University of Maryland Department of Emergency Med

JULY 6, 2023

Burns are common pediatric injuries and usually represent preventable unintentional trauma. Approximately 10% of children hospitalized with burns. Click to view the rest

Burns 61

Burns Pediatrics Hospitals 61

Emergency Medicine Cases

MAY 21, 2019

It turns out that for all burn patients—from minor to severe—there is a lot of room for improvement in ED management, counselling and disposition. The post Ep 124 Burn and Inhalation Injuries: ED Wound Care, Resuscitation and Airway Management appeared first on Emergency Medicine Cases.

Airway Management 52

Airway Management Burns Resuscitation Fluid Resuscitation 52

The Trauma Pro

OCTOBER 3, 2023

I have seen several patients in follow-up who basically stopped wearing their brace as soon as they were out of the hospital. Int J Burns Trauma 12(4):168-174, 2022. But it appears to be so small that the question of whether a brace is really necessary needs to be asked. Most braces are expensive and uncomfortable.

Fractures 203

Fractures Dislocations Operations Burns 203

Ken Grauer, MD

JULY 22, 2023

The ECG in Figure-1 was obtained from an elderly man with a history of coronary disease — who contacted EMS for "burning" chest discomfort that woke him at 3am. The C ASE C ontinues : En route to the hospital — another tracing was done 2 minutes after ECG #1.

EKG/ECG 195

EKG/ECG Burns EMS Wellness 195

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED? ETT onto a fiberoptic scope. ETT onto a fiberoptic scope.

CPR 91

CPR Burns Airway Management Wellness 91

RebelEM

APRIL 29, 2024

Many clinicians don’t consider IO placement while others consider it a last resort or only a pre-hospital procedure. Intravenous vs.intraosseous vascular access during out-of-hospital cardiac arrest – protocol for a randomized clinical trial. PMID: 33350794 10 Meilandt C. Resusc Plus. 2023 PMID: 37502742 11 Schwalbach KT et al.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Sensible Medicine

SEPTEMBER 19, 2024

As a result, one-third of doctors are burned out and doctors have the highest suicide rate of any profession. Trust in hospitals and doctors decreased from 70% to 40%, according to a JAMA study published last month. We have not given doctors the time or resources to study the root causes of disease.

Research 145

Research Military Poisoning Burns 145

Don't Forget the Bubbles

SEPTEMBER 11, 2024

I have been a doctor for half of my life, and my journey to burnout has been a 25-year slow burn that began the day I graduated. And so the slow burn continues… As you become increasingly exhausted, you lose self-control, making it harder to protect yourself from the demands of your job. There is still time to repair. Nothing changes.

Burns 88

Burns Hospitals Emergency Department Wellness 88

University of Maryland CC Project

MAY 25, 2023

Chadi Abouassaly, Assistant Program Director of General Surgery at Medstar Washington Hospital Center and Associate Medical Director of the Trauma and Burn ICU presents a lecture on Pancreatitis as part of the DC5 lecture series.

Burns 40

Burns Hospitals 40

PHEM Cast

JANUARY 4, 2017

Scenario based outdoor simulation in pre-hospital trauma care using a simple mannequin model. Boet S, Bould MD, Layat Burn C, Reeves S. Top 10 (+1) tips to get started with in situ simulation in emergency and critical care departments. Bredmose PP, Habig K, Davies G, Grier G, Lockey D. BMJ Quality & Safety. 2013; 22: 468-477.

Teamwork 52

Teamwork Burns Emergency Department Resuscitation 52

Don't Forget the Bubbles

OCTOBER 18, 2024

Clinical practice guidelines Midline Catheters, Dr Liz Prentice, Anaesthetic Department, The Royal Children’s Hospital, Melbourne, September 2011 The post Midline Catheters in Paediatrics – The Long and Short of it. JAMA Pediatr. 2023 Nov 1;177(11):1132-1140. doi: 10.1001/jamapediatrics.2023.3526. PMID: 37695594; PMCID: PMC10495929.

Administration 89

Administration Pediatrics Ultrasounds Burns 89

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 92

Sepsis Shock Resuscitation Fluid Resuscitation 92

PHEM Cast

SEPTEMBER 25, 2019

Parenteral penicillin for children with meningococcal disease before hospital admission: case-control study. Sörensen HT, Nielsen GL, Schönheyder HC, Steffensen FH, Hansen I, Sabroe S, Dahlerup JF, Hamburger H, Olsen J: Outcome of pre-hospital antibiotic treatment of meningococcal disease. 2006 Jun 3;332(7553):1295–8.

Ambulance Services 52

Ambulance Services Sepsis Burns Hospitals 52

Emergency Medicine Journal

OCTOBER 26, 2023

Background In-hospital alcohol testing provides an opportunity to implement prevention strategies for patients with high risk of experiencing repeated alcohol-related injuries. However, barriers to alcohol testing in emergency settings can prevent patients from being tested. to 0.61) and low falls (aOR=0.17, 95% CI 0.12 to 3.48).

Burns 52

Burns Hospitals 52

RebelEM

AUGUST 7, 2023

What They Did: Prospective randomized clinical trial Patients randomized to: Delayed Sequence Intubation (DSI): IV ketamine 1.5mg/kg in 0.5

Head Injuries 98

Head Injuries Airway Management Outcomes Burns 98

American Medical Compliance

OCTOBER 27, 2023

Over 80% of all intensive care patients treated with an indwelling urinary tract catheter throughout their hospital stay had catheter-associated urinary tract infections (CA-UTIs). Within the first 30 days of hospitalization, the incidence of CA-UTIs exceeds 100%. The rate of occurrence is 3%–10% per day of catheterization.

Burns 52

Burns Hospitals 52

Rural Doctors Net

AUGUST 24, 2013

Q2 : What equipment is available in YOUR hospital (or prehospital pack) to help manage his bleeding? Again circumstances will differ – some rural hospitals will have theatre capability and access to blood – some not. P 120 BP 80. Cap refill 3 secs. Tender in LUQ. Q1 : What are your priorities in managing this patient?

Burns 52

Burns Hospitals 52

ACEP Now

OCTOBER 10, 2024

On physical exam, you notice what appears to be a blister from a burn on her right palm (see photo on cover). When you are done, you tell the mother what you found and ask her if there is any way the child could have been burned. Case Resolution Given the location of the burn, pediatric burn surgery was consulted.

Forensics 40

Forensics Domestic Violence Burns Pediatrics 40

RebelEM

JULY 20, 2023

INTRODUCTION You’re moonlighting in a remote access hospital. EMS radios in for a burn patient and to anticipate a difficult airway. The patient is horribly burned. She was smoking with her home O2 on and has severe mixed partial and full thickness burns to the chest, neck, face, and airway. They’re rolling up now.

EMS 75

EMS Burns Airway Management Wellness 75

Pediatric Emergency Playbook

DECEMBER 1, 2015

Case 1: Toddler with an oral commissure burn An electrical burn to the angle of the mouth cauterizes superficial bleeding vessels, and hours later the wound becomes covered with a white layer of fibrin, surrounded by erythema. Most patients do well, and the burn heals by secondary intention. Take Home Points 1. J Pediatr Surg.

Burns 40

Burns Emergency Department EKG/ECG Shock 40

EMDocs

OCTOBER 21, 2023

In hospital mortality estimated at 30-40%. 17 65-78% of survivors have significant disability one month after hospital discharge. link] Burns JD, Rindler RS, Carr C, et al. 20 Prognosis: Despite advances in imaging and treatment options, BAO is associated with high morbidity and mortality. 2014;45(7):1985–91.

EMS 97

EMS Stroke Outcomes Hospitals 97

American Medical Compliance

NOVEMBER 22, 2022

A new study conducted by the Commonwealth Fund found that over half of medical practitioners under the age of 55 have reported feeling burned out or stressed. The American Hospital Association developed a plan to improve healthcare worker recruitment and retention. The COVID-19 pandemic has contributed to the rise in stressed doctors.

Burns 52

Burns Hospitals 52

RebelEM

MARCH 23, 2023

REBEL Cast Ep115 – Phenobarbital vs Lorazepam in Alcohol Withdrawal Click here for Direct Download of the Podcast Clinical question : Is a phenobarbital-based or lorazepam-based alcohol detoxification protocol associated with a lower hospital length of stay compared to Ativan for alcohol withdrawal? Paper : Hawa F et al.

Emergency Department 52

Emergency Department Burns Outcomes Hospitals 52

Taming the SRU

AUGUST 4, 2024

Wound healing is faster with Dermabond compared to sutures, and can be useful as a less-painful technique to repair certain wounds Dermabond differs from non-medicinal superglue because it is sterile, is more flexible, and ultimately less brittle than standard superglue There have been care reports of non-medicinal glue (superglue, nail glue, etc.)

Dislocations 86

Dislocations Emergency Department Documentation/Coding Burns 86

ACEP Now

AUGUST 29, 2023

Our program pairs training at one of the busiest emergency departments in the country at a nationally recognized county, safety-net, Level I Trauma and Regional Burn Center (MetroHealth) with a world-renowned quaternary academic referral center (Cleveland Clinic). What does your program offer that residents can’t get anywhere else?

Academics 52

Academics Burns Emergency Department Ultrasounds 52

EMDocs

DECEMBER 4, 2023

The facility does not have ultrasound (US) availability at the time of the patient’s presentation, as the sonographer comes to the hospital only 2 days a week. If this is not possible in the hospital system, physicians should communicate directly with someone who can facilitate the order.

Ultrasounds 95

Ultrasounds Documentation/Coding Wellness EMS 95

PulmCCM

FEBRUARY 19, 2024

Let Families Activate Rapid Response Teams, Says SCCM The Society of Critical Care Medicine (SCCM) issued a new guideline on how hospitals and care teams should respond to emergencies outside the ICU or ED (i.e., SCCM now suggests this should be a standard practice at most hospitals. on the medical and surgical wards). Read it here.

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

33 Charts

FEBRUARY 7, 2022

Without the Circle of Safety clinicians burn their emotional energy protecting themselves from an assault of administrative tasks and mushrooming clinical demands. Perhaps part of our burnout crisis in medicine stems from a lack of safety for doctors. The healthcare world is filled with danger.

Leadership 52

Leadership Burns Administration Hospitals 52

SheMD

SEPTEMBER 11, 2023

Is the clinic attached to the hospital or do you need to drive? Are there any attendings in the hospital at night? Is this EMR the same in the hospital and clinic? You’d be surprised at how many hospitals do NOT have these available to trainees, and to purchase on your own can cost hundreds of dollars. Is food provided?*

Hospitals 52

Hospitals Burns Documentation/Coding 52

Critical Care Now

APRIL 21, 2022

The duration of PIRRT also varies between hospitals and published studies making a standardized approach to dosing an issue. While there is definitely more information on HD and CRRT dosing, PIRRT dosing information is frequently lacking. Furthermore, the literature that is available is unfortunately limited to antimicrobials only.

Burns 52

Burns Administration Outcomes Hospitals 52

SheMD

APRIL 26, 2023

To work extra hard as a physician (while also being a perfect “mom,” “wife,” or “daughter” outside the hospital), and to exhibit resiliency when faced with micro aggressions and inequality in the workplace. I would put it all on myself to figure out how to navigate unpredictable appointments and insane medication protocols in the hospital.

Leadership 52

Leadership Burns Research Administration 52

FEMinEM

MARCH 3, 2021

Tunnels of infected tissue and bacteria creep into her blood stream from ulcers that erode her backside and force repeated visits to the hospital. My grandchildren no longer engage in conversation with me at the holiday dinner table and my daughter is afraid I’ll burn myself when I offer to help with the mash potatoes.

Emergency Department 52

Emergency Department Burns Stroke Hospitals 52

ACEP Now

APRIL 4, 2024

The patient’s first and second troponins from the outside hospital were less than 0.01 Dr. Ahdi is a senior emergency medicine resident at Corewell Health William Beaumont University Hospital. Burns E, Buttner R. Figure 1: EKG for Dextrocardia showing STEMI. Click to enlarge.) References Maldjian PD, Saric M. 2019;30(5):390-392.

EKG/ECG 40

EKG/ECG Burns Documentation/Coding Emergency Department 40

Taming the SRU

MARCH 17, 2023

mg/kg IV Versed: 0.2 mg/kg IM, 0.2 mg/kg IN (may repeat to max of 0.4 mg/kg IN), 0.2

Seizures 40

Seizures Fractures Burns Pediatrics 40

AED Leader

OCTOBER 11, 2023

If you are hosting a meal at your home, consider brushing up on your CPR, the Heimlich Maneuver, and the steps to take for cuts and burns. Some portable defibrillators can connect to WiFi at a receiving hospital and send the patient’s heart rhythm and a record of the shocks given.

CPR 52

CPR Burns Hospitals Shock 52

AED Leader

OCTOBER 11, 2023

If you are hosting a meal at your home, consider brushing up on your CPR, the Heimlich Maneuver, and the steps to take for cuts and burns. Some portable defibrillators can connect to WiFi at a receiving hospital and send the patient’s heart rhythm and a record of the shocks given.

CPR 52

CPR Burns Hospitals Shock 52

Dr. Smith's ECG Blog

NOVEMBER 13, 2022

I don’t know the reason why it took so long, but a second troponin turned out to be positive by then and the patient was referred to our hospital for “emergency PCI”. He arrived to our hospital one hour later. The ECG in ER is shown below: ECG is still diagnostic but we are watching the natural course of myocardial infarction here.

EKG/ECG 52

EKG/ECG Burns Documentation/Coding Hospitals 52