American Medical Compliance

SEPTEMBER 9, 2024

Skin health is not only a matter of comfort and well-being but also a key indicator of a resident’s overall health status. Recognize and reward teamwork in addressing skin issues. Monitor and Measure Outcomes Regularly monitor the outcomes of skin care interventions.

Teamwork 105

Teamwork Best Practices Outcomes Wellness 105

ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

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. Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors.

Documentation/Coding 94

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 94

Ken Grauer, MD

FEBRUARY 28, 2023

As a result — IF the 1 lead you are monitoring happens to be one in which P waves are not well seen — then you might assume the irregular rhythm in front of you was AFib. Remember — 12 leads are better than one! Microvascular dysfunction — cardiac vasculitis — intravascular thrombosis.

EKG/ECG 195

EKG/ECG Documentation/Coding Sepsis COPD 195

Don't Forget the Bubbles

JUNE 19, 2024

Well-designed multicentre large studies in children were warranted; cue Leonard et al. 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. Were the predictor variables and the outcome evaluated in a blinded fashion?

CPR 124

CPR Research Outcomes Documentation/Coding 124

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.

Resuscitation 98

Resuscitation EKG/ECG Documentation/Coding COPD 98

ACEP Now

NOVEMBER 7, 2024

Wound management in the ED is only a starting point, and appropriate referral and follow-up are key to an improved outcome. Conclusion Poorly healing wounds pose a significant burden on health care systems and personal well-being, and their presence as a harbinger of severe morbidity and mortality must be appreciated.

Burns 97

Burns Documentation/Coding Outcomes Emergency Department 97

American Medical Compliance

AUGUST 7, 2024

It protects the health and well-being of staff. For example, CMS requires accurate and timely documentation of patient care to ensure proper billing and reimbursement. This plan should clearly define your policies and procedures regarding patient privacy, billing, documentation, and safety.

Hazardous Materials 105

Hazardous Materials Documentation/Coding Legal Issues Patient Safety 105

RebelEM

JULY 3, 2023

Currently, the infusion of IV calcium before diltiazem is not well understood, and more studies have focused on administering IV calcium prior to verapamil than diltiazem. Secondary outcome All secondary outcomes were found to be similar (Not statistically significant) between groups (See table above). Article: Rossi N et al.

Administration 88

Administration Outcomes Documentation/Coding Emergency Department 88

ACEP Now

JULY 7, 2024

You are well prepared for this. Lead your room well. If the resuscitation does not go as well as you wanted, learn from it and move on. If you have a difficult outcome, it is helpful to know what risk management support you have at your hospital. I am wishing them well and reminding myself of how I felt in their shoes.

Resuscitation 98

Resuscitation Risk Management Hospitals Critical Access 98

RebelEM

AUGUST 22, 2024

hours of symptom onset appears to be the most promising approach for improving visual outcomes, supported by multiple studies and meta-analyses. 1,2 Intra-arterial (IA) tPA has also shown benefit but is less well studied. Patients whose last known well (LKW) time was within 24 hours of presentation. 1 week after treatment.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

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.

Administration 97

Administration Emergency Department Outcomes Documentation/Coding 97

ACEP Now

OCTOBER 30, 2023

One case report highlighted an unfortunate outcome from aspiration pneumonia, later found to be due to crayons rather than the expected culprits such as food, secretions, or beverages. This makes documentation and communication of the utmost importance for these patients for their health and safety.

Sexual Assault 98

Sexual Assault Teamwork Outcomes Dehydration 98

Sensible Medicine

JUNE 16, 2023

This can happen while watching my daughter’s track meet; during a swim; even while documenting another patient’s visit. I may be unaware of bad outcomes, and, like most doctors, without this knowledge I assume good outcomes rather than bad. A patient joins the ghost-patient panel when I realize I no longer see them.

Documentation/Coding 98

Documentation/Coding Outcomes Wellness 98

Sensible Medicine

AUGUST 7, 2024

There is evidence that, for children and adults, elevated cortisol levels and chronic stress can lead to behavioral, mental-health, and mood issues, as well as changes in inflammation and immunity. In the resulting document , the working group changed the ages at which children can be expected to reach developmental milestones.

CDC 106

CDC Documentation/Coding Research Pediatrics 106

American Medical Compliance

JULY 2, 2024

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve patient care outcomes. Document observations consistently to identify patterns and trends over time.

Patient Safety 97

Patient Safety Documentation/Coding Outcomes Wellness 97

PulmCCM

FEBRUARY 5, 2024

You can read the document here. Also, many patients with infection won’t have fevers, and those that don’t may be at the highest risk for poor outcomes. Read the original document here. Ultrasound is well-suited for identifying most serious biliary system abnormalities. What’s a Fever?

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

PulmCCM

JULY 31, 2023

severe hypoxemia not doing well or on a bad trajectory while receiving conventional care). To make that leap, I for one would need to see improved outcomes with caloric restriction in patients with less-severe shock. Extracorporeal membrane oxygenation (ECMO) was encouraged, based largely on the EOLIA trial.

Shock 98

Shock Documentation/Coding Outcomes Wellness 98

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 Outcomes Pediatrics Documentation/Coding 75

RebelEM

AUGUST 12, 2024

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

Outcomes 81

Outcomes Hospitals Operations Shock 81

Sensible Medicine

APRIL 12, 2024

For probably the twelfth time on Sensible Medicine, I’ll reference Lisa Rosenbaum’s essay, Being Well while Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training which brought some of the current inter-generational angst to the fore. What could possibly go wrong?

Radiology 80

Radiology Radiology Hospitals Documentation/Coding 80

Sensible Medicine

DECEMBER 15, 2023

His friend had been my patient for well over a decade. ii] Like many doctors , I express respect for people’s beliefs and encourage them to leverage their faith to benefit their well-being. I may very well have but, in my defense, the apron was fresh from the cleaners.) Not every doctor is right for every patient.

Wellness 107

Wellness Documentation/Coding Outcomes 107

Taming the SRU

SEPTEMBER 1, 2023

for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

Mind The Bleep

NOVEMBER 21, 2023

” Yes, I have seen clerking look like this and I can confirm, it does not go down well. Unless you’re documenting something hilarious, please keep it brief and to the point. History of Presenting Complaint In this section use SOCRATES to document the pain.

Documentation/Coding 52

Documentation/Coding COPD EKG/ECG Wellness 52

Dr. Smith's ECG Blog

SEPTEMBER 12, 2024

Long term outcome is unavailable. RED dotted lines in ECG #2 that mark the ST segment baseline in lead V2 , and leads V4 , V5 , V6 — document new ST elevation that was not present in ECG #1. Post cath EF was estimated at 15% with severe global hypokinesis, and akinesis of the apex.

EKG/ECG 124

EKG/ECG EMS Documentation/Coding Shock 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.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

Don't Forget the Bubbles

JULY 26, 2023

A cardiac family history should of course be sought, but think a little outside the box as well. On arrival at hospital the child was well with normal observations. In some specific congenital heart diseases, the prevalence of arrhythmias is now being seen as a late surgical complication as children now survive into adulthood.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Taming the SRU

APRIL 22, 2023

If untreated, atrial fibrillation can increase clot formation and lead to an increased risk for heart attack and stroke as well as development of congestive heart failure. There were similar lengths of say overall and no significant difference in safety outcomes. The diltiazem group had greater reduction in HR at 30 and 60 minutes.

Outcomes 52

Outcomes Stroke Documentation/Coding Fractures 52

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 outcomes measured were the number of CT scans ordered, ED length of stay, and the cost of avoidable CT scans. Cost of care was also estimated.

Emergency Department 52

Emergency Department Documentation/Coding Outcomes Wellness 52

RCEM Learning

JANUARY 23, 2024

This can include randomisation procedures, recruitment and follow-up response rates, what outcome measures patients will prefer, whether patients agree to complete the intervention (in this case the exercise programme) and so on. There was nothing further I could do at that point to change the outcome of the trial.

Research 72

Research Wellness Outcomes Documentation/Coding 72

Sensible Medicine

JUNE 30, 2023

1] Would the outcomes be different? On the other hand, KW was a middle-aged American man with chest pain and significant risk factors for coronary artery disease – hypertension and diabetes – neither of which had ever been terribly well-controlled. She was well hydrated and her vital signs were normal.

Hospitals 98

Hospitals Hospice Resuscitation COPD 98

Sensible Medicine

SEPTEMBER 26, 2023

Researchers would know that whatever they publish is eventually going to be linked to a list of replication attempts and their outcomes.” ” As well, such a rule “would also increase accountability for journals. ” It's time to adopt the Pottery Barn rule.

Research 120

Research Hospitals Documentation/Coding Outcomes 120

Dr. Smith's ECG Blog

OCTOBER 18, 2023

1-3] But these studies were very short duration and used cardiology interpretation of ECGs or emergent angiography rather than patient outcomes. Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. have published a number of warnings about the previous reassuring studies.[4,5]

EKG/ECG 122

EKG/ECG Documentation/Coding Emergency Department Outcomes 122

The Skeptics' Guide to EM

JANUARY 23, 2021

The SGEM bottom line was that increasing APP coverage has minimal effect on ED flow and safety outcomes based on the data. The American College of Emergency Physicians ( ACEP ) also has a number of documents discussing APPs in the ED. The difference in training between and emergency medicine physician and APPs is well recognized.

Poisoning 52

Poisoning Research Documentation/Coding Outcomes 52

Greater Sydney Area HEMS

AUGUST 1, 2023

Why does it work so well? When I found it, I felt the documentation (if done at all) largely tended to be the bare minimum, and certainly not reflective of the beautiful learning conversations happening in the room. It also dovetails with our governance process. M+M, airway audit etc) to ensure they haven’t been missed.

Documentation/Coding 52

Documentation/Coding Outcomes Hospitals Administration 52

Dr. Smith's ECG Blog

MAY 13, 2024

There are findings concerning for anterolateral OMI including ST elevation and hyperacute T waves in the anterolateral leads most prominent in V2-V5, as well as hyperacute T waves in the inferior leads. The ECG shows sinus rhythm and relatively normal QRS morphology. I'll add some thoughts about the first 2 tracings in today's case.

EKG/ECG 123

EKG/ECG Emergency Department Ultrasounds Documentation/Coding 123

Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

It radiated to both shoulders and both upper extremities, and there was shortness of breath and diaphoresis as well. Ongoing pain noted throughout all documentation, but after nitro drip and prn morphine, "pain improved to 2/10." Long term outcome unknown but obviously bleak. He reported a normal stress test a few years ago.

EKG/ECG 81

EKG/ECG Outcomes Academics Documentation/Coding 81