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. However, rapid initiation of treatment is actually patient-centered care that can both lead to better outcomes and limit ED boarding.

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Emergency Department Psychiatric Administration Best Practices 52

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. This is a critical error that leads to poorer outcomes for patients in need of critical care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 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.

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Outcomes Academics Documentation/Coding Emergency Department 105

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. received CaCl 89.3%

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Administration Outcomes Documentation/Coding Emergency Department 98

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.

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Emergency Department Documentation/Coding Outcomes Wellness 52

RebelEM

JUNE 8, 2023

Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose.

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Administration Emergency Department Outcomes Documentation/Coding 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.

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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. The primary outcome was patient CRC screening or scheduling.

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Emergency Department Documentation/Coding Outcomes 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.

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EKG/ECG Documentation/Coding Emergency Department Outcomes 119

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.

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Emergency Department Hospitals Outcomes Wellness 52

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.

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CPR Research Documentation/Coding Outcomes 124

Don't Forget the Bubbles

OCTOBER 10, 2024

Reviewed by: Isabella Davenport Article 2: Does it improve outcomes if you replace the nail in nail bed repair? Children with nail bed injuries were randomly assigned to nail replacement or discarding , with the primary outcomes being secondary infection in 7 days and cosmetic outcome in four months. Arch Dis Child.

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Emergency Department Outcomes Research Operations 75

Don't Forget the Bubbles

MAY 6, 2024

Outcomes included clinical status when urine culture was available, subsequent antibiotic treatment within seven days and subsequent UTI within 30 days. of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) The primary outcome was the successful intubation on the second attempt. Of the 74.9% Why does it matter?

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 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. He is also the CME editor for Academic Emergency Medicine.

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Emergency Department Telemedicine Academics Outcomes 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. 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.

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Emergency Department Dislocations Documentation/Coding Research 52

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.

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Military Resuscitation Emergency Department Documentation/Coding 52

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.

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EKG/ECG EMS Emergency Department Wellness 107

Dr. Smith's ECG Blog

MAY 13, 2024

Written by Destiny Folk, MD, Adam Engberg, MD, and Vitaliy Belyshev MD A man in his early 60s with a past medical history of hypertension, type 2 diabetes, obesity, and hyperlipidemia presented to the emergency department for evaluation of chest pain. I'll add some thoughts about the first 2 tracings in today's case.

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EKG/ECG Emergency Department Ultrasounds Documentation/Coding 120

The Injectable Orange

APRIL 4, 2017

There is a wealth of information relating to best practice in preventing falls and harm from falls, however there is little to guide the accurate prediction of future falls for geriatric patients presenting to the Emergency Department. Predicting Geriatric Falls Following an Episode of Emergency Department Care: A Systematic Review.

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Emergency Department Evidence-Based Practice Academics Documentation/Coding 52

EMDocs

AUGUST 8, 2023

Bimodal age of distribution: at birth and 12-18 years 14% of cases occur in adults; older patients have worse outcomes Bell clapper deformity – bilateral in 80% of patients Prior episode of torsion Family history Trauma (can be minor) Clinical Presentation: Sudden/severe testicular pain Often unilateral, may radiate.

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Ultrasounds Documentation/Coding Outcomes Emergency Department 94

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. Early defibrillation is linked to better outcomes. topics.php?paction=showTopic&topic_id=597)

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Emergency Department EKG/ECG Operations Fractures 40

Taming the SRU

NOVEMBER 14, 2023

Chief complaints involving the ear are a common occurrence in Emergency Departments across the US and include presenting symptoms such as ear pain or fullness, hearing loss, redness, trauma, vertigo, and foreign bodies. A retrospective analysis of the Nationwide Emergency Department Sample (NEDS) from 2009 through 2011 identified 8.6

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

EB Medicine

MAY 3, 2019

This month, we’re moving into uncharted territories for the podcast… we’re talking psychiatry Nachi: Specifically, we’ll be discussing Depressed and Suicidal Patients in the emergency department. The strongest predictor for suicide-related outcomes is history of prior suicidal ideation or suicide attempt.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

RebelEM

OCTOBER 5, 2023

Secondary Outcome By day 90, mortality was 9.3% Strengths: The investigators framed a research question centered on patient outcomes, ensuring the study’s relevance and practicality. Control: Normal Saline via continuous infusion according to the same regimen used in the hydrocortisone group. in the placebo group (p = 0.006).

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Research Outcomes Administration Shock 94

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.

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Ultrasounds Radiology Radiology Emergency Department 68

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.

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Resuscitation Emergency Department Academics Wellness 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.

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Emergency Department Sepsis Operations Dehydration 40

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.

Stroke 40

Stroke Documentation/Coding Emergency Department Resuscitation 40

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. Randomized Double-blind Trial Intramuscular Droperidol, Ziprasidone and Lorazepam for Acute Undifferentiated Agitation in the Emergency Department. Reference: Martel et al.

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Emergency Department Research Outcomes Documentation/Coding 40

The Skeptics' Guide to EM

JANUARY 23, 2021

Emergency Physician and Advanced Practice Provider Diagnostic Testing and Admission Decisions in Chest Pain and Abdominal Pain. AEM January 2021 Case: A 50-year-old male presents to the Emergency Department (ED) with left lower quadrant abdominal pain. The patient is seen by an advanced practice provider (APP).

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Poisoning Research Documentation/Coding Operations 52

EB Medicine

AUGUST 6, 2019

In the end, they reported similar rates of recurrence and bleeding outcomes for acute treatment. Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. This strategy reduces hospital days and costs with otherwise similar outcomes - total win all around.

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Emergency Department Stroke Wellness Resuscitation 40

Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

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EKG/ECG Hospitals Shock Documentation/Coding 98

ACEP Now

MAY 10, 2024

A 59-year-old man presents to your community emergency department (ED) with chest pain that is radiating to his back. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. Erbel R, Aboyans V, Boileau C, et al.

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Ultrasounds Outcomes Academics Documentation/Coding 52

The Skeptics' Guide to EM

MARCH 31, 2023

Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You arrive at 7am to relieve your colleague after a night shift. You find her at the desk, asleep with her face on the keyboard, patient documentation half finished.

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Academics Documentation/Coding Emergency Department Outcomes 52

Cook County EM Blog

MARCH 10, 2022

Delays in care, as seen in our patient, can lead to poor neurological outcomes (1,2). Chronic compressive or mechanical stress on the spinal cord has been well documented to increase the risk of syrinx and secondary spinal cord changes. Braun P, Kazmi K, Nogués-Meléndez P, Mas-Estellés F, Aparici-Robles F. J Neurosurg. 1995;83(1):1.

Emergency Department 52

Emergency Department Hospitals Documentation/Coding Wellness 52

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? 1 Low-dose non-contrast abdominal CT has become the gold standard for diagnosis as it has become readily available in emergency departments nationwide, with some studies touting sensitivity and specificity of 97% and 95%, respectively.2

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Ultrasounds Radiology Radiology Outcomes 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.

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EKG/ECG Documentation/Coding Emergency Department Wellness 52