Don't Forget the Bubbles

FEBRUARY 5, 2025

E.g. burns, neurosurgery, interventional radiology. Excessive IV fluid administration should be avoided due to the risk of acidosis, coagulopathy and electrolyte disturbance – all of which evidence shows significantly increased mortality. What GCS would the administration be recommended for? Stabbings in Adolescents.

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

EMDocs

NOVEMBER 1, 2023

2 , 4 , 5 Recommended by the American College of Radiology (ACR) Appropriateness Criteria but otherwise limited for cervical perforations or alternative etiologies of chest pain. PPI administration to decrease gastric acid secretion. 5 Consider antifungal administration. Discuss with GI/surgeons prior to placement.

Operations 93

Operations Radiology Radiology Fluid Resuscitation 93

RebelEM

FEBRUARY 29, 2024

It is possible that the ceftriaxone altered baseline bacterial colonization within the respiratory tract, causing cultures to be negative despite positive clinical and radiological signs, leaving room for a false negative diagnosis. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62

CDC 122

CDC Radiology Radiology Head Injuries 122

Advanced Medical Reviews

APRIL 17, 2019

Dr. Scott Gottlieb, the 23rd commissioner of the United States Food and Drug Administration, recently resigned after less than two years in the role. Protect the nation from the health effects of emerging and pandemic infectious diseases and chemical, biological, radiological and nuclear (CBRN) threats. FDA Commissioner Resigns.

Infectious Diseases 66

Infectious Diseases Radiology Radiology Administration 66

RebelEM

MAY 25, 2023

Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients with Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial. Intensive Care Med 2020. [13] Not every institution will have TEG/ROTEM and more evidence is needed to support or refute its use 4F-PCC Bouzat P et al.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

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 97

EMS Fluid Resuscitation Resuscitation Radiology 97

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. These multiple hazards include biological, chemical, ergonomic, and radiological risks. This includes dentistry.

PPE 105

PPE Hazardous Materials Documentation/Coding Operations 105

EMDocs

OCTOBER 10, 2024

Delay in administration of antibiotics. A delay in antibiotics administration was unfortunate but no one can say on a “more probable than not” basis that earlier treatment would have changed the outcome. Initial focus only on thigh problem. Delay in diagnosis of abscess of thigh. The leg/groin/thigh area had a “necrotizing infection.”

Documentation/Coding 97

Documentation/Coding Hospitals Sepsis Infectious Diseases 97

ACEP Now

SEPTEMBER 3, 2024

The AMA found that administrative burden of reimbursement and low rates were the most frequent factors in physicians’ decisions to sell their practices. Private equity firm, accused of trying to build a monopoly in radiology, dismissed as defendant in FTC lawsuit. Radiology Business. Heartland-Charleston of Hanahan SC LLC et al.

Hospitals 113

Hospitals Radiology Radiology Emergency Department 113

EMDocs

NOVEMBER 20, 2023

Role of antifibrinolytic agents Recommendation: We recommend against the administration of antifibrinolytic agents such as tranexamic acid in LGIB. However, for patients with recent cardiac stents within 1 year, a multidisciplinary approach should be used to determine the safety of temporarily holding antiplatelets.

Resuscitation 104

Resuscitation Fluid Resuscitation Hospitals Research 104

ACEP Now

JUNE 5, 2023

Finally, on the legislative side, we are working with our Congressional allies to put pressure on the Administration to address these significant implementation issues. For now, that guidance still stands, even though the administration is not enforcing it. ACEP submitted amicus briefs for both earlier this year. What’s Next?

Administration 59

Administration Radiology Radiology 59

PEMBlog

OCTOBER 26, 2023

Radiology of Meckel’s Diverticulum. The Meckel’s scan is the preferred diagnostic modality, and prompt surgical consultation may be necessary for symptomatic cases. References Dixon P & Nolan D. The Diagnosis of Meckel’s Diverticulum: A Continuing Challenge. Clin Radiol. 1987;38(6):615-9 Ghahremani G.

Radiology 64

Radiology Radiology Resuscitation Administration 64

The Skeptics' Guide to EM

AUGUST 24, 2024

This procedure involves the administration of a local anesthetic into the plane between the serratus anterior muscle and the rib cage, targeting the thoracic intercostal nerves that supply sensation to the chest wall. Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial.

Fractures 53

Fractures Emergency Department Ultrasounds Radiology 53

RebelEM

OCTOBER 5, 2023

Pneumonia diagnosis supported by clinical and radiologic criteria. The treating physicians and research personnel were all unaware of the treatment arm, reducing the potential for bias in treatment administration and outcome assessment. Population Inclusion Criteria: Adult patients (≥18 years old).

Research 94

Research Outcomes Administration Shock 94

Medagadget

AUGUST 9, 2023

“As with positron emission tomography, which relies on the administration of radioactive substances as markers, this method has the great advantage of being sensitive and fast without ‘seeing’ interfering background signals from tissue or bone,” said Volker Behr, a researcher involved in the study.

Research 90

Research Administration Wellness Radiology 90

Don't Forget the Bubbles

JUNE 30, 2023

She’s wheeled to radiology. Tranexamic acid administration to pediatric trauma patients in a combat setting: the pediatric trauma and tranexamic acid study (PED-TRAX). Brakes off. You know what,” says your SHO as you roll Polly along the corridor, “we’re going to have the answer to our question in the next couple of years.”

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

Northwestern EM Blog

MAY 16, 2022

vs. It is worth mentioning that this study was a multicenter study based in the US with representation from ED, Radiology, and Urology. Third, for those with proper training, and with some exceptions (see the systematic review paper for case vignettes that highlight these), POCUS is non-inferior to radiology-performed US. J Urol 2019.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

EMDocs

NOVEMBER 4, 2023

A) Administration of a 30 mL/kg bolus of normal saline B) Admission for intravenous vancomycin C) CT scan of the pelvis D) Emergency surgical consultation and broad-spectrum antibiotics Answer: D Fournier gangrene is necrotizing fasciitis of the perineal, genital, or perianal anatomy. Radiology Key. Tracy CR, Steers WD, Costabile R.

EMS 94

EMS Ultrasounds Emergency Department Infectious Diseases 94

ACEP Now

NOVEMBER 14, 2023

Tranexamic acid for treatment of pulmonary hemorrhage after tissue plasminogen activator administration for intubated patient. Inhaled tranexamic acid as a novel treatment for pulmonary hemorrhage in critically ill pediatric patients: An observational study. Crit Care Explor. 2020;2(1):e0075. Sanghvi S, Van Tuyl A, Greenstein J, et al.

Radiology 52

Radiology Radiology Emergency Department Airway Management 52

RebelEM

JANUARY 25, 2023

Radiology US 90% 96% 14.1 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 0.27 – 0.83 Abdominal Distension 62 – 67% 89 – 96% 5.64 – 16.8 0.34 – 0.43 Abdominal X-ray 75% 66% 1.6

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

Taming the SRU

MAY 30, 2023

mg single-dose 5-mL ampule or equivalent, 2 Aspirin, 325-mg tablets, 4 Bronchodilator, metered-dose inhaler or equivalent 50% Dextrose injection, single-dose 50-mL ampule or equivalent Epinephrine injection, 1:1000 (1 mg/mL) single-dose 1-mL ampule or equivalent, 2 Epinephrine injection, 1:10,000 (0.1

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

" The impact of this paper led to massive government regulation, grants, and reorganization of many local ambulance groups to Emergency Medical Services under administrative authorities and with shifts to contracted operators or public agencies such as fire departments who welcomed additional service justification and operating funds.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

EMDocs

NOVEMBER 16, 2024

16 US or CT guided biopsy/joint aspiration (typically performed by Orthopedic surgery or Interventional Radiology). Periprosthetic Joint Infection : Diagnosis requires joint fluid sampling, which is typically obtained in consultation with Interventional Radiology and Orthopedic Surgery. 16 CT Accuracy up to 84% in detecting PJI.

EMS 98

EMS Dislocations Fractures Operations 98

Don't Forget the Bubbles

DECEMBER 2, 2024

IN administration offers a noninvasive way to bypass the blood-brain barrier, allowing drugs to rapidly enter the brain. However, IN administration was faster and more comfortable for patients without any significant difference in potency among the three routes.

Documentation/Coding 98

Documentation/Coding Pediatrics Emergency Department Fractures 98

EMDocs

JUNE 3, 2023

Early administration of antibiotics may not be prioritized in the setting of hemodynamic instability but antibiotics are a critical portion of management if open fracture is suspected. 12 An AP x-ray of the pelvis should be obtained in the ED for unstable patients. Note placement over the greater trochanters.

Fractures 64

Fractures Resuscitation Operations EMS 64

Advanced Emergency Nursing from AENJ

MAY 27, 2015

Dolan, LA Times] Administrators often insist that the hospital be a “weapons-free” zone (as if there was any protection in that), that guards are often unarmed –perhaps with just a radio and a flashlight, and often wearing a “friendly” blazer rather than a uniform of obvious authority. Occupational Safety and Health Administration. (No

Federal Emergency Management Agency 40

Federal Emergency Management Agency Military Hospitals Administration 40

EMDocs

NOVEMBER 13, 2023

The American College of Radiology (ACR) recommends a premedication schedule 12 hours before a contrasted CT with steroids and diphenhydramine in patients who are at high risk for hypersensitivity reaction but recognizes that this is not feasible in the acute setting. 60) Radiology, A. Radiology 2020, 294 (3), 660-668.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

EB Medicine

FEBRUARY 1, 2019

Let’s talk radiology. Nachi: In addition to monitoring ABCs, early care involves the administration of analgesics and anti-emetics. In one study a d-dimer level < 500 mcg/L had a 97% sensitivity and a negative predictive value of 99% - not bad! Nachi: Pretty impressive performance characteristics. 10% of non-traumatic headaches.

Emergency Department 40

Emergency Department Stroke Outcomes Ultrasounds 40

Don't Forget the Bubbles

AUGUST 13, 2023

However, if radiological evidence of raised intracranial pressure is seen, do not perform lumbar puncture. (cerebral abscess, tubercular meningitis, traumatic injuries), with suspected structural defects of the brain or with abnormally large heads. Raised intracranial pressure to be determined clinically rather than by CT scan. meningitis C.

Seizures 97

Seizures Pediatrics Dehydration Radiology 97

Sensible Medicine

MARCH 19, 2025

The three of us took the elevator down to the radiology department to examine the patients’ CT scans. The problem was that the nearest radiology department with a scanner was at another hospital that refused to see her. Only the Lord (and the administration) knows. Prasad and I sat back and took in the information.

Radiology 71

Radiology Radiology Hospitals Administration 71

ACEP Now

FEBRUARY 19, 2025

510 These tools expedite administrative tasks such as recording patient encounters, facilitating quick retrieval of EHR data, and identifying incidental findings on imaging; they even play a role in shared decision making. Artificial intelligence in emergency radiology: where are we going? How Can AI Benefit Teaming? Artif Intell Med.

Teamwork 51

Teamwork Clinical Decision Support Systems Administration Radiology 51

Taming the SRU

JUNE 6, 2023

MULLEN Case #1 Young male presenting with a left eye injury with concerns of wood particles in his eye On exam, reduced visual acuity and small amount of fluorescein uptake noted Initial concern for corneal FB First attempt for removal with a cotton swab Then called ophthalmology, who had concern for corneal laceration & subtle positive Seidel's (..)

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

American Medical Compliance

MARCH 19, 2025

It may include all of the key administrative clinical data relevant to that persons care under a particular provider. This includes demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports.

Documentation/Coding 52

Documentation/Coding Outcomes Radiology Radiology 52