Emergency Medicine Journal

MARCH 25, 2025

The 1-BED.

Sepsis 52

Sepsis Emergency Department Administration Outcomes 52

Pediatric EM Morsels

SEPTEMBER 22, 2023

” Children compensate for blood and volume loss very well… until they don’t. Crystalloid may help, but neurogenic shock may not respond to fluid administration. As our fearless leader likes to say: “children are not aliens, but they are a special population with unique anatomy and physiology.”

Shock 304

Shock Pediatrics Hyperthermia / Hypothermia Dislocations 304

RebelEM

JANUARY 18, 2024

It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Time to antibiotic therapy (from triage, not from onset of infection) has become a quality metric to improve the time to administration of these medications. Paper: Varney J et al. Health Sci Rep 2022. to 0.97; p = 0.02

Sepsis 132

Sepsis Hospitals Administration Outcomes 132

EMDocs

JANUARY 11, 2025

Well keep it short, while you keep that EM brain sharp. Admission allows for close monitoring, given the risks of perforation, ischemic bowel, and ulceration, as well as appropriate management of the condition and patient symptoms. Therefore, administration of IV morphine (A) would not be recommended.

EMS 97

EMS Sepsis Shock Fluid Resuscitation 97

RebelEM

SEPTEMBER 29, 2022

to 6.8L) WATERFALL Trial Fluid Administration Critical Findings: The trial was stopped early due to an interim analysis demonstrating a high incidence of fluid overload with no significant difference in the primary outcome. Baseline disease severity was well-balanced between groups. Median Fluid Received: Aggressive: 7.8L (Range 6.5

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

Ken Grauer, MD

SEPTEMBER 6, 2024

Alternatively — when a portion of the reentry circuit is made up of an AP ( A ccessory P athway ) — the retrograde P wave will typically manifest a moderately long RP' interval ( that occurs well after the QRS — usually within the latter part of the ST segment ). What is happening in today's case is different.

EKG/ECG 245

EKG/ECG Administration Operations Wellness 245

JournalFeed

APRIL 29, 2023

PROCOAG RCT Spoon Feed This well-designed RCT finds early administration of 4-factor prothrombin complex concentrate (PCC) to patients at risk of receiving massive transfusion protocol (MTP) did not reduce 24-hour blood product consumption or mortality but did increase thrombotic events.

Wellness 40

Wellness Administration 40

EM Literature of Note

AUGUST 25, 2024

Well, yes to all of the above, in the appropriate clinical context – But, most prominently, as featured in this brief report, for asthma – particularly childhood asthma. Move over ketamine and TXA, there’s another medication gradually approaching do-it-all darling status in Emergency Medicine: dexamethasone. Sore throats?

Emergency Department 94

Emergency Department Administration Wellness Pediatrics 94

PEMBlog

MARCH 4, 2025

Well cover its clinical presentation, epidemiology, diagnostic approach, and management, including why standard beta-lactam antibiotics wont work. Plus, well discuss whether M. We also don’t know whether administration of antibiotics decreases the incidence or severity of associated mucocutaneous disease.

Pediatrics 94

Pediatrics Military CDC Hospitals 94

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Your partner asks if you want to administer naloxone as well. Naloxone is a well-established medication used primarily for reversing opioid overdoses. Its safety profile is well-tolerated, with the primary adverse effects related to the abrupt reversal of opioid effects, such as acute withdrawal symptoms.

Hospitals 104

Hospitals CPR EMS Outcomes 104

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. Next week I am going to show you what a well-done medical study looks like. It is our goal. Thanks for your support.

Administration 98

Administration Outcomes Research COPD 98

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

The Trauma Pro

SEPTEMBER 20, 2023

These low numbers and the nature of this particular registry could inject significant bias as well. Stay with the room temp platelets for now, and wait for a well-powered prospective analysis before changing your MTP. I’m surprised that a military registry could only come up with 75 patients a year to analyze.

Military 113

Military Blood Transfusions Administration Outcomes 113

RebelEM

AUGUST 22, 2024

Administration of intravenous tissue plasminogen activator (IV tPA) within 4.5 1,2 Intra-arterial (IA) tPA has also shown benefit but is less well studied. Administration of intravenous tissue plasminogen activator (IV tPA) within 4.5 1,2 Intra-arterial (IA) tPA has also shown benefit but is less well studied.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

Sensible Medicine

MAY 15, 2024

There are so many things students are not learning instead — like how to read a paper or how to take care of heart failure (well). I fault the administrators. What’s worse is that it is sanctioned by administrators who cannot be questioned. In both cases, who do I fault? The students? That scares me.

Administration 119

Administration Documentation/Coding Hospitals Wellness 119

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

The Trauma Pro

AUGUST 18, 2023

product ratios are way off) then it should also be discussed at your multidisciplinary trauma PI committee as well. The Broxton tool covers all the basics and includes some additional data points that cover activation criteria, TXA administration, and administration of uncrossmatched blood. Click here to check it out.

Administration 100

Administration Operations Hospitals Wellness 100

EMDocs

NOVEMBER 6, 2023

Naloxone administration may reverse respiratory arrest, preventing progression to cardiac arrest. Standard advanced life support with the addition of administration of sodium bicarbonate is appropriate for the treatment of life-threatening dysrhythmias caused by cocaine or other sodium channel blockers. COR 2a, LOE B-NR.

Poisoning 115

Poisoning Hyperthermia / Hypothermia Seizures Administration 115

EMDocs

NOVEMBER 19, 2024

1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. Second-generation antipsychotic medications: Pharmacology, administration, and side effects. Innov Clin Neurosci.

Poisoning 111

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 111

Intensive Blog

AUGUST 19, 2024

Author: Dr Ken Hoffman Peer Reviewer: A/Prof Chris Nickson In this 5 minute video we examine the use of inhaled nitric oxide in ICU, reviewing the administration, mechanism of action, indications and side effects. If you find these videos useful, please hit the like button on Youtube and subscribe to see more!

Administration 75

Administration Research Wellness 75

ACEP Now

MARCH 11, 2025

First, UFH is often perceived as stronger than alternatives, partially owing to the intravenous route of administration. First, UFH is often perceived as stronger than alternatives, partially owing to the intravenous route of administration. The pervasive maxim quick on, quick off for UFH doesnt hold up as well as touted.

Hospitals 52

Hospitals Administration Outcomes Stroke 52

Sensible Medicine

JUNE 15, 2024

Being well versed in domains of history and sports may even have a greater impact in the clinic, as it allows you to bond with many patients. They would rather hire more compliance officers and mid-level administrators. A greater focus on wellness or work-life balance will solve none of these concerns.

Research 144

Research Wellness Academics Administration 144

Taming the SRU

SEPTEMBER 20, 2023

Baez Potassium Hyperkalemia Peaked T-waves (there is tall and spiked T-waves, that you “wouldn’t want to sit on”) PR interval increases Widening of the QRS Can lead to a sine wave Hypokalemia T wave widening/flattening T wave inversion and U wave (upward deflection after the T wave) Calcium Hypercalcemia Shortened QT interval Osborn wave (positive (..)

EKG/ECG 77

EKG/ECG Pediatrics Administration Wellness 77

RebelEM

JULY 3, 2023

Currently, the infusion of IV calcium before diltiazem is not well understood, and more studies have focused on administering IV calcium prior to verapamil than diltiazem. Critical information such as HR, SBP, drug administration times were occasionally missing. Article: Rossi N et al. received CaCl 89.3%

Administration 96

Administration Outcomes Documentation/Coding Emergency Department 96

EM Literature of Note

SEPTEMBER 1, 2023

In this study, the Epic SPM was evaluated at several difference SPS score thresholds ranging from ≥5 to ≥10 – and compared, as well, with SIRS, qSOFA, and SOFA. Alerts, alerts, alerts – what are they good for? There were two goals for the evaluation: accuracy and timeliness.

Sepsis 107

Sepsis Administration Wellness 107

ACEP Now

MARCH 10, 2025

Although not typical, a medical director may be asked to participate in staff hiring and recruitment, as well as fiscal management of the program. Another consideration is any specific training or course work you may need to better prepare to take over the role.

Sexual Assault 52

Sexual Assault Forensics Leadership Pediatrics 52

RebelEM

JULY 10, 2024

Take Home Points Early administration of antibiotics (within 60 min) in patients with fever and neutropenia is life saving. Fever in sickle cell is an emergency and always requires cultures and antibiotics even if the child appears well. Avoid sedation and lying supine and steroids in patients with mediastinal masses.

Seizures 58

Seizures Administration EMS Wellness 58

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

RebelEM

APRIL 29, 2024

CVC vs PIV The critically ill patient is often associated with pathology that makes IV access difficult such as shock state, hypovolemia, obesity, IV drug abuse, end-stage renal disease, cardiac arrest, as well as other conditions. In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Don't Forget the Bubbles

OCTOBER 12, 2024

When comparing corticosteroids to a placebo, children who received corticosteroids had a more significant reduction in croup scores between 2 and 12 hours of administration. Five studies explored different routes of dexamethasone administration. Additionally, it is more palatable, better tolerated, and has fewer side effects.

Airway Management 85

Airway Management Emergency Department Administration Hospitals 85

ACEP Now

OCTOBER 30, 2024

We don’t incentivize experience in our systems and our laws – both the provider’s experience as well as the patient’s experience, so when it comes to hospital boarding, it falls right in line with that. Another is to deliver the best patient care you possibly can, and those things don’t work very well together.

Telemedicine 40

Telemedicine Critical Access Emergency Department Hospitals 40

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. The reason I think orthopedists have done so well because they’ve been involved, they’ve been politically engaged, they’ve used their assets to preserve their assets.

Telemedicine 105

Telemedicine Critical Access Hospitals Emergency Department 105

EM Literature of Note

SEPTEMBER 13, 2024

Most regions used a strategy in which nirsevimab was provided to new births during RSV season, as well as other young infants born prior to the onset of the season. The two “COVID seasons” of 2020-21 and 2021-22 were excluded from their comparisons.

Emergency Department 87

Emergency Department Pediatrics Administration Wellness 87

The Trauma Pro

OCTOBER 31, 2023

Contact the trauma medical director, service chief, or hospital administrator and see if they can intervene. Explain to the consultant that you truly believe that harm will occur, and you will have to document that fact in the medical record as well as their failure to respond. Appeal to a higher authority.

Risk Management 113

Risk Management Fractures Documentation/Coding Hospitals 113

EM Literature of Note

APRIL 11, 2024

Each of these disease states has well-defined pathways for “optimal” therapy and escalation. These interventions were further supported by “facilitators”, persons assigned to each practice in the intervention cohort to support uptake of the EHR tools.

Outcomes 92

Outcomes Administration Hospitals Wellness 92

Don't Forget the Bubbles

NOVEMBER 27, 2023

And lastly, it’s actually quite hard to see how well the cardiovascular system is working, and this is one of its measurable features. This works well for a while, but eventually, the heart beats too fast to fill adequately. Myth busting: Is peripheral administration safe? It’s only a piece of the puzzle, though. 2021;25(1):146.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

Medagadget

AUGUST 9, 2023

The technology could provide a radiation-free alternative to techniques such as X-ray fluoroscopy and digital subtraction angiography for minimally invasive endovascular procedures, and is well suited for viewing processes such as blood flow. Developing radiation-free imaging systems is a noble goal.

Research 90

Research Administration Wellness Radiology 90