The Skeptics' Guide to EM

MAY 25, 2024

Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. Reference: Borgundvaag et al. When we combine SGEMHOP with an SGEM Xtra I hope we get some…AMAZING knowledge translation for GRACE4.

Emergency Department 101

Emergency Department Best Practices Seizures Research 101

The Trauma Pro

AUGUST 15, 2023

In the emergency department, the surgeon or emergency physician can do this. The emergency physician was left behind in the ED and the surgeon is up to her elbows in trouble. One best practice to consider: a highly trained trauma resuscitation nurse or advanced practice provider (APP) can run the MTP from the sidelines.

Documentation/Coding 130

Documentation/Coding Best Practices Resuscitation Emergency Department 130

PEMBlog

MAY 31, 2023

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. West J Emerg Med. Erratum in: West J Emerg Med. 2019 Mar;20(2):409-418. doi: 10.5811/westjem.2019.1.41344.

Psychiatric 93

Psychiatric Emergency Department Pediatrics Administration 93

PEMBlog

OCTOBER 18, 2024

When patients with DMD present in the Emergency Department (ED), an understanding of the nuanced aspects of their care is essential for optimal management. Below are key considerations based on current best practices.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 52

Emergency Medicine Journal

JUNE 20, 2024

The Royal College of Emergency Medicine Toxicology Special Interest Group in collaboration with the UK National Poisons Information Service and the Clinical Toxicology Department at Guy’s and St Thomas’ NHS Foundation Trust has produced guidance to support clinicians working in the ED with the assessment and management of adults with acute (..)

Best Practices 40

Best Practices Emergency Department Poisoning 40

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. Diagnostic yield of head CT in pediatric emergency department patients with acute psychosis or hallucinations. Pediatr Radiol 2019; 49:240.

Psychiatric 80

Psychiatric Pediatrics Emergency Department Best Practices 80

ACEP Now

JUNE 6, 2023

When considering an optimized environment for compassionate patient communication, the chaotic emergency department (ED) probably gives some clinicians pause. 9) Tell Me More, or What Else, Statements Admittedly, this proficiency can be difficult in the busy emergency department. Example: “My spouse said I should come in.”

Emergency Department 98

Emergency Department Hospitals Best Practices Shock 98

The Trauma Pro

JUNE 30, 2023

A best practice would be to scan (or copy) the paper trauma flow sheet just before the patient leaves the emergency department for good so an interim version can be placed in the EHR. The critical move is that it should be scanned early so that it is available in the EHR as soon as it is complete.

Hospitals 100

Hospitals Administration Resuscitation Best Practices 100

EMDocs

JUNE 2, 2023

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. Erratum in: West J Emerg Med. 2019 Jul;20(4):688-689. PMID: 30881565; PMCID: PMC6404720. Acad Pediatr. 2023.03.005.

Psychiatric 92

Psychiatric Pediatrics Emergency Department Administration 92

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. Clinical scoring tools have improved diagnostic performance in assessing suspected appendicitis in the emergency department.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

ACEP Now

OCTOBER 9, 2024

Emergency physicians have long taken pride in delivering care every day of the week, every hour of the day. ACEP’s Emergency Department Accreditation program adds a layer to that, says Marianne Gausche-Hill, MD, FACEP, FAAP, FAEM, Chair of the program’s Board of Governors.

Emergency Department 52

Emergency Department Critical Access Geriatric Emergencies Ultrasounds 52

Don't Forget the Bubbles

JANUARY 22, 2024

Choosing Wisely aims to help clinicians align with best practices by avoiding interventions that are not supported by evidence. Choosing Wisely in Paediatric Car e A trainee-led project in a UK tertiary paediatric emergency department looked at the usefulness of blood tests in 101 children. 70% had liver function tests.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

EMDocs

JUNE 16, 2023

And now we’re here at our destination, the place we know and love, the emergency room to talk about what we should be doing for the growing volume of children with mental health problems boarding in the emergency department.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

EB Medicine

SEPTEMBER 1, 2022

In this episode, Sam Ashoo, MD interviews Lela Bachrach, MD, MS, Larissa Truschel, MD, MPH, and Makini Chisolm-Straker, MD, MPH - the authors of the July 2022 PEMP article on Human Trafficking of Children and Adolescents: Recognition and Response in the Emergency Department. Do you find this dissuades patients form reporting?

Emergency Department 52

Emergency Department Documentation/Coding EMS Best Practices 52

ACEP Now

JUNE 1, 2023

We need to navigate challenges, foster ethical use, and identify the best practices for emergency department application. However, the implementation of these models also comes with potential risks and downsides.

Best Practices 52

Best Practices Research Documentation/Coding Emergency Department 52

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. ASMBS pediatric committee best practice guidelines. I hope everybody enjoyed a fantastic conference. 2015;25(4):622-627. 2012;8(1):1-7.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

The Injectable Orange

APRIL 4, 2017

In the consistent form of Injectable Orange we have a not so hidden curriculum – critical appraisal and evidence based practice. Predicting Geriatric Falls Following an Episode of Emergency Department Care: A Systematic Review. The Article Carpenter, C. Avidan, M. Fowler, S. A., & Lo, A. Case: 84yo woman (Mrs.

Emergency Department 52

Emergency Department Evidence-Based Practice Academics Documentation/Coding 52

Total Medical ComplianceHIPAA

JULY 6, 2023

Department of Health and Human Services, reached a $240,000 settlement with Yakima Valley Memorial Hospital following an investigation into a privacy breach. The breach involved unauthorized access to 419 patient health records by 23 security guards working in the emergency department.

Hospitals 52

Hospitals Best Practices Emergency Department Wellness 52

EB Medicine

APRIL 30, 2017

This month's episode of EMplify, the podcast corollary to the Emergency Medicine Practice journal, focuses on acute decompensated heart failure. The podcast is based on the full-length review published in the May 2017 issue of Emergency Medicine Practice.

Outcomes 40

Outcomes Burns Best Practices Ultrasounds 40

EM Curious

SEPTEMBER 9, 2015

LITERATURE OF INTEREST An Age-Adjusted D-dimer Threshold for Emergency Department Patients With Suspected Pulmonary Embolus: Accuracy and Clinical Implications. This will be your target. Learn more about this procedure here. Rob Orman breaks down this topic on ER Cast to help us better understand the evidence and demystify this issue.

Stroke 52

Stroke Pediatrics Best Practices EMS 52

Taming the SRU

MARCH 12, 2024

In the context of increasing ED and hospital crowding as well as limited ICU availability, this study aimed to evaluate the impact of a subcutaneous insulin (SQuID) protocol in the treatment of DKA on emergency department length-of-stay (EDLOS) and ICU admissions. If positive (>1.1

Operations 97

Operations Hospitals Best Practices Wellness 97

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. Am J Emerg Med. Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 23, Issue 4, 2009. 2021 Nov;49:226-232.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

ACEP Now

SEPTEMBER 5, 2024

ACEP should seek greater partnerships with residency directors and programs to ensure practicing physicians see the many products of ACEP’s efforts. While some issues are handled locally, many issues cannot be solved in our emergency department or hospital.

Leadership 98

Leadership PPE EMS Wellness 98

Canadian EM

JULY 16, 2024

You are working in an inner city emergency department (ED) and you notice that there are 10 patients who are waiting for their COVID-19 test results.

Emergency Department 40

Emergency Department Best Practices 40

ACEP Now

NOVEMBER 7, 2023

2 Information blocking is any practice that is “likely to interfere with access, exchange, or use of [EHI].” 3 These regulations have led to widespread practices of EHI, such as test results and clinical documentation, being shared with patients in real time. Training opportunities for documentation best practices should be employed.

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

PEMBlog

AUGUST 30, 2023

System changes to electronic ordering have been shown to induce more permanent clinical practice change and continual updates to these systems are necessary to keep pace with knowledge evolution and best practice. Pneumonia in Children Presenting to the Emergency Department with an Asthma Exacerbation. Pediatrics.

Pediatrics 52

Pediatrics Best Practices Hospitals Emergency Department 52

ACEP Now

FEBRUARY 10, 2024

Emergency Medicine Wellness Center of Excellence Award: Presented to an emergency medicine group, department, or clinical site that incorporates wellness and resilience on an institutional level and to use the information gathered in the nominations process to understand more about wellness best practices.

Leadership 52

Leadership Academics Administration EMS 52

Mind The Bleep

MAY 16, 2023

LaznerM, “The Alex Emergency Department, Paediatric Practice Guideline. Belking-Gerson J, “BMJ Best Practice: Constipation in Children,” 5 March 2023. Available: [link]. [4] 4] NICE, “Constipation in Children and Young People: Diagnosis and Management,” 5 March 2023.

Dehydration 52

Dehydration Best Practices Documentation/Coding Emergency Department 52

ACEP Now

NOVEMBER 16, 2023

Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis. Acad Emerg Med. The post Best Practices for Upper Gastrointestinal Hemorrhage appeared first on ACEP Now. Dionne JC, Oczkowski SJW, Hunt BJ, et al. Crit Care Med. 2022;50(3):e313-e319.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

ACEP Now

APRIL 9, 2025

.” 1 A study by van Zwieten in 2004 found that 49 percent of deaths attributed to droperidol required dosages 50 mg, magnitudes greater than typical dosages used in the emergency department (ED). The incidence of QT prolongation and torsades des pointes in patients receiving droperidol in an urban emergency department.

Emergency Department 52

Emergency Department Administration EKG/ECG Resuscitation 52

EM Literature of Note

OCTOBER 14, 2024

link] “Empathy and clarity in GPT-4-Generated Emergency Department Discharge Letters” The cold, unfeeling computer generates better feels than emergency clinicians. Bland treacle, no doubt, but generic bland treacle will beat the terse output of a distracted human any day.

Stroke 89

Stroke Emergency Department Resuscitation Best Practices 89

Broome Docs

JUNE 20, 2023

BMJ Best Practice. PMID: 36996524 This is a qualitative study, based on interviews of 24 adult patients who presented to the emergency department with a presumptive diagnosis of cannabinoid hyperemesis syndrome. Intravenous Haloperidol Has a Limited Role in the Modern Emergency Department. Ann Emerg Med.

Emergency Department 120

Emergency Department Sepsis Best Practices 120

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the Emergency Department, he initiated ‘ The Pause.’ & Liska, H.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

Taming the SRU

SEPTEMBER 16, 2024

In the era of modern medicine, blood transfusions are commonplace, especially in the emergency department. While they are a lifesaving staple of medicine, they also come with risks that emergency providers must be aware of. Adverse reactions to transfusion of blood products and Best Practices for Prevention.”

Blood Transfusions 90

Blood Transfusions Anaphylaxis Emergency Department Sepsis 90

SheMD

APRIL 24, 2023

I break bad news almost every shift in the emergency department. An email with a sad face to a woman jacked up hormones was not the best approach. I put on my scrubs (I was on the schedule… again) and drove myself to the Emergency Department (ED). Breaking bad news is always a challenge. It was certain.

Ultrasounds 83

Ultrasounds Radiology Radiology Emergency Department 83

Don't Forget the Bubbles

MARCH 31, 2025

The value of white blood cell count in predicting serious bacterial infections in children presenting to the emergency department: a multicentre observational study Archives of Disease in Childhood 2025;110:191196. Am J Emerg Med. The sepsis screening tool in paediatric emergency departments can help. 2025.01.054.

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

EB Medicine

MAY 3, 2019

This month, we’re moving into uncharted territories for the podcast… we’re talking psychiatry Nachi: Specifically, we’ll be discussing Depressed and Suicidal Patients in the emergency department. Nachi: Though not yet implemented in the ED setting, this may offer a novel approach to ED patients with psychiatric emergencies in the ED.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40