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

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.

Airway Management 290

Airway Management Pediatrics Wellness Operations 290

AENJ: Current Issue

SEPTEMBER 30, 2023

The emergency department (ED) is a frequent utilizer of alternative routes of medication administration (e.g., One group of medications that has been explored via this route of administration, and is frequently administered in EDs across the nation, is opioids, most notably fentanyl, hydromorphone, and morphine.

Emergency Department 53

Emergency Department Administration 53

EMDocs

JANUARY 11, 2025

A) Administration of IV morphine for pain control B) Admission to general surgery for IV antibiotics C) Discharge home on lactulose D) Emergent surgical consultation for exploratory laparotomy E) Manual disimpaction Correct answer: E Although uncommon, stercoral colitis is a potentially life-threatening complication of chronic constipation.

EMS 94

EMS Sepsis Shock Fluid Resuscitation 94

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. First, oral administration is preferred, as this route can often be as effective as intramuscular administration.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

ACEP Now

JUNE 7, 2023

The preliminary results of the 2022 Emergency Department Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding. Preliminary results of the survey are being released to help emergency physicians understand that current challenges are occurring nationwide.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. Fibrinogen levels should also be obtained, where available, if severe hemorrhage suggests the potential need for administration of fibrinogen concentrate. and youre three hours from the nearest tertiary care center.

Airway Management 98

Airway Management Operations Resuscitation Pediatrics 98

Emergency Medicine Journal

AUGUST 23, 2023

Results We recruited 27 participants (10 nurses, 9 doctors and 8 administrator/managers) working in ED/UCCs serving areas with high deprivation and mixed sociodemographic profiles.

Emergency Department 75

Emergency Department Urgent Care Documentation/Coding Patient Safety 75

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 Emergency Department Administration EMS 132

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 Administration 52

EM Literature of Note

AUGUST 25, 2024

A heartening trend for a simpler administration and adherence strategy – and non-inferior, overall, while entirely reasonable to judiciously select a higher-risk patient in whom it might be plausible to prescribe prednisone/prednisolone instead. emergency departments” [link] Tweet

Emergency Department 94

Emergency Department Administration Wellness Pediatrics 94

RebelEM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.

Emergency Department 52

Emergency Department Administration Dehydration EMS 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 84

Emergency Department Administration EMS Research 84

PEMBlog

JUNE 7, 2023

Department of Health and Human Services (HHS) as part of an award (U07MC37471) totaling $3M with 0 percent financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S.

Pediatrics 123

Pediatrics Psychiatric Emergency Department EMS 123

Don't Forget the Bubbles

NOVEMBER 29, 2023

You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. Pediatric Endotracheal Intubations for Airway Management in the Emergency Department.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

EM Literature of Note

SEPTEMBER 13, 2024

These are each awful, of course, in their own way from a patient- and parent-oriented standpoint, but they’re also quite awful at the population level, overburdening limited pediatric and emergency department resources. “Nirsevimab and Acute Bronchiolitis Episodes in Pediatric Emergency Departments” [link] Tweet

Emergency Department 87

Emergency Department Pediatrics Administration Wellness 87

Northwestern EM Blog

JULY 15, 2024

Edmonson and Adler for this infographic that concisely emphasizes key concepts for the recognition and initial management of acute respiratory distress syndrome (ARDS) in the Emergency Department. Chest imaging and an arterial blood gas are essential to establishing the diagnosis and severity of disease.

Resuscitation 98

Resuscitation Burns Emergency Department Sepsis 98

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

RebelEM

JUNE 8, 2023

The retrospective design of this study omitted assessment of ventricular dysrhythmias related to push dose pressor administration, as they were reliant on information in the EMR. 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

PEMBlog

MAY 31, 2023

Department of Health and Human Services (HHS) as part of an award (U07MC37471) totaling $3M with 0 percent financed with nongovernmental sources. Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry.

Psychiatric 93

Psychiatric Emergency Department Pediatrics Administration 93

The Skeptics' Guide to EM

OCTOBER 19, 2024

Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Case: You’re working your usual day shift in the emergency department (ED) from 9 am to 5 pm on a Tuesday.

Emergency Department 94

Emergency Department EMS Research Administration 94

ACEP Now

MARCH 11, 2025

Many patients with PE can be discharged directly from the emergency department (ED). First, UFH is often perceived as stronger than alternatives, partially owing to the intravenous route of administration. The treatment of patients with pulmonary embolism (PE) has evolved substantially over the past few decades.

Hospitals 52

Hospitals Administration Outcomes Stroke 52

RebelEM

SEPTEMBER 29, 2022

Background: Standard emergency department management of acute pancreatitis has focused on aggressive hydration, analgesia and investigation for an underlying reversible cause (eg gallstones). The aggressive fluid administration arm is far less aggressive than what was historically recommended for pancreatitis.

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

Don't Forget the Bubbles

OCTOBER 12, 2024

doi: 10.1136/archdischild-2023-326773 Two-year-old Moyo is brought to the emergency department because her parents were concerned about noisy breathing. Most children can be discharged from the emergency department after a dose of corticosteroids and an appropriate safety net. Published Online First: 15 April 2024.

Airway Management 85

Airway Management Emergency Department Administration Hospitals 85

PEMBlog

MARCH 4, 2025

Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEMCurrents, the Pediatric Emergency Medicine Podcast. As always, I’m your host, Brad Sobolewski, and today we’re focusing on a pathogen that has been making waves in pediatric emergency departments across the country.

Pediatrics 94

Pediatrics Military CDC Hospitals 94

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 89

Shock Emergency Department Administration Resuscitation 89

ACEP Now

MARCH 10, 2025

You work as the medical director at a suburban, community emergency department (ED). At your monthly meeting with the chief medical officer (CMO) and chief nursing officer (CNO), they inform you of the hospitals plan to start a Sexual Assault Nurse Examiner (SANE) Program. As expected, you have several questions.

Sexual Assault 52

Sexual Assault Forensics Leadership Pediatrics 52

Kings County Downstate EM

DECEMBER 14, 2024

Conway, MD Resident Editor: Philippe Ayres, MD Guest Faculty Editor: James Willis, MD Its nearly midnight in your busy urban emergency department (ED).

Emergency Department 40

Emergency Department EMS Administration 40

PEMBlog

JUNE 14, 2023

Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. Department of Health and Human Services (HHS) as part of an award (U07MC37471) totaling $3M with 0 percent financed with nongovernmental sources. West J Emerg Med. 2019 Jul 22;20(5):690-695.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

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 89

Administration Sepsis Shock Emergency Department 89

EMDocs

NOVEMBER 19, 2024

Second-generation antipsychotic medications: Pharmacology, administration, and side effects. His roommate found an empty pill bottle on the floor next to him. Atypical neuroleptic malignant syndrome precipitated by clozapine and quetiapine overdose: a diagnostic challenge. Innov Clin Neurosci. 2018;15(7-8):20-22. Published 2023. Micromedex.

Poisoning 108

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 108

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 74

Emergency Department Pediatrics Head Injuries Administration 74

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 100

Hospitals Administration Resuscitation Best Practices 100

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 105

Resuscitation Administration Emergency Department Ultrasounds 105

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 113

COPD Patient Safety Emergency Department Administration 113

Pediatric EM Morsels

MAY 24, 2024

Ann Emerg Med. PECARN prediction rules for CT imaging of children presenting to the emergency department with blunt abdominal or minor head trauma: a multicentre prospective validation study. 2013;62:107-116. doi:10.1016/j.annemergmed.2012.11.009. 2012.11.009. Holmes JF, Yen K, Ugalde IT, et al. Lancet Child Adolesc Health.

Pediatrics 164

Pediatrics Blood Transfusions EMS Fractures 164

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.

Emergency Department 98

Emergency Department Administration Seizures Hospitals 98