The Skeptics' Guide to EM

JUNE 5, 2021

He also works at an urgent care and a rural critical access hospital. He also works at an urgent care and a rural critical access hospital. Garreth Debiegun is an emergency physician at Maine Medical Center in Portland, ME and clinical assistant professor with Tufts University School of Medicine.

Stroke 52

Stroke Urgent Care Critical Access Outcomes 52

EMDocs

JUNE 22, 2023

As usual, I was the only physician staffing this rural critical access hospital with limited resources which sits 61 miles away from our state’s only Level 1 trauma center. Did I mention that we only had one unit of blood in the hospital for emergent release? It was an ordinary night, and I was asleep in the on-call room.

Resuscitation 98

Resuscitation Ultrasounds Critical Access Radiology 98

ACEP Now

NOVEMBER 7, 2023

In addition to 7 commendation resolutions and 12 memorial resolutions, the following non-bylaws resolutions were adopted: 19- Scientific Assembly Vendor Transparency (as amended) 20- Emergency Medicine Research Mentorship Network (as substituted) 21- Mitigation of Competition for Procedures Between Emergency Medicine Resident Physicians and Other Learners (..)

Academics 52

Academics Emergency Department Critical Access Pediatrics 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. However, duplex ultrasonography may not be readily available at all times in rural or critical access facilities. The patient is concerned about a potential DVT.

Ultrasounds 96

Ultrasounds Documentation/Coding Wellness EMS 96

ACEP Now

MARCH 12, 2024

Drivers and crews spend months at a time on the road and they travel through rural areas, where only critical access hospitals may be nearby. But the job goes beyond the obvious care provided after a wreck. Dr. Stanton has managed everything from muscle aches to injuries, norovirus outbreaks, and even crew member cardiac arrest.

Critical Access 52

Critical Access Hospitals Wellness 52

AENJ: Current Issue

DECEMBER 31, 2023

A simulation-based learning (SBL) experience was designed as a critical access setting where CSC are in place and three diverse, medically complex patients in need of critical care present to the hospital where one critical care bed remains open. Incorporating a CSC simulation looked to address this knowledge gap.

Critical Access 40

Critical Access Hospitals Wellness EKG/ECG 40

Downeast Emergency Medicine

DECEMBER 1, 2021

329 participants were enrolled at an urban teaching hospital over a period of four years. Rosenberg and colleagues took a qualitative approach when investigating barriers and facilitators to successful implementation of ED-initiated buprenorphine programs in critical access hospital EDs across Maine. ROSENBERG ET AL.

Emergency Department 52

Emergency Department Documentation/Coding Leadership Administration 52

RebelEM

DECEMBER 1, 2022

The weighting from spontaneous pneumothorax was nearly 55% for drainage duration, 77% for complication rates, 96% for hospital length of stay, and 100% for recurrence rates. Similarly, pigtail catheter placement may be accessible to more clinicians, which is ultimately better for patient care, especially those at critical access hospitals.

Outcomes 52

Outcomes Hospitals Research Critical Access 52

The Skeptics' Guide to EM

OCTOBER 10, 2021

After graduation they began working at a high-volume, high-acuity critical access hospital. She and her husband Neil met at medical school. They both matched to the same emergency medicine (EM) program. After a few years they moved back to New York.

Academics 40

Academics Critical Access EMS Hospitals 40

Downeast Emergency Medicine

APRIL 26, 2021

Four level-1 US trauma centers participated in the study where the inclusion criteria were trauma patients who were within 2 hours of their injury and were transported to the trauma center from either the field or another hospital. The primary outcome was head injury-related death in-hospital within 28 days of injury.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

ACEP Now

JULY 6, 2023

Warfarin pills are inexpensive, but the associated hospital care is not. Gaddis is a “PGY-37” who has stepped away from full-time employment after a 32-year full-time career in academic emergency medicine, and now works a limited number of shifts in a rural Critical Access hospital in Missouri.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

Taming the SRU

MARCH 14, 2023

After a several week NICU stay for prematurity, the infant has been generally healthy and this is his first trip back to the hospital since discharge. Case 4 3 year old unresponsive You are working as solo coverage in a critical access hospital. He has a weak cry and you notice bulging fontanelles.

Seizures 52

Seizures Emergency Department Pediatrics Critical Access 52

ACEP Now

AUGUST 1, 2023

Our Indiana ACEP colleagues have helped us all as emergency physicians in championing the passage of state legislation mandating a physician leading a hospital’s emergency department to be physically present in that hospital.

Emergency Department 98

Emergency Department EMS Critical Access Hospitals 98

ACEP Now

AUGUST 1, 2023

Hospital crowding and ED boarding have been longstanding and persistent crises for more than two decades, yet have progressively worsened over the COVID-19 pandemic.2 Even more so, nurses left practice or migrated to non-hospital settings. Here’s what the government can do to impact the hospital crowding and ED boarding crisis.

Military 98

Military Hospitals Emergency Department Leadership 98

The Skeptics' Guide to EM

OCTOBER 15, 2022

This year we reviewed ten recent publications, provided some critical appraisal of the studies and then discussed if the evidence would be applied differently in a rural or critical access hospital compared to a tertiary or urban centre. You can download a copy of our slides at this LINK.

Critical Access 40

Critical Access Hospitals 40

EM Literature of Note

NOVEMBER 20, 2024

For example, how direct is the correlation between “readiness” based on certain equipment and pediatric survival, if the ED in question is a critical access hospital with low annual census? The likelihood of imprecision is magnified as the estimates are combined.

Pediatrics 87

Pediatrics Emergency Department Critical Access Outcomes 87

EB Medicine

FEBRUARY 18, 2025

Dr. Wisemans Background: Overview of her work and responsibilities in rural hospitals and academia. Simulation for Critical Access Neurocritical Care: Saving Brain Hours from Tertiary Care : A customizable simulation designed for you and your team to practice managing patients with brain injury.

EMS 59

EMS Academics Critical Access Emergency Department 59

ACEP Now

FEBRUARY 11, 2025

The NEDI-USA database includes basic ED characteristics such as annual visit volume, critical access hospital (CAH) status, rural location, and freestanding ED status. The 2022 survey (administered in 2023 to all EDs open during 2022) included the physician question.

Critical Access 52

Critical Access Research Hospitals Leadership 52

ACEP Now

MARCH 10, 2025

Youre working the night shift in a rural critical access hospital in the Midwest when a 36-year-old, 31-week primigravida patient with no known prior medical history presents with a mild headache. You call the nearest hospital, but because they dont have a neonatal intensive care unit (NICU), they advise you to call another one.

OB/GYN 52

OB/GYN Seizures Stroke Hospitals 52

Advanced Emergency Nursing from AENJ

SEPTEMBER 13, 2015

She’s there because your hospital is under-resourced, has injury or illness not thought related to gravidity, is too “sick” to make it to OB Labor/Delivery, or you’re trying to get OR to open. In rural Critical Access Hospitals, or austere conditions, you may be all that is available.

Airway Management 40

Airway Management Resuscitation Critical Access Emergency Nursing 40