial Infarction, by Drs Julianna Jung and Sharon Bord. PCI) in STEMI Early administration of aspirin decreases mortality and complications of MI (all types). (19),

Emergency Department 40

Emergency Department Shock EKG/ECG Sepsis 40

EMDocs

AUGUST 24, 2023

Study design Multicenter prospective observational cohort study across seven urban emergency departments. Blood cultures were collected from patients before the admiration of antibiotics (gold standard), and then again 30 – 120 min following administration of antibiotics. Difference of 12% (95% CI 5.4 Ann Intern Med.

Administration 69

Administration Sepsis Shock Outcomes 69

ACEP Now

AUGUST 22, 2023

Intravenous insulin shifts potassium into cells, thereby lowering serum potassium within an hour of administration. A Common Case Hypoglycemia following insulin administration for hyperkalemia is common, occurring in approximately one in six patients (about 17 percent). Am J Emerg Med. J Emerg Med. Eur J Emerg Med.

Emergency Department 52

Emergency Department Administration Outcomes Research 52

Emergency Medicine Journal

JUNE 22, 2023

The main outcome measures were ambulance transport, lumbar imaging, opioid administration and hospital admission. CALD status was defined by country of birth, preferred language and use of interpreter service.

Emergency Department 40

Emergency Department Administration Hospitals Outcomes 40

ACEP Now

NOVEMBER 7, 2023

And in our comment letter responding to the FTC and Department of Justice’s proposed updates to health care merger guidelines, ACEP urged the agencies to finalize these changes that would bring more scrutiny to health care mergers and slow down consolidation.

Leadership 98

Leadership Administration Research Risk Management 98

AENJ: Editors' Picks

JUNE 30, 2011

One of the most important adverse effects of anticoagulation therapy is life-threatening hemorrhage, and it may result in visits to the emergency department. Each of these agents has the potential to reverse specific anticoagulation therapies, but each agent has a unique administration procedure and monitoring parameters.

Emergency Department 52

Emergency Department Administration 52

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. Ong MEH, Chan YH, Oh JJ, et al.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102

Pediatric EM Morsels

JULY 19, 2024

If bleeding, the only lab that is needed in the Emergency Department is a type and cross. Soak the gauze with epinephrine (1:10,000) or TXA (our THIRD route of administration) Apply pressure laterally to the tonsillar fossa with the gauze covered Magill forceps. CBC, coagulation panels, von Willebrand factor etc are less useful.

Pediatrics 285

Pediatrics Airway Management Wellness Administration 285

The Skeptics' Guide to EM

JULY 20, 2024

Case: A 70-year-old man presents to the emergency department (ED) with an exacerbation of COPD. This process involves the administration of supplemental oxygen before the induction of anesthesia to increase the oxygen reserves in the lungs, thereby reducing the risk of hypoxemia.

COPD 91

COPD Patient Safety Administration Emergency Department 91

JournalFeed

APRIL 15, 2023

Ketamine ICP Safety Spoon Feed This retrospective study of thirty-three pediatric patients with severe traumatic brain injury (sTBI) demonstrated no increase in intracranial pressure (ICP) after administration of ketamine.

Academics 52

Academics Pediatrics Administration Operations 52

ALiEM

JUNE 1, 2023

Are you using phenobarbital instead of benzodiazepines as the first-line monotherapy for patients in alcohol withdrawal in the Emergency Department (ED)? Administration of benzodiazepines or barbiturates to these patients risk inducing a prolonged comatose state. The Journal of Emergency Medicine. Open Access Emerg Med.

Administration 98

Administration Emergency Department Seizures Hospitals 98

RebelEM

JULY 3, 2023

Impact of intravenous calcium with diltiazem for atrial fibrillation/flutter in the emergency department. Am J Emerg Med. What They Did: Researchers conducted a multicenter, retrospective cohort study in three community hospitals and two freestanding emergency departments. Article: Rossi N et al. received CaCl 89.3%

Administration 84

Administration Outcomes Documentation/Coding Emergency Department 84

EB Medicine

DECEMBER 30, 2019

Emergency Department Treatment Oxygen Keep O2 saturation >90% Clinicians may choose not to use continuous pulse oximetry (weak recommendation due to low-level evidence and reasoning) 1 Fluids IV or NG administration of fluids to combat dehydration, until respiratory distress and tachypnea resolve. All were UTIs.

Emergency Department 40

Emergency Department Allergic Reactions Dehydration Pediatrics 40

Cook County EM Blog

APRIL 27, 2022

Effectiveness and safety of droperidol in a United States emergency department. Am J Emerg Med. 2019.09.007 What : Retrospective cohort study of all droperidol administrations between January 2012 and April 2018 at an academic and pediatric emergency department in the US with 77,000 annual visits.

Administration 52

Administration EKG/ECG Emergency Department EMS 52

PEMBlog

MAY 17, 2023

Most children who present to Pediatric Emergency Departments these days with mental health concerns – including agitation – have a known psychiatric problem or diagnosis. Department of Health and Human Services (HHS) as part of an award (U07MC37471) totaling $3M with 0 percent financed with nongovernmental sources.

Psychiatric 80

Psychiatric Pediatrics Emergency Department Best Practices 80

EMDocs

MAY 25, 2023

mg/kg or 10 mg Seizures must persist for at least 5 minutes after administration of the prespecified benzodiazepines. In light of these data, I will give levetiracetam due to its less severe side effects and ease of administration. mg/kg or 10 mg Intravenous lorazepam 0.1 mg/kg or 4 mg Intravenous midazolam 0.2

Seizures 63

Seizures Administration Anaphylaxis Outcomes 63

The Trauma Pro

AUGUST 15, 2023

Two sets of documentation are crucial: accurate records of blood product administration (on the trauma flow sheet), and documentation of just about everything else (in the blood bank). In the emergency department, the surgeon or emergency physician can do this. Coolers get delivered, products get transfused.

Documentation/Coding 130

Documentation/Coding Best Practices Resuscitation Administration 130

ACEP Now

JUNE 14, 2024

Transfers have always been an area of concern to hospital administrators and emergency physicians. In 1986, Congress enacted the Emergency Medical Treatment and Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay. emergency departments. Click to enlarge.

Emergency Department 52

Emergency Department Hospitals Operations Leadership 52

Taming the SRU

JUNE 12, 2023

Although not every person seeks health care for these injuries, the majority of those that do end up in the emergency department. In 2008, this led to greater than 316,000 emergency department (ED) visits and about 9,500 hospitalizations [1]. Annals of Emergency Medicine. Annals of Emergency Medicine.

Infectious Diseases 98

Infectious Diseases Emergency Department Administration Academics 98

The Skeptics' Guide to EM

FEBRUARY 27, 2021

Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. Rapid Administration of Methoxyflurane to Patients in the Emergency Department (RAMPED): A Randomised controlled trial of Methoxyflurane vs Standard care. Reference: Brichko et al. Reference: Brichko et al. AEM Feb 2021.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Administration Emergency Department Research 52

Taming the SRU

FEBRUARY 12, 2024

HISTORY OF PRESENT ILLNESS A female in her 30s arrives to the emergency department via emergency medical services. She arrives in the emergency department agitated and unable to answer questions appropriately. The patient is agitated on a backboard with C-collar in place.

Administration 74

Administration Fractures Anaphylaxis Head Injuries 74

ACEP Now

MARCH 12, 2024

ACEP helped make this possible by mobilizing Congress to request HHS action during last year’s Leadership and Advocacy Conference, where emergency physicians from across the country gathered in D.C. This is a daily situation in emergency departments across the country.” to share their concerns directly with elected officials.

Leadership 52

Leadership Emergency Department Pediatrics Research 52

ACEP Now

JUNE 13, 2024

This fall, ACEP will participate in the Agency for Healthcare Research and Quality (AHRQ) Director’s summit on emergency department boarding. ACEP helped make the summit possible by mobilizing Congress to request action from the Department of Health and Human Services (HHS) during the Leadership and Advocacy Conference in 2023.

Hospitals 52

Hospitals Administration Emergency Department Research 52