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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. and Seaver, M.
We’ll keep it short, while you keep that EM brain sharp. A 23-year-old man with no significant medical history presents to the emergencydepartment for evaluation of a syncopal episode. A 36-year-old female presents to the ED after experiencing an episode of sudden syncope. Mayo Clin Proc 2000;2013:845. Heart Rhythm.
Elbow Dislocations in the EmergencyDepartment: A Review of Reduction Techniques. J Emerg Med. PMID: 31082090 Post Peer Reviewed By: Anand Swaminathan MD, MPH (Insta @EMSwami) The post Elbow Dislocations appeared first on REBEL EM - Emergency Medicine Blog. Anatomy, Shoulder and Upper Limb, Radial Nerve.
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 emergencydepartment by EMS after her family reported she was having trouble talking.
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 EmergencyDepartment Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding.
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. EM, April 2011.
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.
12 How do we address these disparities in the emergencydepartment? 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.
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 emergencydepartment is a special beast.
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.
An unknown EP reviews the report, determines that there is no reason to notify the patient, and documents nothing. An attorney is consulted and a lawsuit filed against the hospital, the first ED physician, the EM group, and the PCP. It wasn’t, so you weren’t called, nor did the doc need to document anything. Tyler W et al.
The specialty, he said, spoke to his interest in surgery and EMS in a way that family medicine did not. A phone call to LA CountyUSC revealed that the emergency medicine program had one spot left for the following year. for a few years working as an emergency physician. After residency, he stayed in Orange County, Calif.,
Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergencydepartments (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.
Over the past few years, there has been an increase in emergencydepartment (ED) volumes and lengths of stay. The effect of emergencydepartment crowding on lung-protective ventilation utilization for critically ill patients. Unfortunately, its not clear whether the documentation came from RTs or ED providers.
He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Case: A 65-year-old man is brought into the emergencydepartment (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table.
Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the EmergencyDepartment via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. Pain improved to 1/10 after EMS administers 324 mg aspirin and the following EKG is obtained at triage.
Duchenne Muscular Dystrophy (DMD) is a complex and progressive disease requiring highly specialized care, especially in emergency situations. When patients with DMD present in the EmergencyDepartment (ED), an understanding of the nuanced aspects of their care is essential for optimal management. Orphanet J Rare Dis. Pediatrics.
Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergencydepartment with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. But only 6.4% of such ‘high risk Non-STEMI’ patients get angiography within 2 hours.[2] Take away 1.
Introduction Simulation based training (SBT) has gained significant traction within Emergency-Medicine (EM). However, identifying barriers and enablers when establishing successful SBT programmes in busy EmergencyDepartments (ED’s), and ensuring longevity of such programs, can be difficult.[MJ1]
A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergencydepartment after being found unresponsive at home. With EMS, patient had a GCS of 3 and was saturating 60% on room air. Vital signs were within normal limits on arrival to the EmergencyDepartment. or basilar ischemia.
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.” Indian J Orthop. 2018;52(5):489-500. PMID: 30237606. Leonard JC, Harding M, Cook LJ, et al.
How does that apply to the role of the board certified emergency physician? Fundamentally, I believe every patient coming to an emergencydepartment is best served by care delivered by board certified emergency physicians. When those same fundamentals done right achieve great success, they aren’t little at all.
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 emergencydepartment (ED) with left leg pain and swelling for the past 5 days.
In this episode, Sam Ashoo, MD interviews Lela Bachrach, MD, MS, Larissa Truschel, MD, MPH, and Makini Chisolm-Straker, MD, MPH - the authors of the July 2022 PEMP article on Human Trafficking of Children and Adolescents: Recognition and Response in the EmergencyDepartment. Are these diagnoses mutually exclusive ?
Capacity Management - Sports medicine grand rounds - introduction to bedside teaching - skin adhesives - hypertensive emergency - ultrasound qa review - how to give a presentation capacity management WITH Dr. lane EmergencyDepartment flow can be characterized as Input - Throughput - Output In the ED, we do not have much control over patient input (..)
Document what you gave and why, as well as the impact. Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the EmergencyDepartment: Consensus Statement of the American Association for Emergency Psychiatry. Erratum in: West J Emerg Med. 2019 Jul;20(4):688-689. Acad Pediatr.
Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an EmergencyDepartment that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.
If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergencydepartment pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. Am J Emerg Med. J Med Toxicol. Epub 2019 Jul 3.
PECARN prediction rule for cervical spine imaging of children presenting to the emergencydepartment with blunt trauma: a multicentre prospective observational study. 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.
The emergencydepartment takes care of some of the highest risk patients with the worst access to health care and social services Over the past 20 years, many researchers have created and validated social needs screeners Some examples: iHELP, WE CARE, SEEK, USDA 2-item food insecurity questionnaire Does screening make a difference?
Emerg Med Clin North Am. Structured team approach to the agitated patient in the emergencydepartment. Emerg Med Australas. Use and avoidance of seclusion and restraint: consensus statement of the american association for emergency psychiatry project Beta seclusion and restraint workgroup. Dtsch Arztebl Int.
Impact of intravenous calcium with diltiazem for atrial fibrillation/flutter in the emergencydepartment. Am J Emerg Med. What They Did: Researchers conducted a multicenter, retrospective cohort study in three community hospitals and two freestanding emergencydepartments. Article: Rossi N et al.
Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergencydepartment with 2 days of heavy substernal chest pain and nausea. He had no previously documented medical problems except polysubstance use. Annals of Emergency Medicine , 31 (1), 3–11.
Our state chapter members and leaders are uniquely positioned to follow EMRA’s lead in partnering with local EM residency programs to improve communication of ACEP’s value to EM-bound medical students and EM residents by hosting residency visits or local events relevant to our shared mission.
Emergency thoracotomy in thoracic trauma: a review. EmergencyDepartment thoracotomy for the critically injured patient: Objectives, indications, and outcomes. World Journal of Emergency Surgery; 2006: 1:4. Survival after EmergencyDepartment thoracotomy: review of published data for last 25 years.
EMS reports intermittent sinus tachycardia and bradycardia secondary to some type of heart block during transport. Smith comment: Go here for a comprehensive blog post on syncope and link to the most detailed version of the Canadian Syncope Rule: EmergencyDepartment Syncope Workup. Figure-2: I've labeled ECG #2.
This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on EmergencyDepartment Management of Patients With Complications of Bariatric Surgery. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.
Author: Damian Roland / Editor: Govind Oliver / Code: / Published: 06/02/2020 There are many old and unhelpful stereotypes in medicines. The burly orthopaedic surgeon ignoring everything but the bone, the pipe-smoking, cardigan-wearing psychiatrist and the jack-of-all-trades emergency doctor just looking for the next cool gadget to play with.
This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: EmergencyDepartment Diagnosis and Management. Post opiate hypotension in prehospital trauma patients is a rare but documented complication. Ann Emerg Med. Prospective; 333 patients) 73.* topics.php?paction=showTopic&topic_id=597)
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 […] The post SGEM#315: Comfortably Numb with Topical Tetracaine for Corneal Abrasions first appeared on The Skeptics Guide to Emergency Medicine.
This was not a Code 3 respiratory distress, fentanyl overdose with minimal response to Narcan or even an unconscious stroke patient with the blood pressure of a giraffe. In hindsight, I was not 100% certain, but relaying on my years of training, the voice inside my head and the gnawing feeling in my cut, it felt like the right thing to do.
1 It is a quickly deployable and easily interpreted study that can be done in real time to guide decisions in the EmergencyDepartment. Point of care biliary ultrasound in the emergencydepartment (BUSED) predicts final surgical management decisions. Acad Emerg Med. and specificity of 88.0% 2022;7(1):e000944.
1 As fresh challenges of the pandemic and hospital operations changed emergency medicine practice, one of the more challenging areas was the movement of admitted patients out of the first emergencydepartment (ED). emergencydepartments. Another COVID casualty: The emergencydepartment transfer process.
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