EB Medicine

SEPTEMBER 13, 2024

Eckler, MD discuss the September 2024 Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Department Introduction and Announcements Elder Abuse and Neglect: An Overview Risk Factors and Reporting Pre-Hospital and Emergency Department Considerations Screening Tools and (..)

Elder Abuse 87

Elder Abuse Emergency Department Documentation/Coding Hospitals 87

ACEP Now

NOVEMBER 7, 2024

About three percent of emergency department (ED) visits are due to skin and soft tissue infections, but data are lacking on the contribution of chronic wounds to this number. Photographic documentation of the wound is helpful to enhance continuity of care.

Burns 97

Burns Documentation/Coding Outcomes Emergency Department 97

RebelEM

NOVEMBER 6, 2024

Elbow Dislocations in the Emergency Department: A Review of Reduction Techniques. J Emerg Med. Anatomy, Shoulder and Upper Limb, Radial Nerve. 2023 Nov 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30521261 Gottlieb M, Schiebout J. 2018 Jun;54(6):849-854. doi: 10.1016/j.jemermed.2018.02.011.

Dislocations 114

Dislocations Fractures Soft Tissue Injuries Outcomes 114

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 Emergency Department 130

ACEP Now

JUNE 7, 2023

ED leaders worked to develop new physician documentation and coding guidelines that needed to be implemented at the beginning of 2023. The preliminary results of the 2022 Emergency Department Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. Mental health evaluation teams can rely on documentation and interviews to understand a patient’s initial agitation level.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

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 105

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 105

The Trauma Pro

OCTOBER 18, 2024

To take some of the variability out of the decision-making process for admitting service, two surgical groups on Long Island created a scoring system that incorporated several parameters described in the ACS Optimal Resource Document (Orange book). The only gray zone is the score of 4 or 5.

Documentation/Coding 147

Documentation/Coding Emergency Department Hospitals 147

ACEP Now

NOVEMBER 7, 2024

Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. Boarding of mentally ill patients in emergency departments: American Psychiatric Association resource document. West J Emerg Med. Pediatrics.

Psychiatric 59

Psychiatric Pediatrics Hospitals Emergency Department 59

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

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

RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. Unfortunately, its not clear whether the documentation came from RTs or ED providers.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

EMDocs

SEPTEMBER 26, 2024

An unknown EP reviews the report, determines that there is no reason to notify the patient, and documents nothing. It wasn’t, so you weren’t called, nor did the doc need to document anything. This patient’s history was either poorly taken or poorly documented. Too much weight was given to the EKG, CXR, and labs.

Radiology 98

Radiology Radiology EKG/ECG Documentation/Coding 98

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. Academic Emergency Medicine 22.2

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

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 105

Documentation/Coding Hospitals Patient Safety Emergency Department 105

PEMBlog

MARCH 4, 2025

Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEMCurrents, the Pediatric Emergency Medicine Podcast. As always, I’m your host, Brad Sobolewski, and today we’re focusing on a pathogen that has been making waves in pediatric emergency departments across the country.

Pediatrics 94

Pediatrics Military CDC Hospitals 94

EM Literature of Note

OCTOBER 9, 2024

This exploration of LLMs in the emergency department is a bit unique in its conceptualization. emergency departments are general cesspools of aggressive empiric antibiotic coverage, driven by CMS regulations – so it may in fact be the LLM displaying astute clinical judgement, here. For what its worth, of course, U.S.

Radiology 86

Radiology Radiology Emergency Department Documentation/Coding 86

PEMBlog

JUNE 14, 2023

Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. West J Emerg Med. Mental Health Revisits at US Pediatric Emergency Departments. Prolonged emergency department length of stay for US pediatric mental health visits (2005-2015).

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

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 123

Documentation/Coding EMS Operations Emergency Department 123

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 98

Documentation/Coding Patient Safety Emergency Department Hospitals 98

EMDocs

JUNE 9, 2023

We’re defining “protocol” here as a written document that provides oversight from the medical director about how to assess and treat patients. Reassessment and Documentation After any type of restraint is instituted, careful assessment, re-assessment, and documentation is required. Was the documentation complete?

EMS 98

EMS Documentation/Coding Pediatrics Psychiatric 98

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

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 52

Emergency Department Documentation/Coding Outcomes Wellness 52

PEMBlog

OCTOBER 18, 2024

Duchenne Muscular Dystrophy (DMD) is a complex and progressive disease requiring highly specialized care, especially in emergency situations. When patients with DMD present in the Emergency Department (ED), an understanding of the nuanced aspects of their care is essential for optimal management.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 52

Northwestern EM Blog

MARCH 1, 2025

While a randomized control trial should be done to evaluate the effect of early proning in a controlled environment, these studies suggest that we should consider using this in our Emergency Department for patients who present with hypoxia and concern for mild to moderate ARDS without urgent need for intubation. Crit Care Med.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

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 139

EKG/ECG Emergency Department Shock Ultrasounds 139

ACEP Now

DECEMBER 6, 2024

This case report documents the first known instance of using NTG during an emergency department resuscitation to treat a patient in cardiac arrest due to severe coronary artery vasospasm. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

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

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

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

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

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 88

Documentation/Coding Operations Emergency Department Wellness 88

EMDocs

JUNE 2, 2023

Document what you gave and why, as well as the impact. 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. Acad Pediatr.

Psychiatric 94

Psychiatric Pediatrics Emergency Department Administration 94

RebelEM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. J Med Toxicol. Epub 2019 Jul 3. Intensive Care Med.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Dr. Smith's ECG Blog

OCTOBER 12, 2024

A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. Vital signs were within normal limits on arrival to the Emergency Department. Written by Bobby Nicholson What do you think of this “STEMI”? Blood glucose was not low at 162 mg/dL.

EKG/ECG 116

EKG/ECG Documentation/Coding Emergency Department COPD 116

EMDocs

FEBRUARY 13, 2024

You can’t control the influx, but you can control how you approach it, how you document, your own internal triage, team communication. What happens in the emergency department impacts your life outside the emergency department. For example, “All of my shifts that I rated as bad were crazy busy.

Emergency Department 98

Emergency Department Hospitals Documentation/Coding Wellness 98

Pediatric EM Morsels

JULY 5, 2024

We collected data directly from the bedside clinician which enabled us to gather pertinent patient symptoms and physical examination findings that may not be well documented in the medical record, but more accurately identify the child’s injuries.” Indian J Orthop. 2018;52(5):489-500. PMID: 30237606. Leonard JC, Harding M, Cook LJ, et al.

Pediatrics 164

Pediatrics Head Injuries Dislocations Research 164