Emergency Live

APRIL 4, 2024

A detailed journey into the enigmatic realm of chromosomes, the pillars of life that safeguard the genetic blueprint of every organism These intricate structures, composed of complex strands of DNA intertwined with proteins, reside within the nucleus of cells, where they orchestrate a multitude of vital functions, transcending mere storage and transmission (..)

Documentation/Coding 92

Documentation/Coding 92

Mind The Bleep

FEBRUARY 2, 2025

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. Drugs/Allergies When documenting drugs – try to get the dose and frequency (this can be found on Summary Care Records from the GP if you have access).

Documentation/Coding 95

Documentation/Coding COPD EKG/ECG Wellness 95

The Trauma Pro

JUNE 23, 2023

And finally, one of the most common issues complicating malpractice cases of any kind is documentation. Collection and review of documentation, identification of experts, and collection of depositions takes time. Collection and review of documentation, identification of experts, and collection of depositions takes time.

Documentation/Coding 246

Documentation/Coding Administration 246

The Trauma Pro

JUNE 28, 2024

Work not documented is work not done” This is my quote and it’s one of my favorites. Accurate, complete, timely, and legible documentation is a must! Documentation, or lack thereof, will not get you sued. Documentation, or lack thereof, will not get you sued. And providing a date and time is absolutely critical.

Documentation/Coding 202

Documentation/Coding 202

Mount Sinai EM

AUGUST 7, 2024

Evidence of right heart strain is important but the evidence of fibrinolysis during arrest is mixed with many studies showing no 30-day mortality benefit to lysing during a code. Rapidly intervened-upon cardiac tamponade in PEA during cardiac arrest has significantly higher hospital discharge rates. survival to hospital discharge rate.

Ultrasounds 235

Ultrasounds CPR Documentation/Coding COPD 235

Sensible Medicine

MARCH 14, 2025

Secondary outcomes included code activation, pressor therapy, initiation of HD, MDROs, and C. Screening reduced the use of vasopressor therapy and detection of multidrug-resistant organisms but increased code activation, incident HD, and C. Thus, the results would have to be adjusted. Median age was 59; 51% were male. diff infection.

Sepsis 98

Sepsis Wellness Documentation/Coding Fluid Resuscitation 98

PulmCCM

FEBRUARY 5, 2025

A new meta-analysis challenges that dogma , and makes an already challenging decision-making process even thornier for neurologists answering “code strokes” At least 8 randomized trials have been published testing IV thrombolytics given more than 4.5 hours after stroke symptom onset.

Stroke 101

Stroke Documentation/Coding Outcomes 101

American Medical Compliance

JUNE 21, 2024

Here are key areas where they can make a significant impact. Accurate Documentation and Coding Accurate documentation and coding are fundamental in preventing fraud, waste, and abuse. This includes segregation of duties, regular audits, and having checks and balances in billing and coding processes.

Documentation/Coding 105

Documentation/Coding Leadership Best Practices Outcomes 105

EM Ottawa

NOVEMBER 30, 2023

Sunita Puir, a palliative care doctor, talks about how it is an “open secret in medicine that CPR is brutal and rarely effective,” yet how the public seems […] The post Decoding Code Status: A Goals of Care Framework appeared first on EMOttawa Blog.

Documentation/Coding 82

Documentation/Coding CPR Resuscitation 82

ACEP Now

MARCH 10, 2025

ACEP has summarized these issues in its Code of Ethics: Emergency physicians shall communicate truthfully with patients and secure their informed consent for treatment, unless the urgency of the patients conditions demands an immediate response. American College of Emergency Physicians: Code of Ethics for Emergency Physicians.

Documentation/Coding 52

Documentation/Coding Emergency Department Psychiatric Risk Management 52

Dr. Smith's ECG Blog

NOVEMBER 25, 2024

The guide is a living document, which I (Willy Frick) will continuously update as I encounter additional angiographic images worth learning from. Attaining expertise in angiography requires dedication and practice. What follows is an introduction to angiography -- a guide meant for people with no prior experience interpreting angiograms.

Documentation/Coding 119

Documentation/Coding EKG/ECG 119

The Trauma Pro

NOVEMBER 10, 2023

You can download the full document using the link at the bottom of this post. Document your consultation results in writing (paper or EMR) promptly. Bottom line: A uniform “code of behavior” is essential! Click here to download a sample Trauma Services consultant guidelines document.

Documentation/Coding 113

Documentation/Coding Best Practices 113

The Trauma Pro

JUNE 21, 2024

This situation was first documented in a paper published in the 1960s, which noted that VIP patients have worse outcomes. The VIP syndrome occurs in healthcare when a celebrity or other well-connected “important” person receives a level of care that the average person does not. Who is a VIP? It may be a celebrity. A family member.

Documentation/Coding 290

Documentation/Coding Outcomes Hospitals Wellness 290

Ken Grauer, MD

FEBRUARY 28, 2023

Figure-2: I've color-coded P waves from Figure-1 according to P wave morphology ( See text ). NOTE: For clarity — I've color-coded P waves in the long lead II rhythm strip according to morphology. Microvascular dysfunction — cardiac vasculitis — intravascular thrombosis.

EKG/ECG 195

EKG/ECG Documentation/Coding Sepsis COPD 195

Sensible Medicine

OCTOBER 19, 2023

We wrote this letter and submitted it to the journal, documenting that the trial violated ethical codes. Kids are a vulnerable population— subject to teasing and bullying— and frankly the dogs were not that good at sniffing COVID19. Lots of false positives and negatives. Yet the journal refuses to print it.

Documentation/Coding 129

Documentation/Coding Pediatrics Research Outcomes 129

Dr. Smith's ECG Blog

NOVEMBER 27, 2023

Written by Jesse McLaren A 45 year old presented with two weeks of recurring non-exertional chest pain, now constant for an hour. Below is old and then new ECG (old on top; new below). What do you think? Both ECGs have normal sinus rhythm, normal conduction and normal voltages.

EKG/ECG 110

EKG/ECG Documentation/Coding Wellness 110

Emergency Live

DECEMBER 21, 2023

The Importance of Color Codes in Hospital Emergency Situations and on Rescue Vehicles Color Codes in Hospital Emergencies In hospital settings, color codes are used to communicate specific emergency situations quickly and effectively.

Documentation/Coding 105

Documentation/Coding Hospitals 105

Ken Grauer, MD

JUNE 22, 2024

I cannot tell you how many times such "written" documentation was off, due to the tendency to inscribe a normal number instead of counting for 30 seconds because "the patient looked like they were breathing normally". KEY Point: The respiratory rate that is written on the chart does not count!

EKG/ECG 429

EKG/ECG Stroke Documentation/Coding Wellness 429

EM Literature of Note

JANUARY 16, 2025

There are going to be issues with confounding, mis-coded data, and variation across sites. The general implication vilifying those clinicians with higher rates of admission, as these behaviors are generating only short (read: unnecessary) admissions of no value (no mortality difference).

Outcomes 77

Outcomes Radiology Radiology Emergency Department 77

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. State regulations and codes may place that responsibility on our shoulders.

Documentation/Coding 98

Documentation/Coding Patient Safety Emergency Department Hospitals 98

Pediatric EM Morsels

OCTOBER 27, 2023

He, along with Dr. Bob Luten, a PEM physician in Jacksonville, FL , designed the Broselow-Luten color-coded length-based system to help estimate a child’s weight, and thereby offload the cognitive burden of medication dosing and choice of equipment sizes in pediatric resuscitations. .”

Pediatrics 271

Pediatrics Resuscitation Documentation/Coding Wellness 271

EMDocs

APRIL 2, 2024

Check the pulse RSI= Resuscitation Sequence Intubation Hypoxia, Hypotension, and Acidosis are the reason patients code during/post intubation These patients are super high risk for all 4 Optimize first pass success – Induction agent + paralytic Unconscious patients will still have muscle tone Induction Ketamine or Etomidate at half doses (i.e.,

Documentation/Coding 115

Documentation/Coding CPR EKG/ECG Sepsis 115

Mind The Bleep

FEBRUARY 2, 2025

Your response may range from simply documenting the event somewhere secure, so that you have a contemporaneous record of what happened and who else may have been involved to support any future decisions you might make, all the way up to formally speaking up. It is hard to speak up sometimes.

Documentation/Coding 98

Documentation/Coding Outcomes Burns Wellness 98

The Trauma Pro

JULY 5, 2024

The emergency physician should be sure to convey their concerns very clearly, tell the specialist that the conversation will be documented carefully, and then do so. Be sure to fill out a consent as soon as practical, and document any attempts that were made to obtain it. Make sure all is documented well on the consent or in the EHR.

Documentation/Coding 113

Documentation/Coding Fractures Emergency Department Wellness 113

ACEP Now

DECEMBER 17, 2024

One of the first documented strikes among house staff officers took place in 1974 at Howard University here in Washington, D.C., Historically, labor unionization among health care workers is uncommon, 5 including among resident physicians, 6 and the prospect of striking even more so.

Burns 105

Burns Hospitals Documentation/Coding Emergency Department 105

EMCrit

DECEMBER 10, 2023

Some authors on the ATS document were from Europe, and similarly some authors […] EMCrit Project by Josh Farkas. Within the past year, two major societies have released guidelines on ARDS: the ATS (American Thoracic Society) and the ESICM (European Society of Intensive Care Medicine).

Documentation/Coding 138

Documentation/Coding 138

Mind The Bleep

FEBRUARY 2, 2025

Don’t panic: If you are the only available person and dont know the patient, document the information in the notes and let your senior know. Again, document the call clearly, discuss with your senior and implement further investigations/treatment as appropriate. If not, ask for your seniors help.

Radiology 98

Radiology Radiology Documentation/Coding Hospitals 98

The Trauma Pro

SEPTEMBER 10, 2024

And there are far more papers written than actual documented cases. For this reason, I’ll focus on field amputation for the rest of this issue. In reality, these procedures are discussed much more often than performed. There is one old paper that is cited frequently which consisted of a survey from 1996!

EMS 201

EMS Documentation/Coding 201

The Trauma Pro

AUGUST 15, 2023

MTP logistics include details such as who will be delivering the blood, what actually goes in each cooler, what ratios should be used, limitations imposed by the use of frozen plasma, and documentation. Documentation is critically important, both in the trauma bay and the blood bank. And there are plenty around all the time!

Documentation/Coding 130

Documentation/Coding Best Practices Resuscitation Emergency Department 130

Sensible Medicine

OCTOBER 19, 2023

We wrote this letter and submitted it to the journal, documenting that the trial violated ethical codes. Kids are a vulnerable population— subject to teasing and bullying— and frankly the dogs were not that good at sniffing COVID19. Lots of false positives and negatives. Yet the journal refuses to print it.

Documentation/Coding 91

Documentation/Coding Pediatrics Research Outcomes 91

PEMBlog

NOVEMBER 21, 2024

Deb Hsu, MD, MEd – Division Director, Stanford Documenting feedback: Facilitate trainee growth and ensure program accreditation Discussed structuring feedback to ensure trainees and faculty receive actionable insights for growth while providing programs with documented evidence of this feedback to meet accreditation requirements.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department 52

ACEP Now

OCTOBER 29, 2024

Our nurse did not study Paul Ekman’s Facial Action Coding System for Action Units to code “fear” in the patient’s face. Passively, I watch another clinician’s cursory examination of a critically ill patient to determine how they deem a patient “toxic-appearing” or their bedside neurological assessment to activate a code stroke.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

Emergency Live

APRIL 26, 2024

It’s a special nitrogen-containing compound that pairs with adenine, cytosine, and thymine (or uracil in RNA) to form the genetic code. One of the four main building blocks of DNA and RNA is guanine. What makes guanine unique is its […] The post The Essential Role of Guanine in DNA and RNA appeared first on Emergency Live.

Documentation/Coding 98

Documentation/Coding 98

EMDocs

MAY 4, 2024

. #1: Emergent Cath Lab Activations with “Normal” Computer ECG Interpretations Spoon Feed A significant minority of code STEMI patients have an initial normal computer ECG interpretation. Consequently, emergency physicians must remain vigilant to identify signs of OMI regardless of the initial computer ECG interpretation.

Documentation/Coding 98

Documentation/Coding Stroke Emergency Department Pediatrics 98

Sensible Medicine

AUGUST 3, 2024

These participants received a gift card code in this email so they could purchase a 50-pack of masks at their local pharmacy. To reiterate, the intervention was an email with instructions and a gift code. Half of the participants were instructed to wear masks when out in public. What was the outcome? The outcome was not illness.

Documentation/Coding 144

Documentation/Coding Outcomes Research 144

Dr. Smith's ECG Blog

OCTOBER 18, 2023

4,5] We have now formally studied this question: Emergency department Code STEMI patients with initial electrocardiogram labeled ‘normal’ by computer interpretation: a 7-year retrospective review.[6] have published a number of warnings about the previous reassuring studies.[4,5] Am J Emerg Med. 2022 ; 55 : 180 - 182 6.

EKG/ECG 119

EKG/ECG Documentation/Coding Emergency Department Outcomes 119

American Medical Compliance

MARCH 11, 2024

These are recordkeeping and documentation. In a survey , dental providers agree that careful and precise recordkeeping is indispensable, emphasizing the importance of documenting elements such as patient histories, examination results, diagnoses, radiographs, treatment plans, consent forms, and clinic notes.

Documentation/Coding 105

Documentation/Coding Best Practices Operations Outcomes 105