PulmCCM

NOVEMBER 17, 2023

Kenny MD [ @heart_lung ] In part 1 , right atrial pressure [P ra ] and cardiac output/venous return [CO/VR] were considered as two hemodynamic measures bound at the operating point [OP] of the circulatory system. OP is operating point. Shows what happens when Ppc, Pmsf, Rcardiac and Rvr all vary [grey operating points].

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

Ken Grauer, MD

SEPTEMBER 6, 2024

Depending on which of above considerations is operative — the differential diagnosis of the rhythm in ECG #1 will be between: i ) A reentry SVT rhythm with retrograde atrial conduction; ii ) ATach ( A trial T achycardia ) ; — or — iii ) Junctional Tachycardia.

EKG/ECG 245

EKG/ECG Administration Operations Wellness 245

The Trauma Pro

AUGUST 18, 2023

Presentation at your transfusion committee is fine, but this data is most suitable for presentation at the trauma operations committee. The Broxton tool covers all the basics and includes some additional data points that cover activation criteria, TXA administration, and administration of uncrossmatched blood.

Administration 100

Administration Operations Hospitals Wellness 100

ACEP Now

NOVEMBER 7, 2023

Expand Your Knowledge of the Business of EM Practice Essentials, an online, asynchronous curriculum developed by ACEP and EMRA, dives into reimbursement, contracts, operations and risk management, and other topics that may not have been covered in depth during medical school or residency. Learn more at openbook.acep.org.

Leadership 98

Leadership Administration Research Risk Management 98

Pediatric EM Morsels

NOVEMBER 3, 2023

Both have a range of detection limits, which can be greatly dependent on operator. Food and Drug Administration Approval of Artesunate for Severe Malaria: Enough to Achieve Best Practice? Imported Malaria in Countries where Malaria Is Not Endemic: a Comparison of Semi-immune and Nonimmune Travelers. Clin Microbiol Rev.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

The Trauma Pro

JANUARY 3, 2024

They postulated that, since hemorrhagic shock can cause hyperfibrinolysis (HF) and early administration of agents like TXA seem to work better when given early, wouldn’t it be nice to have a more objective way of identifying it as early as possible?

Shock 113

Shock Operations Administration Hospitals 113

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

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. The patient’s symptoms begin to improve after initial intravenous (IV) fluid administration of one litre of 0.9%

Diabetic Emergencies 102

Diabetic Emergencies Operations Hospitals Research 102

RebelEM

AUGUST 22, 2024

Administration of intravenous tissue plasminogen activator (IV tPA) within 4.5 Administration of intravenous tissue plasminogen activator (IV tPA) within 4.5 Moreover, there are multiple operational and patient-specific barriers rendering timely thrombolytic administration difficult. 9 patients received IA-tPA treatment.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

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

EMDocs

DECEMBER 6, 2024

In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. 5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. 2 L/hr in adults.

Poisoning 94

Poisoning Fluid Resuscitation Seizures Resuscitation 94

PulmCCM

NOVEMBER 6, 2023

TEG or ROTEM) is becoming a more widely used tool to help guide the administration of blood products in hemorrhage from trauma, although its effects on meaningful clinical outcomes remain uncertain. Based on this data, transfused cryoprecipitate does not seem to a merit addition as a component of massive transfusion protocols for trauma.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

EMDocs

NOVEMBER 1, 2023

PPI administration to decrease gastric acid secretion. 5 Consider antifungal administration. Answer : Esophageal Perforation 1-6 Epidemiology : Most frequent etiology is iatrogenic injury from instrumentation accounting for 60% of cases (e.g. upper endoscopy, transesophageal echo, etc.). Discuss with GI/surgeons prior to placement.

Operations 86

Operations Radiology Radiology Fluid Resuscitation 86

The Trauma Pro

JULY 10, 2023

This stream of information continues after the patient leaves the trauma bay for CT, imaging, interventional radiology, operating room, ICU, or floor bed. During chart reviews, I have seen numerous examples of fluids, vital signs, and drug administration recorded well after the patient has been declared dead! Several are simultaneous.

Resuscitation 100

Resuscitation Radiology Radiology Operations 100

RebelEM

JUNE 19, 2023

PMID: 37314244 Clinical Question: In advanced trauma systems, does prehospital administration of TXA increase the rate of survival with a favorable neurologic outcome in patients at risk for trauma-induced coagulopathy? Article: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Prehospital Tranexamic Acid for Severe Trauma.

Blood Transfusions 105

Blood Transfusions Outcomes Administration Hyperthermia / Hypothermia 105

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. Resuscitation. 9 Zhang W et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

RebelEM

OCTOBER 2, 2023

The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics.

Operations 97

Operations Academics Outcomes Fluid Resuscitation 97

American Medical Compliance

AUGUST 7, 2024

Moreover, compliance with HIPAA helps healthcare providers avoid substantial fines and legal penalties associated with data breaches, thereby maintaining compliance with federal standards and ensuring the smooth operation of their practices. It ensures healthcare providers operate ethically.

Hazardous Materials 105

Hazardous Materials Documentation/Coding Legal Issues Patient Safety 105

Total Medical ComplianceHIPAA

JANUARY 12, 2023

Many comments to the NPRM noted that this would be an operational and compliance risk issue for providers. The NPRM received around 1,390 public comments. Covered entities (providers, practices, etc.) and business associates will have 240 days to become compliant with the new rule after it is published in the Federal Register.

Operations 104

Operations Best Practices Documentation/Coding Administration 104

Emergency Live

AUGUST 6, 2024

Three interventions in a few hours: one death and two rescues A day of routine administration has turned into a race against time for the rescuers of Pesaro. Three separate interventions in a few hours have put to the test the operational capabilities of the Harbour Office. Among the victims, one death.

Operations 52

Operations Administration 52

American Medical Compliance

FEBRUARY 17, 2024

With the Occupational Safety and Health Administration (OSHA) setting standards to protect workers from occupational hazards, healthcare organizations face unique challenges in maintaining compliance due to the complexity of their operations and the diverse array of risks inherent in patient care.

Best Practices 105

Best Practices PPE Infectious Diseases Documentation/Coding 105

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

American Medical Compliance

MARCH 11, 2024

Amidst the busy dental appointments, treatments, and patient care, there are crucial aspects that often operate in the background but hold importance. These are recordkeeping and documentation. While the primary focus in dentistry is patient health and well-being, carefully keeping records is equally needed.

Documentation/Coding 105

Documentation/Coding Best Practices Operations Outcomes 105

American Medical Compliance

OCTOBER 3, 2024

Occupational Safety and Health Administration (OSHA) regulations are vital for maintaining a safe and healthy work environment in all industries. Dental practices must maintain radiation safety protocols and provide radiation safety training for staff operating radiographic equipment. This includes dentistry.

PPE 105

PPE Hazardous Materials Documentation/Coding Operations 105

Don't Forget the Bubbles

NOVEMBER 29, 2023

Even though sedation after endotracheal intubation (ETI) reduces the risk of self-extubation, uncontrolled pain, and awakening awareness, several small single-centre studies demonstrate low rates of sedative drug administration after ETI in the emergency department (ED). When there is an immediate threat to life (e.g.,

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

Medagadget

SEPTEMBER 29, 2023

These limitations include the following: In-hospital administration through external catheters that can cause infection over time. Mike Maglin: The device operates by inserting catheters into the brain tissue driven by a pump, allowing for the controlled infusion of therapeutic agents. Medgadget: How does the device work?

Operations 105

Operations Administration Hospitals 105

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 Operations Emergency Department 52

RebelEM

NOVEMBER 6, 2023

ug/kg/min of norepinephrine equivalent at time of hydroxocobalamin or methylene blue administration Exclusion Criteria: Administration of hydroxocobalamin or methylene blue for non-VS indications Hydroxocobalamin or methylene blue given > 48 hours after CPB Pre-intervention cardiac index < 2.0 J Cardiothorac Vasc Anesth.

Shock 71

Shock Administration Academics Hospitals 71

American Medical Compliance

FEBRUARY 15, 2023

Congress established the Occupational Safety and Health Administration (OSHA), with the purpose of creating safe and health conscience work conditions. Passing the exam will qualify the individual for an assisted living administrator certificate. Furthermore, OSHA estimates that 5.6 The specific requirements of the exam vary.

Administration 52

Administration Infectious Diseases Operations Best Practices 52

American Medical Compliance

FEBRUARY 15, 2023

Congress established the Occupational Safety and Health Administration (OSHA), with the purpose of creating safe and health conscience work conditions. Passing the exam will qualify the individual for an assisted living administrator certificate. Furthermore, OSHA estimates that 5.6 The specific requirements of the exam vary.

EMS 52

EMS Administration Infectious Diseases Operations 52

PulmCCM

JANUARY 6, 2025

With financial penalties coming for noncompliance with the new rule, hospital administrators rapidly deployed the alerts to fire on all eligible inpatients. Instead of clinical micromanagement, in its new form it would incentivize continuous improvement in systemwide operational processes. And have they fired.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

ACEP Now

JULY 7, 2024

2,3 In this case, aortic dissection was visualized neither on initial bedside nor on repeat inpatient TTE, despite operator knowledge of a known lesion and extensive operator training. Her orthopedic injury was managed non-operatively until her aortic repair could be performed. Axial abdominal aortic dissection.

Operations 59

Operations Hospitals Administration Outcomes 59

PulmCCM

MARCH 11, 2024

Palliative care programs are sometimes pitched to administrators on the basis of their potential to reduce costs, by shortening length-of-stay or intensity of expensive and unhelpful therapies at the end of life. Ascension is a $27 billion, 140-hospital conglomerate operating in 19 states—the third largest system in the U.S

Operations 52

Operations Administration Research Hospitals 52

Advanced Medical Reviews

FEBRUARY 13, 2019

It is intended to streamline workflow, reduce administrative burden and improve patient care, but when poorly designed, technology may increase stress for physicians. This stress is part of a large problem in healthcare: physician burnout. Doctors who spend large amount of time on EHRs at home had a 1.9 times greater chance of burnout.

Documentation/Coding 64

Documentation/Coding Administration Operations Research 64

EM SIM Cases

SEPTEMBER 19, 2024

Treatment includes tourniquet application to the limb and rapid blood product administration. Intubation for clinical course and pain management need to be addressed with disposition to the operating room. The trauma team will be activated and he will be brought to the ED. Boating Trauma Download [link] ECG Source = [link]

Shock 52

Shock Emergency Nursing Operations Administration 52

EMDocs

SEPTEMBER 7, 2024

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 93

EMS Fluid Resuscitation Resuscitation Radiology 93

EMDocs

MARCH 2, 2024

A) Administration of mannitol B) Admission for observation C) Discharge home D) Discharge home with oral steroids Answer: B The patient has a skull fracture with an overlying laceration. Administration of mannitol (A) is indicated for patients with elevated intracranial pressure.

EMS 119

EMS Fractures Seizures Head Injuries 119