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. Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. Patient volume losses in 2020 reversed in 2021.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

PEMBlog

MARCH 4, 2025

Garcia T, Florin TA, Leonard J, Shah SS, Ruddy RM, Wallihan R, Desai AP, Alter S, El-Assal O, Marzec S, Keaton M, Yun KW, Leber AL, Mejias A, Cohen DM, Ramilo O, Ambroggio L; Childrens Hospitals Initiative for Research in Pneumonia (CHIRP). Pediatr Emerg Care. 2025 Feb 17. doi: 10.1097/PEC.0000000000003338. 0000000000003338.

Pediatrics 94

Pediatrics Military CDC Hospitals 94

EMDocs

JUNE 9, 2023

How do we manage the agitated child in the pre-hospital environment? There are protocols in place that assist highly trained Emergency Medical Service providers in assuring that agitated children are safely transported to their destination. Unlike a hospital, there is limited space, staff, equipment, and medication. mg/kg IN; 0.1-0.15

EMS 98

EMS Documentation/Coding Pediatrics Psychiatric 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. ED crowding impairs this mission.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

RebelEM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Unfortunately, its not clear whether the documentation came from RTs or ED providers.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

ACEP Now

NOVEMBER 14, 2023

In 1901, UVA opened its first hospital with 25 beds and three operating rooms. 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.

Academics 52

Academics Emergency Department Leadership Operations 52

EMDocs

JUNE 13, 2024

An attorney is consulted, and a lawsuit is filed against the EP, the hospital, the pharmacy, and the dentist. We just don’t document it. Result : Pre-trial settlement against the hospital and EP for a minimal amount. Documenting our warnings should be standard care. difficile enterocolitis. difficile colitis.

Documentation/Coding 98

Documentation/Coding Patient Safety Emergency Department Hospitals 98

ACEP Now

DECEMBER 6, 2024

1 Relatively little literature on the clinical characteristics and outcomes of out-of-hospital cardiac arrest (OHCA) patients complicated by coronary vasospasm exists beyond anecdotal reports, however. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented. Angina pectoris. 1959;27:375-388.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

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

EMDocs

SEPTEMBER 30, 2024

Inhaled Corticosteroids Rarely Prescribed at Emergency Department Discharge Despite Low Rates of Follow-Up Care. J Emerg Med. Among patients with a primary provider documented in the chart, 30-day outpatient follow-up rate was 21.3% (n = 313). The primary outcome was hospital admission rates.

Outcomes 105

Outcomes Academics Documentation/Coding Emergency Department 105

EMDocs

FEBRUARY 13, 2024

If tomorrow, CMS came out with a new pay-for-performance metric that tied hospital reimbursement with clinician work satisfaction, what do you think would happen? The hospital would move heaven and earth to improve your satisfaction scores. Maybe your group or hospital has something to this effect and, if so, embrace it.

Emergency Department 97

Emergency Department Documentation/Coding Hospitals Wellness 97

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

Don't Forget the Bubbles

MARCH 19, 2024

This has coincided with a widespread shortage of specialist placements for children facing behavioural, psychiatric, and child protection challenges, leading to an over-reliance on the placement of these children in hospitals. A paediatric social admission is one where a child is admitted to the hospital but not for a medical reason.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 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. West J Emerg Med. Erratum in: West J Emerg Med. 2019.1.41344.

Psychiatric 92

Psychiatric Pediatrics Emergency Department Administration 92

Don't Forget the Bubbles

NOVEMBER 20, 2023

Neck lumps are a common presenting complaint to the paediatric emergency department with many aetiologies, sometimes resulting in a diagnostic conundrum. Document the size, consistency and location in the notes to compare if they represent. Royal Children’s Hospital. Royal Children’s Hospital, Melbourne.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 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.

Administration 96

Administration Outcomes Documentation/Coding Emergency Department 96

Northwestern EM Blog

OCTOBER 31, 2022

Written by: Mike Tandlich, MD (NUEM ‘24) Edited by: David Feiger, MD (NUEM ‘22) Expert Commentary by : Michael Schmidt, MD Expert Commentary While EMTALA was first enacted to address issues with “patient dumping”, it has had broad influence on how patients are treated, dispositioned, and transferred in emergency department and hospital settings.

Emergency Department 52

Emergency Department Administration Documentation/Coding Hospitals 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 95

Ultrasounds Documentation/Coding Wellness EMS 95

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. This may limit the generalisability of the results in regional/community hospital settings. Lancet Child Adolesc Health. 2024 Jun 3:S2352-4642(24)00104-4.

CPR 124

CPR Research Documentation/Coding Outcomes 124

The Injectable Orange

APRIL 4, 2017

For many Australian hospitals, April is ‘No Falls Month’ This month we have a full-scale education attack against one of the most prevalent forms of in hospital patient harm – the fall. Predicting Geriatric Falls Following an Episode of Emergency Department Care: A Systematic Review. Avidan, M.

Emergency Department 52

Emergency Department Evidence-Based Practice Academics Documentation/Coding 52

ACEP Now

JUNE 14, 2024

Transferring patients from one ED to another hospital is an established part of emergency medicine practice. Patients who need inpatient services do not match the index hospitals’ capabilities, or the patient requests such a transfer, or the hospital has no available inpatient space. emergency departments.

Emergency Department 52

Emergency Department Operations Hospitals Leadership 52

The Skeptics' Guide to EM

MARCH 22, 2019

Date: March 20th, 2019 Guest Skeptic: Dr.Katie Walker is an emergency physician in Melbourne, Australia. She is a clinical researcher at Cabrini Hospital and an Adjunct Clinical Associate Professor at Monash University. Case: The emergency department is backing up. Case: The emergency department is backing up.

Emergency Department 52

Emergency Department Dislocations Documentation/Coding Research 52

Don't Forget the Bubbles

JANUARY 22, 2024

Repeated GP and hospital attendance might stimulate increased testing and unnecessary prescriptions. Choosing Wisely in Paediatric Car e A trainee-led project in a UK tertiary paediatric emergency department looked at the usefulness of blood tests in 101 children. Families and patients may drive over-investigation.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

Don't Forget the Bubbles

OCTOBER 10, 2024

This time the team from Bristol Royal Children’s Hospital ED tell us what is new in the world of paediatric literature… Led by Dr John Coveney a Paediatric Emergency Medicine Trainee in Bristol who has revived The Journal Club at Bristol Royal Children’s Hospital ED on a monthly basis. Arch Dis Child.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

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. Reference: Pines et al. AEM November 2020. AEM November 2020. AEM November 2020.

Emergency Department 52

Emergency Department Telemedicine Academics Outcomes 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. The patient during his hospital stay developed ARDS and was on mechanical ventilation for 20 days.

Academics 64

Academics Documentation/Coding Emergency Department Hospitals 64

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

The Skeptics' Guide to EM

SEPTEMBER 14, 2024

Full dose challenge of moderate, severe and unknown beta-lactam allergies in the emergency department. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: It’s another day, another dollar in the emergency department (ED). AEM August 2024.

Anaphylaxis 57

Anaphylaxis Emergency Department Documentation/Coding Hospitals 57

EMDocs

JUNE 16, 2023

Episode 4 covered management of the agitated child in the pre-hospital environment. 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.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

Don't Forget the Bubbles

MAY 6, 2024

of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) 807 patients between the ages of 7 days to 17 years, from the ED, ward and PICU, were included across ten hospitals in Switzerland. Data collected were the worst values documented within the same calendar day as the blood cultures were obtained. Of the 74.9%

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

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.

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

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. The patient’s eye lesion and symptoms resolved and he was discharged on hospital day eight.

Academics 56

Academics Documentation/Coding Emergency Department Hospitals 56

The Skeptics' Guide to EM

OCTOBER 28, 2017

Pediatrics 2017 Guest Skeptic: Dr. Anthony Crocco is a Pediatric Emergency Physician and is the Medical Director & Division Head of the Division of Pediatric Emergency at McMaster’s Children’s Hospital. Case: […] The post SGEM#193: Stop, In the Name of Love first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Documentation/Coding Emergency Department Hospitals 52

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

JournalFeed

MARCH 26, 2022

Epi vs. NorEpi Spoon feed: Continuous epinephrine infusion for post-resuscitation shock in out of hospital cardiac arrest (OHCA) was associated with both higher all-cause and cardiovascular specific mortality when compared to norepinephrine. Check out journalfeed.org for details.

Stroke 40

Stroke Documentation/Coding Emergency Department Resuscitation 40

The Skeptics' Guide to EM

APRIL 24, 2021

Date: April 19th, 2021 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). Reference: Martel et al.

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. Jeff: Also, worth mentioning here is the importance of hematology input in developing hospital-wide protocols for reversal agents, especially if availability of certain agents is limited.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40