RebelEM

NOVEMBER 6, 2024

Medial epicondyle fractures in the pediatric population. J Emerg Med. 2018 Jun;54(6):849-854. doi: 10.1016/j.jemermed.2018.02.011. 2018.02.011. Epub 2018 Apr 19. PMID: 29681420 Gottschalk HP, Eisner E, Hosalkar HS. J Am Acad Orthop Surg. 2012 Apr;20(4):223-32. Doi: 10.5435/JAAOS-20-04-223. PMID: 22474092 Hankin FM.

Dislocations 114

Dislocations Fractures Soft Tissue Injuries Outcomes 114

The Trauma Pro

JULY 16, 2024

Typical options would be direct correspondence with a liaison for simple one-service issues or discussion (and good documentation) from a morbidity and mortality conference. Alternate review pathways There are more options for review other than the primary and secondary pathways mentioned in the previous paragraph.

Operations 147

Operations Documentation/Coding Pediatrics 147

Sensible Medicine

OCTOBER 19, 2023

A few months ago, a sensational letter came out in JAMA Pediatrics. We wrote this letter and submitted it to the journal, documenting that the trial violated ethical codes. The authors took California school children out of the classroom, and had them line up in the school yard. Then a dog sniffed them to see if they had COVID19.

Documentation/Coding 92

Documentation/Coding Pediatrics Research Outcomes 92

Pediatric EM Morsels

AUGUST 18, 2023

Jackson 2016) A systematic review of safety data for over 16000 pediatric patients did show MAEs were the most frequently reported event. None of the patients were documented to have joint disease at follow up. 451 pediatric patients were included. Pediatrics. Clin Pediatr. Pediatr Infect Dis J. Pediatrics.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

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

EMDocs

AUGUST 22, 2024

7 This has also been observed in a pediatric patient population. 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. Pediatrics. Lion KC, et al.

Documentation/Coding 104

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

Pediatric EM Morsels

MAY 5, 2023

Adults are one thing, but how does that translate to our growing, developing pediatric patients? Lemale J, Mas E, Jung C, Bellaiche M, Tounian P; French-speaking Pediatric Hepatology, Gastroenterology and Nutrition Group (GFHGNP). Arch Pediatr. The post Vegan Diets in Children appeared first on Pediatric EM Morsels.

Pediatrics 130

Pediatrics Documentation/Coding EMS 130

PEMBlog

JUNE 14, 2023

Leyenaar; Pediatric Mental Health Boarding. Pediatrics October 2020; 146 (4): e20201174. Zima; Follow-up After Pediatric Mental Health Emergency Visits. Pediatrics March 2023; 151 (3): e2022057383. Boarding of Mentally Ill Patients in Emergency Departments: American Psychiatric Association Resource Document.

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

The Skeptics' Guide to EM

OCTOBER 1, 2022

Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference. She is the cofounder of FOAMcast and is a pulmonary embolism […] The post SGEM#378: Keepin’ It REaL when Treating Pediatric Migraine Patients first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Emergency Department Documentation/Coding Research 52

Don't Forget the Bubbles

NOVEMBER 20, 2023

Document the size, consistency and location in the notes to compare if they represent. Evaluation and Management of Pediatric Neck Masses. Pediatric Neck Mass. International Journal of Pediatrics. Journal of Pediatric Surgery. They may grow again with subsequent upper respiratory tract infections.

Pediatrics 124

Pediatrics Documentation/Coding Emergency Department Ultrasounds 124

EMDocs

JUNE 2, 2023

Document what you gave and why, as well as the impact. Pediatric Agitation in the Emergency Department: A Survey of Pediatric Emergency Care Coordinators. Acad Pediatr. Let’s look at management based on etiology: As always follow local procedures and recommendations. Summary All right, so that’s it for this episode.

Psychiatric 92

Psychiatric Pediatrics Emergency Department Administration 92

Taming the SRU

FEBRUARY 22, 2024

M&M - Arterial Lines - Fat Embolism Syndrome - CPC Morbidity & Mortality WITH Dr. Finney Case 1: MVC AMA, especially in pediatrics, is a high-risk disposition that requires thorough discussion and documentation Approach pediatric blunt abdominal trauma with a thorough physical exam and consider decision making tools when applicable Case 2 & (..)

Pediatrics 82

Pediatrics Documentation/Coding Wellness 82

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 Pediatrics Outcomes Documentation/Coding 75

Sensible Medicine

AUGUST 7, 2024

A 2015 Nature (Pediatric Research) paper by Nils J. I found no data on how many excess pediatric and craniofacial-specialist visits PP has consumed over the years to rule out craniosynostosis. In the resulting document , the working group changed the ages at which children can be expected to reach developmental milestones.

CDC 113

CDC Documentation/Coding Research Pediatrics 113

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 Documentation/Coding Outcomes 124

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. Reference: Harrison et al.

Pediatrics 52

Pediatrics Documentation/Coding Emergency Department Hospitals 52

EMDocs

JUNE 16, 2023

Pediatric Mental Health Specifically within the pediatric population, there has been a steady rise in mental health concerns and suicide in children. As these sites face an increase in pediatric mental health visits, more efforts need to be directed at preparing community EDs to be pediatric ready. Doherty, Jennifer L.

Psychiatric 52

Psychiatric Pediatrics Emergency Department Best Practices 52

Don't Forget the Bubbles

FEBRUARY 26, 2024

Noninvasive positive-pressure ventilation in pediatric status asthmaticus. Pediatric Critical Care Medicine. Bilevel positive airway pressure in the treatment of status asthmaticus in pediatrics. Frontiers in Pediatrics. Non‐invasive ventilation in pediatric status asthmaticus: a prospective observational study.

Pediatrics 72

Pediatrics Research Documentation/Coding Outcomes 72

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? This is especially true in children – the majority of pediatric ambulatory visits do not require blood work to make a decision about acute care. The punchline is, use a pediatric reference.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

EMDocs

AUGUST 8, 2023

Document consideration of torsion in males with abdominal pain. Pediatr Emerg Care. Medicolegal considerations: 3rd most common cause of malpractice suits in males 12-17 years old & average settlement of $60,000. Missed diagnosis often due to: atypical presentation, torsion not considered, or no testicular exam was done.

Ultrasounds 93

Ultrasounds Documentation/Coding Outcomes Emergency Department 93

AED Leader

JULY 3, 2024

Yes, Cardiac Science AEDs have pediatric capabilities. They come equipped with pediatric pads or electrodes that are specifically designed for use on children. These pads deliver a reduced energy level suitable for pediatric patients, ensuring their safety during rescue. Q4: Can Cardiac Science AEDs be used on children?

CPR 52

CPR Resuscitation Pediatrics Operations 52

Taming the SRU

NOVEMBER 14, 2023

million visits resulting in otologic diagnoses, encompassing about 1.01% of all adult visits and 6.79% of pediatric visits (1). Foreign body removal steps Assess hearing before and after the procedure and document any suspected damage/injury prior to removal attempts so that these will not later be attributed to the procedure (6).

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

ACEP Now

NOVEMBER 14, 2023

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. They also developed standard work documents for each role. They adopted a completely new flow model that allowed for acuity-based patient segmentation.

Academics 52

Academics Emergency Department Leadership Operations 52

Pediatric Emergency Playbook

AUGUST 1, 2018

0.34) Documented temperature >38° or >38.5°C Pediatrics. J Pediatrics. Use this new post-test probability to help in your decision Your patient has palatal petechiae, which confers a positive likelihood ratio (LR+) of 2.7 7.62) 0.94 (0.90-0.97) 0.97) 0.08 (0.05-0.14) 0.14) 0.98 (0.95-0.99) 0.99) Palatal petechiae 2.69 (1.92-3.77)

Pediatrics 52

Pediatrics Documentation/Coding 52

AED Leader

JUNE 11, 2024

Seamless Integration with Data Management Systems Efficient data management is essential in the medical field, especially when documenting and analyzing resuscitation events. Some Philips defibrillator models, such as the HeartStart OnSite, offer pediatric pads specifically designed for children.

CPR 52

CPR Shock Resuscitation Operations 52

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

AED Leader

APRIL 24, 2024

Some models, such as the Powerheart G5 and Powerheart G3, offer pediatric pads specifically designed for children. These pads deliver a reduced energy level that is suitable for pediatric patients. Yes, Cardiac Science AEDs can be used on children. Yes, Cardiac Science AEDs are covered by a warranty.

CPR 52

CPR Shock Pediatrics Documentation/Coding 52

Pediatric Education

AUGUST 6, 2023

There is at least 1 study documenting differences in facial temperature without unilateral facial flushing in patients receiving thoracic epidural anesthesia which the authors state may indicate that there is a subclinical harlequin color change. Detection of subclinical Harlequin syndrome in pediatric patients. Pediatr Anesth.

Pediatrics 40

Pediatrics Wellness Documentation/Coding 40

Don't Forget the Bubbles

DECEMBER 13, 2023

Failure to thrive’ has many definitions We use standardized charts to document infant growth. Eur J Pediatr. Infants who are slow to gain weight require early treatment as they are at risk for having a short stature, behavioural and emotional problems, and developmental delays. 2016 Apr;175(4):573-9. doi: 10.1007/s00431-015-2676-4.

Dehydration 98

Dehydration CDC Hospitals Wellness 98

Don't Forget the Bubbles

JANUARY 22, 2024

A QIP performed in a paediatric intensive care unit aimed to reduce unnecessary LFT requests by implementing a blood test request form and a table of common investigations to facilitate and document discussion between the nursing and medical teams. Front Pediatr. Lina Jankauskaite, Grechukha Y, Kjær KA, et al. 2022 Sep 13;10:945540.

Emergency Department 90

Emergency Department Best Practices Radiology Radiology 90

Advanced Emergency Nursing from AENJ

NOVEMBER 27, 2017

The following quotes from the ILCOR and AHA documents, under fair-use doctrine, will help summarize for you the changes. What is the impact of dispatch-assisted CPR instructions on cardiac arrests from noncardiac causes such as drowning, trauma, or asphyxia in adult and pediatric patients? AHA] "2017 Recommendations—Updated 1.

CPR 40

CPR Basic Life Support Resuscitation Pediatrics 40

EMDocs

FEBRUARY 9, 2024

The same principles can be applied to pediatric patients with modified doses. The literature base for the use of lidocaine for torsade storm is documented primarily by case studies in drug-induced TdP. If the response is appropriate, get another EKG and assess the QT interval. mg/kg/hour infusion 1.

EKG/ECG 96

EKG/ECG Hyperthermia / Hypothermia EMS Documentation/Coding 96

PEMBlog

OCTOBER 18, 2024

These documents should be reviewed promptly upon presentation, as they often contain critical information about the patient’s DNR status, preferred ventilation strategies, and other key management instructions. Pediatrics. Cardiac Management of the Patient With Duchenne Muscular Dystrophy. 2018 Oct;142(Suppl 2):S72-S81. 2018-0333I.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 52

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. Pediatric volume in community EDs is up. Commercial payers aggressively abused the No Surprises Act as a method to delay, downcode, and deny payment for emergency services.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

Pediatric Education

NOVEMBER 12, 2023

No specific documentation regarding the duration of the car seat testing could be identified in the medical records. Pediatrics. Pediatrics. Pediatrics. D’Alessandro, MD Professor of Pediatrics, University of Iowa The pertinent physical exam showed the patient was now 3.34 2009;123(5):1424-1429. J Perinatol.

Pediatrics 40

Pediatrics Poisoning Hospitals Documentation/Coding 40

Don't Forget the Bubbles

MARCH 19, 2024

Acknowledging the challenges associated with paediatric social admissions begins with documenting social issues and assessing their social history with the same level of detail as their medical history. Key messages Consider social determinants of health and document these in a child’s clinical notes. What can clinicians do?

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

ACEP Now

JULY 6, 2023

Added benefit would accrue when a pediatric patient avoids CT images, thereby decreasing the potential risk for a subsequent cancer. Brian Zink captured a wonderful initial vision statement for our specialty with the title of his book, “Anyone, Anything, Anytime,” which documented the history of our specialty. N Engl J Med. 2018;6:1-7.

Head Injuries 52

Head Injuries Emergency Department Research Pediatrics 52