ACEP Now

NOVEMBER 14, 2023

The emergency department (ED) at UVA was rebuilt in 2019 and the department had not fully optimized its operations when COVID-19 hit. They also developed standard work documents for each role. The post Re-Engineering Flow in an Academic Emergency Department appeared first on ACEP Now.

Academics 52

Academics Emergency Department Leadership Operations 52

The Trauma Pro

JULY 5, 2024

Improper care during an emergency This situation can occur in the emergency department when the emergency physician calls a specialist to assist with management. Specialists, make sure you understand the emergency physician’s concerns and clearly explain why you think you don’t need to see the patient in person.

Documentation/Coding 113

Documentation/Coding Fractures Emergency Department Wellness 113

Emergency Medicine Journal

JUNE 20, 2024

Emergency departments (ED) represent a promising setting to address preventive health measures like CRC screening. We evaluated feasibility of identification, provided preliminary effect size estimates and documented participant acceptability.

Emergency Department 40

Emergency Department Documentation/Coding Outcomes 40

AENJ: Current Issue

SEPTEMBER 30, 2023

The overuse of computed tomographic (CT) scans for patients who present to the emergency department (ED) after mild traumatic brain injury (mTBI) has been well-documented. The Canadian Computed Tomography Head Rule (CCHR) is a validated tool to guide ED providers in determining the need for emergent CT of mTBI patients.

Emergency Department 53

Emergency Department Documentation/Coding Outcomes Wellness 53

Emergency Medicine Journal

NOVEMBER 28, 2023

Patients assessed by an Emergency Department (ED) based Frailty Intervention Team (FIT) are routinely asked ‘What Matters To You’ (WMTY). Age, Gender, Clinical Frailty Score (CFS) and documentation of ‘WMTY’ was analysed. 468 (79%) patients had documentation of WMTY. Five themes emerged – 1.

Emergency Department 40

Emergency Department Documentation/Coding Administration Hospitals 40

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? 13 Interventions may include: Ascertaining a patient’s preferred language early in the clinical encounter (during registration, for instance), and clearly documenting this preference in a place that is visible to all providers. 45:446-458. Taira B, et al.

Documentation/Coding 81

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 81

Emergency Medicine Journal

JULY 24, 2023

Introduction Pain is the most common presenting feature within the ED, yet undertreatment of pain in the ED is a well-documented problem worldwide. Despite the development of interventions to address this problem, there is still limited understanding of how pain management can be improved within the ED.

Emergency Department 74

Emergency Department Documentation/Coding Research Wellness 74

The Trauma Pro

AUGUST 15, 2023

MTP logistics include details such as who will be delivering the blood, what actually goes in each cooler, what ratios should be used, limitations imposed by the use of frozen plasma, and documentation. Documentation is critically important, both in the trauma bay and the blood bank. And there are plenty around all the time!

Documentation/Coding 130

Documentation/Coding Best Practices Resuscitation Administration 130

Taming the SRU

JULY 14, 2023

Yates and Hughes Early pregnancy loss accounted for over 900,000 emergency department visits in 2021 alone, and there is concern with the changing legal landscape of safe medically provided abortions that this number will increase due to self-managed abortion complications.

Documentation/Coding 60

Documentation/Coding Emergency Department 60

EMDocs

JULY 25, 2024

The nurse completes the Columbia-Suicide Severity Rating Scale (C-SSRS) and documents that the patient’s recent thoughts of killing himself and his detailed plan makes him “High Risk” for suicide. There is no documented handoff to the on-coming emergency physician (EP) who assumes care. ” (See reference #1 below.)

Documentation/Coding 81

Documentation/Coding Hospitals Patient Safety Emergency Department 81

EMDocs

JUNE 13, 2024

We just don’t document it. If we don’t use printed instructions, document our verbal instructions regarding the most common side effects of the drug(s) being prescribed. Documenting our warnings should be standard care. Giving written instructions about a drug is the pharmacist’s job. Vashi A, Rhodes K. EM, April 2011.

Documentation/Coding 77

Documentation/Coding Patient Safety Emergency Department Hospitals 77

EMergucate

MAY 25, 2016

Information Systems (Computerised Vs Manual) Manual systems Pros Cheap Easy Convenient Cons Failed documentation – notes, timing, summaries, legibility Difficult … Continue reading →

Emergency Department 40

Emergency Department EMS Documentation/Coding 40

Emergency Medicine Journal

NOVEMBER 28, 2023

Measures of time taken (mins : secs), number information technology (IT) support calls, quality of documentation (using a visual analogue scale), and cognitive load (NASA Task Load Index) were recorded and analysed. Quality of documentation improved with OSLER 4.3 ± 0.3 vs 2.7 ± 0.9 (p p < 0.001). 95% CI 2.3 – 3.5

Documentation/Coding 40

Documentation/Coding Emergency Department 40

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

EM Literature of Note

OCTOBER 1, 2023

” This brief report in Annals describes a retrospective experiment in which 30 written case summaries lifted from the electronic documentation system were fed to either clinician teams or ChatGPT. “ ChatGPT and Generating a Differential Diagnosis Early in an Emergency Department Presentation “ Tweet

Documentation/Coding 95

Documentation/Coding Operations Emergency Department Wellness 95

Pediatric EM Morsels

FEBRUARY 2, 2024

In one ED study, ALL cases of missed travel-related illness did not have a documented travel history in their ED note , whereas 90% of the identified travel-related illnesses had a provider documented travel history (Greenky 2022) Those who are visiting friends and relatives (VFR) are typically at highest risk. Pediatr Emerg Care.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

ACEP Now

AUGUST 1, 2023

In late June, ACEP organized a congressional briefing with the Emergency Nurses Association (ENA) and the National Alliance on Mental Illness (NAMI) to express strong concerns to legislators about the impact of emergency department boarding on our health care safety net. Read more at acep.org/boarding-briefing.

Documentation/Coding 52

Documentation/Coding Emergency Department Emergency Nursing Research 52

EMDocs

OCTOBER 3, 2023

Emergency Physician and founder of Orman Physician Coaching Host of the Stimulus Podcast Learn more at roborman.com If you want to hear the coaching session where Brit and Rob deconstructed his shift and came up with this strategy, it’s here. Episode 87: Conquering Mid-Shift Overwhelm Mid-shift in an emergency department is a special beast.

Documentation/Coding 97

Documentation/Coding EMS Operations Emergency Department 97

ACEP Now

JUNE 14, 2024

1 As fresh challenges of the pandemic and hospital operations changed emergency medicine practice, one of the more challenging areas was the movement of admitted patients out of the first emergency department (ED). emergency departments. Another COVID casualty: The emergency department transfer process.

Emergency Department 52

Emergency Department Hospitals Operations Leadership 52

EB Medicine

APRIL 2, 2019

Show Notes Jeff: Welcome back to EMplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. This month, we’re moving from the trauma bay back to a more private setting, to discuss Emergency Department Diagnosis and Treatment of Sexually Transmitted Diseases. Jeff: Exactly. Jeff: Exactly.

Infectious Diseases 40

Infectious Diseases Emergency Department Sexual Assault CDC 40

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage. What do you think?

EKG/ECG 137

EKG/ECG Emergency Department Shock Ultrasounds 137

ACEP Now

JULY 8, 2024

Recently published experiments with LLMs in the emergency department fall into a handful of primary areas of interest. In a similar vein, another study evaluated the ability of an LLM to assess “clinical acuity” in the emergency department. J Am Coll Emerg Physicians Open. 2024;26(1):40-46. JAMA Netw Open.

Emergency Department 52

Emergency Department Operations Documentation/Coding Research 52

ALiEM

JANUARY 22, 2024

A 40-year-old male, tailor by occupation, was brought to the Emergency Department with complaints of high-grade fever for the past 11 days. Fever was documented to be 102°F and was not associated with any chills or rigors.

Documentation/Coding 64

Documentation/Coding Academics Emergency Department Hospitals 64

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. Am J Emerg Med.

EKG/ECG 119

EKG/ECG Documentation/Coding Emergency Department Outcomes 119

ACEP Now

JUNE 1, 2023

We need to navigate challenges, foster ethical use, and identify the best practices for emergency department application. Documentation LLMs can assist with generating initial drafts of referral letters, medical excuses, and discharge summaries.

Best Practices 52

Best Practices Research Documentation/Coding Administration 52

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. Post opiate hypotension in prehospital trauma patients is a rare but documented complication. Ann Emerg Med. Prospective; 333 patients) 73.* topics.php?paction=showTopic&topic_id=597)

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

The Skeptics' Guide to EM

NOVEMBER 21, 2020

Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine. The impact of advanced practice provider staffing on emergency department care: productivity, flow, safety, and experience. He is also the CME editor for Academic Emergency Medicine.

Emergency Department 52

Emergency Department Telemedicine Academics Outcomes 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. Vitamin D, B12, Calcium, foate, iron, and thiamine deficiencies are all well documented complications.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ALiEM

MARCH 11, 2024

In July 2022, a 32-year-old male with a past medical history of HIV (on antiretroviral therapy, CD4 390, viral load undetectable) presented to the emergency department with constitutional symptoms and a rash for 4-5 days. There is limited literature documenting eye involvement and pictographic examples of its presentation.

Documentation/Coding 56

Documentation/Coding Academics Emergency Department Hospitals 56

The Skeptics' Guide to EM

MARCH 22, 2019

Date: March 20th, 2019 Guest Skeptic: Dr.Katie Walker is an emergency physician in Melbourne, Australia. Case: The emergency department is backing up. Your medical team is great, but you […] The post SGEM#250: Scribes – I Want to Break Free (from the EMR) first appeared on The Skeptics Guide to Emergency Medicine.

Emergency Department 52

Emergency Department Documentation/Coding Dislocations Research 52

Taming the SRU

AUGUST 4, 2024

to teach you and your learner something new on shift skin adhesives WITH dr. hill Dermabond is a polymer (octyl cyanoacrylate) that can be used to repair lacerations in the Emergency Department faster than sutures, allowing the ED physician to be more efficient.

Emergency Department 78

Emergency Department Dislocations Documentation/Coding Burns 78

Northwestern EM Blog

SEPTEMBER 26, 2022

Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The Emergency Department is a challenging work environment for a variety of reasons. Promoting hot debriefing in an emergency department. 2021, August 16).

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

Ultrasounds 70

Ultrasounds Wellness Documentation/Coding EMS 70

EMDocs

SEPTEMBER 19, 2023

American College of Cardiology released a new consensus statement, “ Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: A Report of the American College of Cardiology Solution Set Oversight Committee “. J Am Coll Cardiol. 2022 Nov 15;80(20):1925-1960.

Seizures 72

Seizures Documentation/Coding EKG/ECG Emergency Department 72

RebelEM

JULY 3, 2023

Impact of intravenous calcium with diltiazem for atrial fibrillation/flutter in the emergency department. Am J Emerg Med. What They Did: Researchers conducted a multicenter, retrospective cohort study in three community hospitals and two freestanding emergency departments. Article: Rossi N et al.

Administration 84

Administration Outcomes Documentation/Coding Emergency Department 84

JournalFeed

MARCH 26, 2022

High-dose IN Fentanyl Spoon Feed: Higher doses of intranasal (IN) fentanyl for pain ranging from 2-5 μg/kg (with a maximum of 200 μg) were given in a pediatric emergency department, with no documented episodes of apnea, hypotension, or respiratory failure.

Documentation/Coding 40

Documentation/Coding Stroke Emergency Department Resuscitation 40

Don't Forget the Bubbles

JUNE 19, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. A proportion of the patients who were initially missed using the CDR were found to actually have risk factors documented in EMS reports or the medical record.

CPR 121

CPR Research Outcomes Documentation/Coding 121