Ken Grauer, MD

FEBRUARY 28, 2023

Applying the Above to Today's Case: In addition to being Covid-positive — the patient in today's case had longstanding COPD. He was wheezing, and required supplemental oxygen.

EKG/ECG 195

EKG/ECG Documentation/Coding Sepsis COPD 195

ACEP Now

DECEMBER 6, 2024

A 45-year-old male with a history of chronic obstructive pulmonary disease (COPD), asthma, amphetamine and tetrahydrocannabinol (THC) use, and coronary vasospasm presented to triage with chest pain. and at Naples Community Hospital in Naples, Fla. Dr. Rad is ED faculty at Wellstar Kennestone Regional Medical Center in Marietta, Ga.,

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

EB Medicine

OCTOBER 1, 2017

COPD has huge economic and human burdens in the US. In fact, in 2010, two studies estimated that COPD exacted a direct and indirect cost of somewhere between $36 and $50 billion dollars in the US. million ED visits for COPD - related problems, with nearly 1/5th requiring hospitalization.

COPD 40

COPD Hospitals 40

Sensible Medicine

JUNE 30, 2023

Patients present with troublesome symptoms that they “just want checked out before the weekend” and I’m left either worrying about them all weekend or admitting them to the hospital where I know little will happen for the next two days. She did not require hospitalization. It was not exertional.

Hospitals 98

Hospitals Hospice Resuscitation COPD 98

Sensible Medicine

AUGUST 21, 2023

This is a common probably insurmountable problem with morbidities, such as hypertension, diabetes , COPD , etc. This is not always obvious in the clinical data sets, since mortality out of hospital may be recorded in vital status databases but not in hospital or healthcare system databases especially if patients move, etc.

Administration 98

Administration Outcomes Research COPD 98

The Skeptics' Guide to EM

APRIL 8, 2023

The objective of that study was the following: * To investigate how the’ natural experiment’ of reconfiguring the emergency healthcare system in Denmark affected in-hospital and 30-day mortality on a national level. They found no statistical difference for in-hospital mortality but slightly increased 30-day mortality.

Stroke 56

Stroke Emergency Department COPD Academics 56

ALiEM

FEBRUARY 16, 2024

An 86-year-old man with a past medical history of coronary artery disease, hypertension, hyperlipidemia, chronic kidney disease, COPD, choledocholithiasis requiring ERCP and sphincterotomy 2 years ago presented with five days of feeling unwell. History was limited due to cognitive impairment.

Radiology 64

Radiology Radiology Ultrasounds COPD 64

Taming the SRU

OCTOBER 1, 2023

It can be further divided into two types: primary--those that occur in generally healthy individuals without underlying lung disease, and secondary--those that occur in individuals with underlying lung disease such as COPD [1]. Smoking is a known risk factor, as is cannabis use [2,5, 7-8].

Fractures 96

Fractures COPD Hospitals Emergency Department 96

The Skeptics' Guide to EM

JUNE 29, 2019

Population: Patients over the age of 65 who stayed overnight in the emergency department or were admitted to hospital. The derivation population was from five hospitals in Australia, while the validation population was from a single hospital in Ireland. Intervention:The CriSTAL score, and its various components.

Emergency Department 52

Emergency Department COPD Hospitals Outcomes 52

PulmCCM

SEPTEMBER 23, 2024

Daily duration of long-term oxygen therapy and risk of hospitalization in oxygen-dependent COPD patients. 2016 Sep 20;11(9):e0163293. doi: 10.1371/journal.pone.0163293. PMID: 27649490; PMCID: PMC5029935. Sundh J, Ahmadi Z, Ekström M. Int J Chron Obstruct Pulmon Dis. 2018 Aug 28;13:2623-2628. doi: 10.2147/COPD.S167523.

COPD 52

COPD Research Academics Hospitals 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2017

Written by Pendell Meyers, edits by Smith: Case A 72 year old female with hypertension and COPD presented with sudden shortness of breath and chest pain. On day 3 of hospitalization she underwent coronary angiography, revealing a 95% lesion in the mid-LAD which was stented. There is sinus rhythm with PACs and PVCs.

COPD 52

COPD EKG/ECG Wellness Outcomes 52

PulmCCM

JUNE 10, 2024

3 days for anoxic encephalopathy to regain pupillary responses after cardiac arrest, 4-7 days for a DNR/DNI patient to receive NIPPV for COPD exacerbation, etc.) days, with fewer patients receiving mechanical ventilation or invasive procedures, and with no difference in hospital mortality. ICU length of stay fell by a median of 1.3

COPD 45

COPD Outcomes Hospitals EMS 45

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. million hospitalized people annually. He’s afebrile.

Sepsis 40

Sepsis Emergency Department COPD Hospitals 40

Emergency Medicine Ireland

MARCH 27, 2023

Oh Chapter 37 is dedicated to NIV in the ICU and is probably worth some time given that this is a common respiratory support both in the ICU and throughout the hospital. Exacerbations of COPD in this scenario the lungs are scarred and the airways constricted and obstructed. Welcome back to the tasty morsels of critical care podcast.

COPD 52

COPD Wellness Fractures Hospitals 52

Sensible Medicine

MAY 26, 2023

Atrial fibrillation, COPD, serous otitis media, pyelonephritis, a sprained knee, a rash, epididymitis, (I could go on and on and on) are all within your purview. If you’re being honest with yourself, primary care general internal medicine is what you imagined being a doctor would be like. You can answer any patient’s concerns.

COPD 63

COPD Wellness Outcomes Operations 63

EMDocs

APRIL 22, 2024

1-3 VTE is responsible for hospitalizing over 250,000 Americans every year, and there are an estimated 100,000 deaths annually associated with these conditions. 1-3 As many as 25% of acute PE cases present as sudden cardiac death. 10,11 Vid 1. SubX4 Asystole RV > LV. SubX2 Asystole RV > LV.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

University of Maryland CC Project

JANUARY 3, 2023

Emil Oweis is a board-certified pulmonary and critical care attending physician and is an Associate Medical Director of Respiratory Therapy at MedStar Washington Hospital Center. He gives a lecture as part of the DC5 Lecture Series entitled "Mechanical Ventilation in Obstructive Lung Disease". Dr. Emil S.

Hospitals 40

Hospitals COPD 40

Taming the SRU

MARCH 17, 2023

mepivacaine (1-3 h) 1% lidocaine +/- epi (2-3h) 0.25% bupivacaine (2-3 h) 0.25-0.5% 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

Mind The Bleep

NOVEMBER 21, 2023

For example: “If ultrasound negative then reassure and discharge”, “If CRP normal then safety net and advise to see GP if symptoms recur” Treatment Escalation Plan/ DNACPR Clearly document if the patient has an existing DNACPR in place- they may come to hospital with a copy.

Documentation/Coding 52

Documentation/Coding COPD EKG/ECG Wellness 52

EB Medicine

OCTOBER 1, 2018

For those listening, my hospital probably looks a little bit like yours. Roughly half of in-hospital mortality is associated with septic in some fashion. clearly this is an important topic if it warrants it’s own chair at a major hospital in NYC. At our hospital in southern Manhattan, patients tend to breathe around 16.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

She was discharged after a short hospitalization with oncology and cardiology follow-up. At our hospital, I think all of our docs would want to place a pigtail catheter in the ED, under ultrasound guidance and not wait for cardiology to take the patient to the cath lab. A repeat POCUS showed resolution of her pericardial effusion.

EKG/ECG 40

EKG/ECG Ultrasounds Documentation/Coding COPD 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. Author continued : STE in aVR is often due to left main coronary artery obstruction (OR 4.72), and is associated with in-hospital cardiovascular mortality (OR 5.58).

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

ACEP Now

JUNE 14, 2024

Chronic obstructive pulmonary disease (COPD) is a chronic disease of the lungs caused by inflammatory and structural changes of the small airways and parenchyma of the lungs that result in chronic airflow obstruction and gas trapping. In 2019, the global prevalence of COPD was estimated to be 10.3 8 Bronchodilators Albuterol 2.5-5

COPD 52

COPD Hospitals Emergency Department Outcomes 52

Sensible Medicine

SEPTEMBER 22, 2024

In studies, and in practice, these people tend to be patients with COPD who have resting O 2 sats of < 88%. The primary outcome was a composite of hospitalization or death from any cause within one year. About 80% had either COPD or pulmonary fibrosis and the mean PaO 2 and O 2 sats were about 50mm Hg and 80%, respectively.

COPD 117

COPD Outcomes Shock Hospitals 117

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

RebelEM

MAY 15, 2024

Follow your hospital’s protocol (if available). High Risk Patients will need hospitalization and IV antibiotics. This will have been formulated based on local resistance patterns and likely with input from your institution’s oncologists.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

The Skeptics' Guide to EM

MARCH 25, 2018

Case: An 85-year-old woman with a history of chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), and type-2 diabetes (DM-2), and her 65-year-old otherwise healthy daughter present to the emergency department after a car accident.

Outcomes 40

Outcomes Geriatric Emergencies Emergency Department COPD 40

PulmCCM

OCTOBER 23, 2023

Among >2500 patients under age 50 in an observational cohort who contracted Covid-19 in the Omicron era, those taking Paxlovid had no fewer deaths, emergency department visits, or hospitalizations (as a composite) than those not treated with the drug , with the exception of those with cardiovascular disease or cancer.

Hospitals 98

Hospitals COPD Emergency Department CDC 98

PulmCCM

SEPTEMBER 28, 2023

There was a strong trend toward reduction in the combined endpoint of hospitalization or death, among patients randomized to inhaled budesonide. Outcomes tested were the time to sustained recovery (three days symptom-free, hazard ratio 1.01), hospitalizations (three in each group), or death by day 28 (there were none).

COPD 95

COPD Stroke Academics Urgent Care 95

Taming the SRU

JANUARY 22, 2025

2,3] In 2020, the CDC estimates that asthma exacerbations accounted for almost 1,000,000 ED visits and almost 100,000 inpatient hospitalizations. [4] COPD is characterized by episodes of exacerbations, which require prompt recognition and management due to their potential to escalate rapidly and cause significant morbidity and mortality.

COPD 80

COPD CDC Research Emergency Department 80

PulmCCM

MARCH 11, 2024

You probably don’t ever see this–you bill as usual, but CMS reportedly doesn’t pay your hospital for any of your 99292s until billed time goes over 104 minutes. Ascension is a $27 billion, 140-hospital conglomerate operating in 19 states—the third largest system in the U.S

Hospice 52

Hospice Documentation/Coding Administration Hospitals 52

The Skeptics' Guide to EM

JANUARY 22, 2022

Early in the pandemic, there was some observational data that concluded that inhaled steroids were associated with an increased mortality from COVID-19 in patients with asthma and COPD ( Schultze Lancet Resp Med 2020 ). However, the most likely explanation was not causal. It did report positive results.

Urgent Care 40

Urgent Care COPD Outcomes Emergency Department 40

Taming the SRU

OCTOBER 28, 2024

Most common triggers include respiratory conditions such as asthma, COPD, and pneumonia which can lead to forceful coughing -Other common triggers include forceful exertion, severe coughing or vomiting, asthma exacerbation, intense physical activity, or Valsalva maneuvers (e.g., Unique patient case from UCMC Hospital. PubMed] 13.

COPD 79

COPD Pediatrics Emergency Department Ultrasounds 79

EMDocs

FEBRUARY 8, 2025

Four days ago, he presented to the ED for a COPD exacerbation. On chart review, a sputum culture collected during a recent hospital visit grew a species of Aspergillus. COPD, cystic fibrosis), HIV/AIDS, cancer, immunosuppressed (i.e. COPD, cystic fibrosis), HIV/AIDS, cancer, immunosuppressed (i.e.

Infectious Diseases 72

Infectious Diseases EMS COPD Research 72

Dr. Smith's ECG Blog

FEBRUARY 18, 2025

Written by Willy Frick A man in his 50s with COPD presented with dizziness and hypotension. He had worked overnight the night before and presented to the hospital after his shift. His first recorded blood pressure was 88/53 mm Hg. Here is his presenting ECG: What do you think? The ECG shows sinus rhythm.

EKG/ECG 63

EKG/ECG COPD CPR Administration 63

Sensible Medicine

JANUARY 3, 2024

I served the neighborhood of Austin, disproportionately debilitated by opioid overdoses, gun violence, and incarceration, not to mention COPD, diabetes and asthma. How often will vaccination prevent hospitalization and death? I somehow doubt the new booster would have prevented his hospitalization. What were their limitations?

CDC 143

CDC Allergic Reactions Hospitals COPD 143