Pediatric EM Morsels

OCTOBER 27, 2023

James Broselow, a family medicine-turned-emergency medicine physician from Hickory, North Carolina , recognized that his team spent a lot of time trying to calculate doses of medications rather than spending their mental energy on the actual medical decisions for the resuscitation. Int J Emerg Med. J Emerg Med. Resuscitation.

Pediatrics 271

Pediatrics Resuscitation Documentation/Coding Wellness 271

ACEP Now

DECEMBER 17, 2024

We deal with difficult and traumatizing situations daily, and nowhere is this more apparent than in the emergency department, where sickness, violence, and death are routine. One of the first documented strikes among house staff officers took place in 1974 at Howard University here in Washington, D.C., died by suicide.

Burns 105

Burns Hospitals Documentation/Coding Emergency Department 105

AENJ: Current Issue

SEPTEMBER 30, 2023

PI monitoring and treatment are often overlooked in the emergency department (ED). Emergency care professionals must be proactive about PI early identification and prevention strategies. A team at a Level 1 trauma center recognized the need for ED-friendly documentation and a validated ED skin risk assessment instrument.

Emergency Department 74

Emergency Department Patient Safety Documentation/Coding Research 74

Emergency Medicine Journal

NOVEMBER 28, 2023

Introduction Most Irish emergency departments (EDs) do not record diagnosis in a standardised way at the conclusion of each patient care episode. The number, spread and accuracy of coded patient care episodes and opinions of clinicians involved regarding system usability were evaluated. 67% of available codes were used.

Documentation/Coding 40

Documentation/Coding Emergency Department Operations Administration 40

Emergency Medicine Journal

AUGUST 23, 2023

Interviews were transcribed verbatim and coded inductively by the primary researcher. We coded all items to capture experiences of 111 First within the full project coding tree and from this constructed two explanatory themes which were refined by the wider research team.

Emergency Department 75

Emergency Department Urgent Care Documentation/Coding Patient Safety 75

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

EB Medicine

DECEMBER 8, 2020

Use code AMAZON20 Write us at emplify@ebmedicine.net. Don’t forget about the $50 Amazon card with any order over $300 through 12/31/20. Write us at emplify@ebmedicine.net (mailto:emplify@ebmedicine.net).Don’t Don’t forget about the $50 Amazon card with any order over $300 through 12/31/20.

Emergency Department 52

Emergency Department Documentation/Coding Hospitals 52

PEMBlog

NOVEMBER 21, 2024

Michael “Fish” Fishman, MD, PEM – Fellow, Boston Children’s Utilizing Co-regulated Evaluations (CORE) to Optimize Feedback and Evaluations Explored success in implementing and maintaining a co-regulated evaluation system in the Emergency Department.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department 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. 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

The Trauma Pro

JULY 5, 2024

Improper care during an emergency This situation can occur in the emergency department when the emergency physician calls a specialist to assist with management. Specialists, make sure you understand the emergency physician’s concerns and clearly explain why you think you don’t need to see the patient in person.

Documentation/Coding 113

Documentation/Coding Fractures Emergency Department Wellness 113

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? 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.

Documentation/Coding 105

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 105

Dr. Smith's ECG Blog

OCTOBER 18, 2023

If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation? Emergent cardiac outcomes in patients with normal electrocardiograms in the emergency department. Am J Emerg Med.

EKG/ECG 119

EKG/ECG Documentation/Coding Emergency Department Outcomes 119

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. Vashi A, Rhodes K.

Documentation/Coding 98

Documentation/Coding Patient Safety Emergency Department Hospitals 98

EB Medicine

SEPTEMBER 13, 2024

Eckler, MD discuss the September 2024 Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Department Introduction and Announcements Elder Abuse and Neglect: An Overview Risk Factors and Reporting Pre-Hospital and Emergency Department Considerations Screening Tools and (..)

Elder Abuse 87

Elder Abuse Emergency Department Documentation/Coding Hospitals 87

Downeast Emergency Medicine

DECEMBER 1, 2021

While the ongoing COVID-19 pandemic has contributed to overdose deaths and taxed constrained Emergency Department (ED) resources, it has also clarified the important role that emergency physicians have in expanding access to life-saving medications to treat opioid use disorder. Annals of Emergency Medicine. Hawk, et al.

Emergency Department 52

Emergency Department Documentation/Coding Leadership Administration 52

RebelEM

NOVEMBER 6, 2024

Elbow Dislocations in the Emergency Department: A Review of Reduction Techniques. J Emerg Med. Anatomy, Shoulder and Upper Limb, Radial Nerve. 2023 Nov 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30521261 Gottlieb M, Schiebout J. 2018 Jun;54(6):849-854. doi: 10.1016/j.jemermed.2018.02.011.

Dislocations 116

Dislocations Fractures Soft Tissue Injuries Outcomes 116

ACEP Now

NOVEMBER 7, 2024

About three percent of emergency department (ED) visits are due to skin and soft tissue infections, but data are lacking on the contribution of chronic wounds to this number. Photographic documentation of the wound is helpful to enhance continuity of care.

Burns 97

Burns Documentation/Coding Outcomes Emergency Department 97

ACEP Now

NOVEMBER 13, 2023

Physicians, nurses, and staff in emergency departments (EDs) across the country have encountered workplace violence for years. 1,2 In a 2018 study by ACEP, nearly half of emergency physicians polled reported a physical assault while at work. J Emerg Nurs. Accessed October 10, 2023. Lee H, Yun H, Choi M, Kim H.

Emergency Department 52

Emergency Department Documentation/Coding Psychiatric Best Practices 52

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

The Skeptics' Guide to EM

APRIL 13, 2024

He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Case: A 70-year-old woman was brought into the emergency department by EMS after her family reported she was having trouble talking. CT perfusion showed a 10 mL core and 189 mL penumbra.

Stroke 138

Stroke Documentation/Coding Emergency Department EMS 138

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. Mental health evaluation teams can rely on documentation and interviews to understand a patient’s initial agitation level.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

ACEP Now

MAY 5, 2023

What is your role as the emergency physician? Introduction Law enforcement officers frequently accompany emergency department (ED) trauma patients or patients who are under arrest or require assistance. Law enforcement gathering in the emergency department: Legal and ethical background and practical approaches.

Emergency Department 52

Emergency Department Documentation/Coding 52

The Trauma Pro

OCTOBER 18, 2024

To take some of the variability out of the decision-making process for admitting service, two surgical groups on Long Island created a scoring system that incorporated several parameters described in the ACS Optimal Resource Document (Orange book). The only gray zone is the score of 4 or 5.

Documentation/Coding 147

Documentation/Coding Emergency Department Hospitals 147

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Arch Dis Child.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

ACEP Now

NOVEMBER 7, 2024

Elizabeth Wharff was the director of emergency psychiatry at Boston’s Children’s Hospital in the late 1990s when she became concerned about what was, then, a new problem. Boarding of mentally ill patients in emergency departments: American Psychiatric Association resource document. West J Emerg Med. Pediatrics.

Psychiatric 59

Psychiatric Pediatrics Hospitals Emergency Department 59

Emergency Medicine Journal

JULY 24, 2023

Introduction Pain is the most common presenting feature within the ED, yet undertreatment of pain in the ED is a well-documented problem worldwide. Despite the development of interventions to address this problem, there is still limited understanding of how pain management can be improved within the ED.

Emergency Department 74

Emergency Department Documentation/Coding Research Wellness 74

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. They also developed standard work documents for each role. The post Re-Engineering Flow in an Academic Emergency Department appeared first on ACEP Now.

Academics 52

Academics Emergency Department Leadership Operations 52

Don't Forget the Bubbles

AUGUST 23, 2023

In most Emergency Departments, staff are allotted little of that scarce resource, time, to begin processing what has just occurred. The Pause Jonathon Bartels worked as an Emergency Nurse in America in 2009. After the death of a young person in the Emergency Department, he initiated ‘ The Pause.’ & Liska, H.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. Unfortunately, its not clear whether the documentation came from RTs or ED providers.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Emergency Medicine Journal

JULY 22, 2024

Therefore, the Silver Code and the components of Safe Hospitals, in accordance with the Hartford consensus and PAHO guidelines, were implemented in the hospitals of the Institute of Public Health of the State of Guanajuato, with a focus on the actions of healthcare personnel to prevent collateral damage.

Emergency Department 52

Emergency Department Documentation/Coding Hospitals 52

EMDocs

SEPTEMBER 26, 2024

An unknown EP reviews the report, determines that there is no reason to notify the patient, and documents nothing. It wasn’t, so you weren’t called, nor did the doc need to document anything. This patient’s history was either poorly taken or poorly documented. Too much weight was given to the EKG, CXR, and labs.

Radiology 98

Radiology Radiology EKG/ECG Documentation/Coding 98

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. Academic Emergency Medicine 22.2

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

EMDocs

JULY 25, 2024

The nurse completes the Columbia-Suicide Severity Rating Scale (C-SSRS) and documents that the patient’s recent thoughts of killing himself and his detailed plan makes him “High Risk” for suicide. There is no documented handoff to the on-coming emergency physician (EP) who assumes care. ” (See reference #1 below.)

Documentation/Coding 105

Documentation/Coding Hospitals Patient Safety Emergency Department 105

EMDocs

SEPTEMBER 19, 2023

Reference: emDOCs – NCSE Journal of Emergency Medicine – Review Case 4: 52-year-0ld male brought in by EMS with “code STEMI” ECG demonstrates ST depressions with rocket like T waves in V2-V4. This document covers high sensitivity troponin, risk disposition pathways, and STEMI equivalents.

Seizures 100

Seizures Documentation/Coding EKG/ECG Emergency Department 100

EM Literature of Note

OCTOBER 9, 2024

This exploration of LLMs in the emergency department is a bit unique in its conceptualization. emergency departments are general cesspools of aggressive empiric antibiotic coverage, driven by CMS regulations – so it may in fact be the LLM displaying astute clinical judgement, here. For what its worth, of course, U.S.

Radiology 86

Radiology Radiology Emergency Department Documentation/Coding 86

PEMBlog

JUNE 14, 2023

Thousands of children and adolescents spend days at time in Emergency Departments waiting for definitive mental health disposition. West J Emerg Med. Mental Health Revisits at US Pediatric Emergency Departments. Prolonged emergency department length of stay for US pediatric mental health visits (2005-2015).

Psychiatric 98

Psychiatric Emergency Department Pediatrics Best Practices 98

EMDocs

OCTOBER 3, 2023

Emergency Physician and founder of Orman Physician Coaching Host of the Stimulus Podcast Learn more at roborman.com If you want to hear the coaching session where Brit and Rob deconstructed his shift and came up with this strategy, it’s here. Episode 87: Conquering Mid-Shift Overwhelm Mid-shift in an emergency department is a special beast.

Documentation/Coding 123

Documentation/Coding EMS Operations Emergency Department 123