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. If you have restraints in your ambulance, are those restraints appropriately sized for pediatric patients? Was the documentation complete? What type of restraint was used?

EMS 98

EMS Documentation/Coding Pediatrics Psychiatric 98

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

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. While most academic EDs have lost pediatric volume, the UVA ED continues to see almost 20 percent pediatric patients. Pediatric patients go to their own zone.

Academics 52

Academics Emergency Department Leadership Operations 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. Acad Pediatr. 2023.03.005.

Psychiatric 93

Psychiatric Pediatrics Emergency Department Administration 93

The Skeptics' Guide to EM

OCTOBER 1, 2022

Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference. Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. AEM September 2022.

Pediatrics 52

Pediatrics Emergency Department Documentation/Coding Research 52

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. Evaluation and Management of Pediatric Neck Masses. Pediatric Neck Mass.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

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. Pediatrics. 2018-0333I.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 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.

CPR 124

CPR Research Documentation/Coding Outcomes 124

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. Challenges while Boarding The length of stay for pediatric mental health visits has increased.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

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 95

Emergency Department Pediatrics Wellness Fractures 95

Don't Forget the Bubbles

MAY 6, 2024

Acad Pediatr. of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) Pediatric Critical Care Medicine , 25 (3), pp.e117-e128. Data collected were the worst values documented within the same calendar day as the blood cultures were obtained. 2024;24(1):111-118. doi:10.1016/j.acap.2023.06.023 Of the 74.9%

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

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. The pediatric age group represents one of the populations at risk for oligoanalgesia.

Pediatrics 52

Pediatrics Documentation/Coding Emergency Department Hospitals 52

Don't Forget the Bubbles

JANUARY 22, 2024

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. You receive a referral for a 7-year-old Josh, who presented to the emergency department (ED) with a 5-day history of fever, cough, and borderline oxygen saturation.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

EMDocs

AUGUST 8, 2023

Document consideration of torsion in males with abdominal pain. Just the facts: assessment and management of testicular torsion in the emergency department. Pediatr Emerg Care. Medicolegal considerations: 3rd most common cause of malpractice suits in males 12-17 years old & average settlement of $60,000.

Ultrasounds 95

Ultrasounds Documentation/Coding Outcomes Emergency Department 95

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 86

Dislocations Emergency Department Documentation/Coding Burns 86

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. 2015;25(4):622-627. Surg Obes Relat Dis.

Emergency Department 40

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

Pediatric Emergency Playbook

APRIL 1, 2016

Read on to go from bread-and-butter pediatric blood work to answer the question – what’s up with troponin, lactate, d-dimer, and BNP in kids? A fundamental tenet of emergency medicine: We balance our obligation to detect a dangerous condition with our suspicion of the disease in given patient. Cohen et al. Cohen et al.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

ACEP Now

JULY 6, 2023

Emergency physicians have earned the right to “re-brand” ourselves as indispensable, money-saving change agents in the health care enterprise. Of course, the bill for any episode of emergency department (ED) care can be substantial, exceeding the billed charges for equivalent care provided in some primary care offices.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52

EB Medicine

AUGUST 6, 2019

Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. Jeff: DOACs should be used with caution for pregnant, breastfeeding, and pediatric patients. This can help with destination selection when relevant. Nachi: Extremely important to identify DOAC use early.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

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 97

EKG/ECG Hyperthermia / Hypothermia EMS Documentation/Coding 97

Don't Forget the Bubbles

MARCH 19, 2024

Becasue paediatric emergency departments are accessible out-of-hours they become the de facto place of safety with access to immediate support. Key messages Consider social determinants of health and document these in a child’s clinical notes. What can clinicians do? They can assume a ‘coordinating role’. Master’s Thesis).

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

ACEP Now

OCTOBER 10, 2024

Corneal abrasions are the most commonly encountered emergent ophthalmologic issue in the emergency department (ED) and are generally associated with significant discomfort. Use in pediatric patients should be avoided due to a lack of studies in these patients. proparacaine, tetracaine). and RR 1.13, 95 percent CI 0.23-5.46,

Documentation/Coding 40

Documentation/Coding Outcomes Emergency Department Pediatrics 40

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

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 98

Pediatrics Emergency Department Psychiatric Documentation/Coding 98

EMDocs

JULY 11, 2023

Pediatric patients: Post circumcision bleed, head bleeds, bruises. PECARN Pediatric Head Injury/Trauma Algorithm, Canadian CT Head Injury Rule, Ottawa Knee and Ankle Rules) do not apply to those with hemophilia and should not guide management. Once they started walking it was bruising, MSK, and mouth bleeds. Clinical decision tools (e.g

Head Injuries 75

Head Injuries Pediatrics Dislocations CDC 75

Don't Forget the Bubbles

DECEMBER 16, 2024

Clear history taking In the Emergency Department, healthcare professionals should prioritise thorough history-taking when assessing potential suspected cases. Pediatric vaccination during the COVID-19 pandemic. Pediatrics. European Centre for Disease Prevention and Control. Measles facts [Internet].

Infectious Diseases 59

Infectious Diseases Documentation/Coding Pediatrics CDC 59

Northwestern EM Blog

MAY 16, 2022

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 Please ensure that you document and discuss with the patient accordingly. References Fwu, C.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

ACEP Now

DECEMBER 10, 2023

Corneal injury and defects have been documented from direct contact of milkweed sap to the eye and any exposure should be immediately treated with copious water irrigation. corneal toxicity secondary to latex from Asclepias curassavica in a pediatric patient. J Chem Ecol. 2019;45(1):50-60. Yang JF, Beal CJ. 2021;40(12):1607-1609.

Poisoning 52

Poisoning Seizures Documentation/Coding Emergency Department 52

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.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

Accessed July 28, 2014 **Quoting original documents of fascinating history. Study finds EMS able to do more tasks, document better, perform physiological monitoring, with use of ATV. Prehospital endotracheal intubation: rationale for training emergency medical personnel. The Journal of emergency medicine, 40(6), 661-667.

Resuscitation 40

Resuscitation CPR Documentation/Coding Military 40

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

Act V, scene I [Text from Folger Shakespeare Library] [Audio recording of Dramatic Reading; Chapter Vox] [Video recording of Act V, scene1] Most deaths that are brought to, or occur in, an emergency department will require, at least, discussion with the local Coroner or Medical Examiner. No "practice procedures" should be done.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

ALiEM

JANUARY 10, 2025

A 3-month-old male with no past medical history was brought to the emergency department for evaluation of newly asymmetric pupils. Other documented pharmacological causes of anisocoria include nebulized ipratropium bromide and scopolamine (14-19). Pediatr Dermatol. Pediatrics. Pecha JD, Yen KG, Moisiuc A, et al.

Pediatrics 64

Pediatrics Academics Documentation/Coding Emergency Department 64

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. Glob Pediatr Health.

Infectious Diseases 167

Infectious Diseases Pediatrics Sepsis Documentation/Coding 167

Taming the SRU

SEPTEMBER 1, 2023

Can also extend this logic to those with TBI’s or trauma patients are inebriated Can attempt try to mitigate the risk and harm associated with iWBCT’s Future use of low-dose iWBCT Full-body MR imaging is already being used in pediatric patients Logistic regression in REACT-2 patient population identified 10 characteristics to warrant iWBCT in patients (..)

Sepsis 96

Sepsis Fractures Documentation/Coding Administration 96

Taming the SRU

FEBRUARY 3, 2025

It is also worth noting that these aggressive hematologic cancers occur more commonly in children and thus the risk of TLS can be higher in the pediatric population6. mg/dl (pediatrics) calcium < 7 mg/dl Clinical Tumor Lysis Syndrome (2) - laboratory TLS + one of the following: cardiac arrhythmia seizure sudden death creatinine > 1.5x

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56

Taming the SRU

JUNE 6, 2023

million presentation to ED’s throughout the US Usually occur due to falls Also commonly occur due to sports, MVC’s, etc.

Documentation/Coding 65

Documentation/Coding Seizures Psychiatric Wellness 65