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 Documentation/Coding Academics 52

Advanced Emergency Nursing from AENJ

SEPTEMBER 4, 2014

This is the fifth part of our series on "Early Modern Resuscitation." " Part I: Oral Airways, early resuscitation, and recognition of airway care. It was not a practical resuscitative aid until production could be commercially successful (~1895) and made portable in compressed form. Pulmotor is 1907. Beecher, M.

Resuscitation 40

Resuscitation CPR Documentation/Coding EMS 40

PHEM Cast

DECEMBER 12, 2016

pdf Equipment required for resuscitative thoracotomy: Surface anatomy: Appearance of pericardial clot A foley catheter being used to fill a cardiac wound – note how easily this could be pulled out. An open chest with aortic compression Simulation of resuscitative thoracotomy by London HEMS team. Resuscitation; 2011: 1194-1197

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

EMDocs

SEPTEMBER 19, 2023

Airway plan discussed with resuscitation team. 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. Cric is progression of the airway plan ; it is not a failure.

Seizures 73

Seizures Documentation/Coding EKG/ECG Emergency Department 73

EM Updates

JUNE 15, 2021

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 Emergency Department that treats approximately 120,000 patients per year. and Emergency Medicine residents, in 12 hour shifts.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

The Skeptics' Guide to EM

AUGUST 10, 2024

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 emergency department (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table.

Stroke 68

Stroke Airway Management Documentation/Coding Outcomes 68

SheMD

DECEMBER 1, 2023

But less physicians talk about the difficult “firsts” like failing your first test, losing your first patient, or being involved in your first code. It means a patient is dying and requires immediate resuscitation. I remember my first code blue like it was yesterday. Thirty minutes after he arrived a code blue was called.

Documentation/Coding 52

Documentation/Coding Pediatrics Emergency Department Resuscitation 52

RebelEM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. J Med Toxicol. Epub 2019 Jul 3. Intensive Care Med.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Northwestern EM Blog

SEPTEMBER 26, 2022

Written by: Diana Halloran (NUEM ‘24) & Andrew Long (NUEM ‘25) Edited by: Nick Wleklinski (NUEM ‘22) Expert Commentary by : John Bailitz, MD Introduction The Emergency Department is a challenging work environment for a variety of reasons. Any team member of the resuscitation may lead the hot debrief.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52

Don't Forget the Bubbles

MAY 6, 2024

of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) Data collected were the worst values documented within the same calendar day as the blood cultures were obtained. The mean time to randomisation was 2 hours, which excludes the initial resuscitation window. Of the 74.9% 1872 children (mean age 2.5

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

Taming the SRU

SEPTEMBER 15, 2023

ETT onto a fiberoptic scope.

CPR 88

CPR Burns Airway Management Wellness 88

EB Medicine

MARCH 1, 2019

This month, after a few months of primarily medical topics, we’re talking trauma, specifically Blunt Cardiac Injury: Emergency Department Diagnosis and Management. Post opiate hypotension in prehospital trauma patients is a rare but documented complication. Ann Emerg Med. Let’s move on to treatment. 2006;48(3):227-235.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Vitamin D, B12, Calcium, foate, iron, and thiamine deficiencies are all well documented complications.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

All Ohio EM

JULY 15, 2019

By Christy Rukamp DO and Zachary Hampton DO At times, documentation feels like the bane of existence. In residency, we practice resuscitations, rehearse critical procedures, and review in-service test questions; however, we rarely learn key components of documentation. It is more than a record of the patient’s ED timeline.

Documentation/Coding 52

Documentation/Coding Wellness Emergency Department Resuscitation 52

JournalFeed

MARCH 26, 2022

Epi vs. NorEpi Spoon feed: Continuous epinephrine infusion for post-resuscitation shock in out of hospital cardiac arrest (OHCA) was associated with both higher all-cause and cardiovascular specific mortality when compared to norepinephrine. Check out journalfeed.org for details.

Stroke 40

Stroke Documentation/Coding Emergency Department Resuscitation 40

EB Medicine

AUGUST 6, 2019

Interestingly, one retrospective study found limited agreement between EMS records and hospital documentation on current DOAC usage. Jeff: For all agents, regardless of the DOAC, the initial resuscitation follows the standard principles of hemorrhage control and trauma resuscitation. Nachi: So I think that rounds out testing.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

The Skeptics' Guide to EM

NOVEMBER 13, 2021

Neil Dasgupta is an emergency physician and ED intensivist from Long Island, NY, and currently an assistant clinical professor and Director of Emergency Critical Care at Nassau University Medical Center. Case: A code blue is called for a 71-year-old male in-patient that is boarding in the emergency department (ED).

Advances Cardiac Life Support (ACLS) 40

Advances Cardiac Life Support (ACLS) Hospitals Emergency Department Resuscitation 40

The Skeptics' Guide to EM

DECEMBER 2, 2017

Case: You are working a regular shift in the emergency department when you hear a code blue called. You are the first physician to respond and you begin to resuscitate the patient. Cardiac Arrest: Pulselessness requiring chest compressions and/or defibrillation, with a hospital wide or unit based emergency response.

Hospitals 40

Hospitals CPR Resuscitation Documentation/Coding 40

PHEM Cast

APRIL 21, 2021

Guidance documents College of Paramedics Statement on Intubation, available here. Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Association Between Repeated Intubation Attempts and Adverse Events in Emergency Departments: An Analysis of a Multicenter Prospective Observational Study.

Airway Management 40

Airway Management Resuscitation EMS Hospitals 40

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. Electrical injuries in the emergency department: an evidence-based review. Emerg Med Pract.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Northwestern EM Blog

SEPTEMBER 12, 2022

Other things listed on tags can be a patient’s name, bar code, MRN or other tracking criteria. These patients are expected to decompensate within the hour but did not need immediate resuscitation [2]. Hospital-Based Emergency Care: At the Breaking Point. In theory, this is a good way for patients to be tracked and accounted for.

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Hazardous Materials 52

Advanced Emergency Nursing from AENJ

NOVEMBER 20, 2014

It is critically important to document the physical findings in a plain-seeing, plain-speaking, non-judgmental manner that will not color or taint future investigations. Accurate time entries are important to document. Ballistic injuries in the emergency department. Emergency medicine practice, 13(12), 1-30.

Military 40

Military Forensics Documentation/Coding Emergency Nursing 40

Pediatric Emergency Playbook

APRIL 1, 2016

used BNP in the emergency department to differentiate heart failure from respiratory causes in infants and children with heart failure and those with no past medical history. for the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Cohen et al. Later, Maher et al. Am J Cardiol.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Don't Forget the Bubbles

JULY 3, 2023

This time we have our first group of colleagues from Birmingham Children’s Hospital Emergency Department. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Am J Hematol.

Emergency Department 105

Emergency Department Hospitals Domestic Violence Pediatrics 105

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Unstable patients do not belong in a radiology suite - they belong in the ED resus bay to be resuscitated first. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Taming the SRU

FEBRUARY 22, 2023

Paske et al.

Hospice 40

Hospice EKG/ECG Wellness Resuscitation 40

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

A Rising Troponin That afternoon, he complained of increased shortness of breath and was noted to have oxygen saturations in the 70s, prompting a mini code to be called. He became pulseless on more than 1 occasion ( presumably in EMD ) — but responded to resuscitation + treatment with pressors, by regaining a pulse with a spontaneous rhythm.

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). In contrast, ABG and pH alone are not reliable in determining the clinical futility of resuscitation after major trauma. (14,

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Written by Destiny Folk MD, with edits by Meyers, peer reviewed by Smith and Grauer A woman in her late 20s with a past medical history of cervical cancer status post chemotherapy and radiation therapy presented to the emergency department for shortness of breath, chest tightness, and two episodes of syncope.

EKG/ECG 40

EKG/ECG Ultrasounds Documentation/Coding COPD 40

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, million presentation to ED’s throughout the US Usually occur due to falls Also commonly occur due to sports, MVC’s, etc.

Documentation/Coding 63

Documentation/Coding Seizures Psychiatric Wellness 63

ACEP Now

DECEMBER 10, 2023

A middle-aged male with squamous cell carcinoma and extensive metastases is brought to the emergency department (ED) after being found unresponsive following a believed suicide attempt (SA) by methadone ingestion. You want to respect patient autonomy, but is it legal to let him die without any emergency resuscitation?

Resuscitation 52

Resuscitation EKG/ECG Documentation/Coding Hospitals 52

RebelEM

MAY 15, 2024

Comparison of the MASCC and CISNE scores for identifying low-risk neutropenic fever patients: analysis of data from three emergency departments of cancer centers in three continents. Application of the MASCC and CISNE Risk-Stratification Scores to Identify Low-Risk Febrile Neutropenic Patients in the Emergency Department.

Infectious Diseases 97

Infectious Diseases Administration Sepsis Anaphylaxis 97

EM Updates

DECEMBER 29, 2024

The protocol below does not apply to resuscitation patients. For resuscitation patients, see The First Five Minutes of Resuscitation. I see one patient at a time, and I document after each patient. Is this a resuscitation patient improperly assigned to a non-resus priority? Review at the vital signs.

Emergency Department 52

Emergency Department Documentation/Coding Resuscitation Wellness 52

Dr. Smith's ECG Blog

DECEMBER 31, 2024

She presented to the Emergency Department at around 3.5 The note documents that the first view of the LCX showed 99%, TIMI 2 flow, but then (before intervention) was seen to fully occlude in real time (100%, TIMI 0). The chest pain was described as severe pressure radiating to both shoulders. hours since onset.

EKG/ECG 113

EKG/ECG Documentation/Coding Emergency Department Resuscitation 113

EMDocs

JANUARY 6, 2025

4,5 Of particular concern is the Sudanese conflict, which began in April 2023, and which has caused the largest internal displacement of a population in documented history. HIV Prevention and Treatment: The Evolving Role of the Emergency Department. Ann Emerg Med. Use of Medical Interpreters in the Emergency Department.;

Infectious Diseases 41

Infectious Diseases CDC PPE Rapid Diagnostic Testing 41

ACEP Now

OCTOBER 4, 2023

3,4 There was a total of more than 2,300 shootings in the city in 2021—that shows up in the trauma bays and resuscitation rooms in our emergency departments. A resident once said to me that in emergency medicine, “we carry our graveyards with us.” Well, unfortunately my graveyard is bursting at the seams.

Emergency Department 110

Emergency Department Documentation/Coding Hospitals Academics 110

ACEP Now

OCTOBER 29, 2024

Initial echocardiogram (ECG) on arrival (see figure 2) to our emergency department revealed normal sinus rhythm, mild interventricular conduction delay (RSR’), and possible right ventricular hypertrophy. 7 The ECG findings can be concealed or transient after resuscitation from cardiac arrest. Figure 1: The EMS rhythm strip.

Pediatrics 52

Pediatrics EKG/ECG Documentation/Coding Hospitals 52