EMDocs

JUNE 9, 2023

After listening to this episode you will be able to: Identify unique aspects of the pre-hospital environment that impact assessment and treatment of agitated children Describe the role of EMS personnel and EMS director in the care of agitated children. That includes the patient, EMS personnel, and general public.

EMS 98

EMS Documentation/Coding Pediatrics Psychiatric 98

EM Ottawa

DECEMBER 28, 2023

There is a well-documented correlation amongst EMS and adult ED physicians who provide less pediatric care to […] The post Pediatric Traumatic Cardiac Arrest appeared first on EMOttawa Blog. Pediatric trauma is a high acuity but low frequency event (2).

Pediatrics 83

Pediatrics Documentation/Coding EMS Wellness 83

The Skeptics' Guide to EM

JANUARY 25, 2025

Jestin Carlson is the Program Director for the AHN-Saint Vincent EM Residency in Erie Pennsylvania. Dr. Richard Bukata We have had the pleasure of both working for the Legend of EM, Dr. Richard Bukata.He P-hacking is not exclusive to AUC but is a well-documented problem in broader research, particularly surrounding the 0.05

Research 49

Research EMS Documentation/Coding Operations 49

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

OCTOBER 11, 2023

.” The tech cleans the wound and documents it as 2cm long and “ dirty.” The ED physician documents suturing a 3 cm laceration in a single layer, omitting any reference to any wound exploration, cleansing or debridement. I thought they were incidental “ bone islands” so I didn ’ t document them. Negligence was present.

Documentation/Coding 93

Documentation/Coding Radiology Radiology Patient Safety 93

EM Ottawa

SEPTEMBER 28, 2023

You are treating a 43-year-old male with two days of left lower quadrant abdominal pain, a documented fever of 38.4 and malaise. He has no urinary or bowel symptoms. His past medical history is unremarkable. He looks well by ED standards. After a focused history and physical examination, you narrow the differential to diverticulitis.

Documentation/Coding 115

Documentation/Coding Wellness Infectious Diseases EMS 115

American Medical Compliance

FEBRUARY 15, 2023

The EMS Fraud Waste and Abuse Training course is designed to combat fraud, waste, and abuse in the workplace. The EMS Fraud Waste and Abuse Training is designed to educate EMS workers on how to prevent, detect, and report fraud, waste, and abuse in the healthcare setting. Documentation of this distribution is required.

EMS 52

EMS Administration Documentation/Coding Operations 52

EMDocs

APRIL 18, 2024

The admitting nurse documents an “OTJ injury” with a chief complaint of “My boss made me come.” Reference : EM@3AM: High-Pressure Injection Injury High-Pressure Injection Injuries. The employee is surprised when his boss tells him “Get to the E.R! Right now!” He arrives in the ED of his small community hospital about 30 minutes later.

Patient Safety 105

Patient Safety Hospitals Documentation/Coding EMS 105

Dr. Smith's ECG Blog

JUNE 7, 2024

Now let’s look at the actual sequence, with the addition of clinical context, and see how the patient was managed: The patient received aspirin from EMS and arrived at triage painfree (ECG #1). But that’s not always the case.

EKG/ECG 112

EKG/ECG Documentation/Coding EMS Outcomes 112

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

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 96

Ultrasounds Documentation/Coding Wellness EMS 96

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

Dr. Smith's ECG Blog

OCTOBER 12, 2024

With EMS, patient had a GCS of 3 and was saturating 60% on room air. He improved to 100% with the addition of non-rebreather, however remained altered and was intubated by EMS with ketamine and succinylcholine. Preliminary findings documented in the cath lab were “Anterior STEMI and no significant coronary artery disease.” (!!!)

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.” Triage tools for detecting cervical spine injury in pediatric trauma patients. PMID: 29215711.

Pediatrics 164

Pediatrics Head Injuries Dislocations Research 164

EMDocs

AUGUST 22, 2024

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. Utilizing certified interpreters and documenting their use. Educating patients on their rights.

Documentation/Coding 104

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

Pediatric EM Morsels

MAY 5, 2023

The post Vegan Diets in Children appeared first on Pediatric EM Morsels. Nutrient status and growth in vegan children. 2021 Jul;91:13-25. doi: 10.1016/j.nutres.2021.04.005. 2021.04.005. Epub 2021 May 18. PMID: 34130207.

Pediatrics 130

Pediatrics Documentation/Coding EMS 130

EB Medicine

SEPTEMBER 1, 2022

EMS/Prehospital Care What role do EMS providers play in the recognition of trafficking? History - HEADS-ED Physical examination - Findings that lead to suspicion, documentation best practices. EMS/Prehospital Care* What role do EMS providers play in the recognition of trafficking?ED Lab testing: STI, anything else?

Emergency Department 52

Emergency Department Documentation/Coding EMS Best Practices 52

ALiEM

JANUARY 26, 2024

The nursing home called EMS given the patient’s severe and progressive rash and the fact that the patient was feeling unwell. Ciprofloxacin has been documented as a cause of IgA vasculitis. It was not on her palms or soles. She had no mucous membrane involvement. She lives alone.

Academics 73

Academics Documentation/Coding EMS Hospitals 73

Don't Forget the Bubbles

JUNE 19, 2024

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. In practice, questions remain about who applies the CDR and the inter-rater reliability. CASP checklist for Clinical Prediction Rule (CPR) studies Is CPR clearly defined?

CPR 124

CPR Research Outcomes Documentation/Coding 124

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. The described rhythm was an irregular, wide complex rhythm.

EKG/ECG 131

EKG/ECG Documentation/Coding Psychiatric EMS 131

RebelEM

JULY 3, 2023

Pregnant or incarcerated patients Documentation for systolic BP is incomplete Intervention: Administration of IV calcium within 60 min prior to or 30 min after IV diltiazem administration in patients with AF/AFL with RVR. The study was dependent on EMR documentation which is prone to error.

Administration 98

Administration Outcomes Documentation/Coding Emergency Department 98

Pediatric EM Morsels

AUGUST 18, 2023

None of the patients were documented to have joint disease at follow up. PMID: 29356761 The post Fluoroquinolone Use In Children appeared first on Pediatric EM Morsels. There were 2523 children included. Number of adverse effects was similar between the groups, however in the Levofloxacin group 85% of MSK complaints were arthralgias.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

Northwestern EM Blog

JULY 25, 2023

With the numerous indications for antibiotics, including some dealing with breastfeeding itself, it is imperative that EM providers recognize that most antibiotics are considered safe. Case reports have documented the potential for metronidazole to cause Candida infections and diarrhea in the infant.

Documentation/Coding 52

Documentation/Coding EMS Hospitals 52

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. 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 TikTok.

EMS 52

EMS Documentation/Coding Emergency Department 52

PHEM Cast

DECEMBER 12, 2016

Joint Position Statement of Nat Assoc EMS Physicians and ACS Committee on Trauma. pdf Equipment required for resuscitative thoracotomy: Surface anatomy: Appearance of pericardial clot A foley catheter being used to fill a cardiac wound – note how easily this could be pulled out. J Am Coll Surg. 2001, 193 (3): 303-309.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

RebelEM

JUNE 8, 2023

Rezaie, MD (Twitter: @srrezaie ) The post The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults appeared first on REBEL EM - Emergency Medicine Blog. Am J Emerg Med. 2016; PMID: 27720568 Guest Post By: Courney Knieriem, MD PGY-1, Emergency Medicine Resident RWJBH Community Medical Center, Toms River, NJ Courtneyknieriem.md@rutgers.edu

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 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. Patient arrival by EMS increased and more of those patients were admitted. There is an increasing percentage of patients arriving in EDs via EMS, now averaging about 19.7

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

The Skeptics' Guide to EM

MAY 2, 2020

A Contemporary Analysis Using National EMS Information System (NEMSIS) Data. A Contemporary Analysis Using National EMS Information System (NEMSIS) Data. The EMS crew arrives and performs a 3 lead EKG that does not show an ST elevated myocardial infarction. Date: April 24th, 2020 Reference: Watanabe et al.

Documentation/Coding 40

Documentation/Coding EMS EKG/ECG Outcomes 40

Taming the SRU

AUGUST 4, 2024

None of the patients in this study went on to require operative drainage Aspiration in the ED can lead be complicated by poor wound healing and/or formation of a fistulous tract Occult Knee Dislocation High likelihood of associated vascular injury with knee dislocations Even if ABI is normal, patient’s with any sign of vascular compromised should undergo (..)

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

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. Am J Emerg Med.

EKG/ECG 96

EKG/ECG Hyperthermia / Hypothermia EMS Documentation/Coding 96

EMDocs

JUNE 2, 2023

Document what you gave and why, as well as the impact. Let’s look at management based on etiology: As always follow local procedures and recommendations. More importantly, try non-pharmacologic means first – I cannot stress that enough. Summary All right, so that’s it for this episode.

Psychiatric 93

Psychiatric Pediatrics Emergency Department Administration 93

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. Training opportunities for documentation best practices should be employed. 2 Information blocking is any practice that is “likely to interfere with access, exchange, or use of [EHI].”

Documentation/Coding 52

Documentation/Coding Best Practices Ethical Issues Academics 52

PHEM Cast

APRIL 21, 2021

Guidance documents College of Paramedics Statement on Intubation, available here. Difficult prehospital endotracheal intubation – predisposing factors in a physician based EMS. Difficult prehospital endotracheal intubation – predisposing factors in a physician based EMS. Tracheal intubation. 20(12);681-686. Resuscitation.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

SheMD

OCTOBER 8, 2023

As I transitioned from medical student to resident to faculty member and first started interviewing applicants for our EM residency program, I was so nervous about questions I COULD NOT ask. And if you worry about reporting a program because of retaliation, document all of it and submit after match or anonymously.

Leadership 105

Leadership Best Practices Academics Documentation/Coding 105

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

It is well documented with continuous 12-lead monitoring that acute re-occlusion is frequently asymptomatic. It shows that on a 7 day angiogram, only 58% of re-occlusions were symptomatic: Ohman EM, Califf RM, Topol EJ et al. Here is the most recent documentation that T-wave inversion does indicate reperfusion: [link] 6.

EKG/ECG 52

EKG/ECG Documentation/Coding Emergency Department Wellness 52

RebelEM

AUGUST 22, 2024

Documented at the following time points: Before treatment. appeared first on REBEL EM - Emergency Medicine Blog. Outcomes: Primary Outcome: Visual Acuity (VA) Improvement Measured using logarithm of the minimum angle of resolution (logMAR). Within 24 hours after treatment. 1 week after treatment. 1 month after treatment.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

RebelEM

MARCH 27, 2023

There may have very well been a policy where only RTs can make changes to a ventilator after an order was placed to ensure accurate documentation. Unfortunately, its not clear whether the documentation came from RTs or ED providers. Females and patients with increased BMI are at increased risk of not being placed on LPV.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52