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 104

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 104

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. EM, April 2011. Giving written instructions about a drug is the pharmacist’s job. Vashi A, Rhodes K.

Documentation/Coding 98

Documentation/Coding Patient Safety Emergency Department Hospitals 98

EMDocs

SEPTEMBER 19, 2023

Episode 86: Tricky Cases Part 2 Case 3: 56-year-old female with history of seizures, actively seizing, EMS called. Patient seized for approximately 20 minutes prior to EMS arrival. This document covers high sensitivity troponin, risk disposition pathways, and STEMI equivalents. They administer two doses of 10 mg midazolam IM.

Seizures 98

Seizures Documentation/Coding EKG/ECG Emergency Department 98

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. Orphanet J Rare Dis. Pediatrics.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 52

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. With EMS, patient had a GCS of 3 and was saturating 60% on room air. Vital signs were within normal limits on arrival to the Emergency Department. or basilar ischemia.

EKG/ECG 116

EKG/ECG Documentation/Coding Emergency Department COPD 116

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

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 95

Ultrasounds Documentation/Coding Wellness EMS 95

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. Are these diagnoses mutually exclusive ?

Emergency Department 52

Emergency Department Documentation/Coding EMS Best Practices 52

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 92

Psychiatric Pediatrics Emergency Department Administration 92

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. Am J Emerg Med. J Med Toxicol. Epub 2019 Jul 3.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

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 124

CPR Research Documentation/Coding Outcomes 124

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 98

Administration Outcomes Documentation/Coding Emergency Department 98

PHEM Cast

DECEMBER 12, 2016

Emergency thoracotomy in thoracic trauma: a review. Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. World Journal of Emergency Surgery; 2006: 1:4. Survival after Emergency Department thoracotomy: review of published data for last 25 years.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

Taming the SRU

AUGUST 4, 2024

Capacity Management - Sports medicine grand rounds - introduction to bedside teaching - skin adhesives - hypertensive emergency - ultrasound qa review - how to give a presentation capacity management WITH Dr. lane Emergency Department flow can be characterized as Input - Throughput - Output In the ED, we do not have much control over patient input (..)

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

The Skeptics' Guide to EM

JANUARY 16, 2021

Annals of EM 2020 Guest Skeptic: Dr. Will Flanary is an ophthalmologist, writer, and comedian who moonlights in his free time as “Dr. Glaucomflecken” on Twitter and […] The post SGEM#315: Comfortably Numb with Topical Tetracaine for Corneal Abrasions first appeared on The Skeptics Guide to Emergency Medicine.

EMS 52

EMS Documentation/Coding Emergency Department 52

RebelEM

SEPTEMBER 11, 2023

1 It is a quickly deployable and easily interpreted study that can be done in real time to guide decisions in the Emergency Department. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Acad Emerg Med. and specificity of 88.0% 2022;7(1):e000944.

Ultrasounds 68

Ultrasounds Radiology Radiology Emergency Department 68

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. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

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 Operations Hospitals Leadership 52

EMDocs

FEBRUARY 9, 2024

Authors: Adam Roussas, MD, MBA, MSE // Reviewed by: Jamie Santistevan, MD ( @jamie_rae_EMdoc, EM Physician, Presbyterian Hospital, Albuquerque, NM); Manpreet Singh, MD ( @MPrizzleER ); and Brit Long, MD ( @long_brit ) Case A 40-year-old female presents to the emergency department for palpitations and lightheadedness.

EKG/ECG 96

EKG/ECG Hyperthermia / Hypothermia EMS Documentation/Coding 96

EMDocs

JUNE 16, 2023

And now we’re here at our destination, the place we know and love, the emergency room to talk about what we should be doing for the growing volume of children with mental health problems boarding in the emergency department. McEnany, Olutosin Ojugbele, Julie R. Doherty, Jennifer L. McLaren, JoAnna K. 10.1542/peds.2020-1174

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

The Skeptics' Guide to EM

APRIL 24, 2021

Randomized Double-blind Trial Intramuscular Droperidol, Ziprasidone and Lorazepam for Acute Undifferentiated Agitation in the Emergency Department. On investigating you find a collection of nursing, EMS and hospital security personnel surrounding an obviously agitated patient with blood on his head who is attempting to punch them.

Emergency Department 40

Emergency Department Research Outcomes Documentation/Coding 40

EB Medicine

AUGUST 6, 2019

Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. Perhaps, most importantly, prehospital providers should specifically ask about DOAC usage, especially in trauma, given increased rates of complications and potential need for surgery.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Document at each reassessment and always have a low threshold to add on a CTH or labs if the patient is not progressing appropriately. As always, document clinical sobriety before discharge.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

PHEM Cast

APRIL 21, 2021

Guidance documents College of Paramedics Statement on Intubation, available here. Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Association Between Repeated Intubation Attempts and Adverse Events in Emergency Departments: An Analysis of a Multicenter Prospective Observational Study.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

ACEP Now

NOVEMBER 7, 2023

3 These regulations have led to widespread practices of EHI, such as test results and clinical documentation, being shared with patients in real time. In turn, concerns have arisen regarding when information blocking is appropriate and what ethical issues emergency department (ED) physicians must consider prior to information blocking.

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

This was a male in his 50's with a history of hypertension and possible diabetes mellitus who presented to the emergency department with a history of squeezing chest pain, lasting 5 minutes at a time, with several episodes over the past couple of months. Also see this incredible case of the use of 12-lead ST Segment monitoring.

EKG/ECG 52

EKG/ECG Documentation/Coding Emergency Department Wellness 52

The Skeptics' Guide to EM

DECEMBER 5, 2020

John’s Riverside Hospital Emergency Medicine Residency in Yonkers, New York. She is the New York ACEP liaison for the Research and Education Committee and is a past ALL NYC EM Resident Education Fellow. She has nystagmus but no other physical exam findings. We’ve even used it to help decide whether or not to get a head CT.

Stroke 40

Stroke Documentation/Coding Emergency Department Hospitals 40

ACEP Now

JULY 6, 2023

Emergency medicine (EM) has evolved over time and has long passed a crossroads where previously unachievable capabilities should be celebrated and shared. Emergency physicians have earned the right to “re-brand” ourselves as indispensable, money-saving change agents in the health care enterprise. Warfarin side effects.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

EMDocs

NOVEMBER 16, 2024

We’ll keep it short, while you keep that EM brain sharp. Posterior – Shortened, adducted, internally rotated 5,6 Anterior – Shortened, abducted, externally rotated 5,6 As with all dislocations, perform and document distal neurovascular exam before and after management. 8 Perform and document distal neurovascular exam.

EMS 97

EMS Dislocations Fractures Operations 97

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

It is critically important to document the physical findings in a plain-seeing, plain-speaking, non-judgmental manner that will not color or taint future investigations. Accurate time entries are important to document. Ballistic injuries in the emergency department. Emergency medicine practice, 13(12), 1-30.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Written by Destiny Folk MD, with edits by Meyers, peer reviewed by Smith and Grauer A woman in her late 20s with a past medical history of cervical cancer status post chemotherapy and radiation therapy presented to the emergency department for shortness of breath, chest tightness, and two episodes of syncope.

EKG/ECG 40

EKG/ECG Ultrasounds Documentation/Coding COPD 40

EMDocs

SEPTEMBER 23, 2023

We’ll keep it short, while you keep that EM brain sharp. A 23-year-old man with no significant medical history presents to the emergency department for evaluation of a syncopal episode. A 36-year-old female presents to the ED after experiencing an episode of sudden syncope. Mayo Clin Proc 2000;2013:845. Heart Rhythm.

EMS 105

EMS EKG/ECG Documentation/Coding Emergency Department 105

ACEP Now

OCTOBER 9, 2023

However, actual increases in available services in emergency departments based on prior state-level requirements have been mixed. Physicians should document the interpreter’s name and identification number if available in the patient’s chart. Annals of EM. Annals of EM. Flores G, Abreu M, Barrone CP, et al.

Emergency Department 64

Emergency Department Documentation/Coding EMS Wellness 64

EMDocs

SEPTEMBER 26, 2024

An unknown EP reviews the report, determines that there is no reason to notify the patient, and documents nothing. An attorney is consulted and a lawsuit filed against the hospital, the first ED physician, the EM group, and the PCP. It wasn’t, so you weren’t called, nor did the doc need to document anything. Tyler W et al.

Radiology 97

Radiology Radiology EKG/ECG Documentation/Coding 97

Dr. Smith's ECG Blog

AUGUST 9, 2024

Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. He had no previously documented medical problems except polysubstance use. Annals of Emergency Medicine , 31 (1), 3–11.

EKG/ECG 107

EKG/ECG EMS Emergency Department Wellness 107

EMDocs

MAY 26, 2023

Emerg Med Clin North Am. Structured team approach to the agitated patient in the emergency department. Emerg Med Australas. Use and avoidance of seclusion and restraint: consensus statement of the american association for emergency psychiatry project Beta seclusion and restraint workgroup. Dtsch Arztebl Int.

Pediatrics 97

Pediatrics Psychiatric Emergency Department Documentation/Coding 97

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