The Trauma Pro

DECEMBER 26, 2023

Screening looks at patient factors such as age, obesity, and previous VTE, as well as injury risk factors like spine and pelvic fractures and decreased mobility. But the key fact is that every compression device manufacturer includes existing DVT as a contraindication in their product documentation.

Fractures 124

Fractures Documentation/Coding Hospitals Research 124

Dr. Smith's ECG Blog

APRIL 18, 2024

The ECG is just a test: a Bayesian approach to acute coronary occlusion If a patient with a recent femur fracture has sudden onset of pleuritic chest pain, shortness of breath, and hemoptysis, the D-dimer doesn’t matter: the patient’s pre-test likelihood for PE is so high that they need a CT. But does this matter? But only 6.4% Take away 1.

EKG/ECG 122

EKG/ECG Documentation/Coding Fractures Emergency Department 122

The Trauma Pro

OCTOBER 31, 2023

Many simple fractures and wounds do not need immediate attention. Explain to the consultant that you truly believe that harm will occur, and you will have to document that fact in the medical record as well as their failure to respond. Are they right? Does that problem really need to be dealt with in the ED in the middle of the night?

Risk Management 113

Risk Management Fractures Documentation/Coding Hospitals 113

Northwestern EM Blog

MARCH 1, 2025

Absolute contraindications of prone positioning are severely increased intracranial pressure as positioning of the head in prone position can partially obstruct cerebral venous drainage, as well as unstable spinal fractures because the manipulation while repositioning a patient may lead to further injury (Guerin et. 2020; Koulouras et.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

Taming the SRU

JULY 25, 2024

Indication - skeletally mature patients with a radiographically documented femur fracture (hip to knee) Contraindications: Patient refusal Allergy to local anesthetic Infection over site of planned injection Obtunded/uncooperative patient Crush injury No available provider or space Medication: 0.5%

Stroke 98

Stroke Fractures Operations Outcomes 98

Taming the SRU

MAY 11, 2024

For mid-shaft femur fractures, traction appears to may reduce blood loss and pulmonary complications, but the available data is very scarce. Usually presents consistent with failure of that organ.

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

All efforts to identify the decedent by hospital staff, law enforcement agencies or social service agencies should be well documented in the medical records. All deaths involving hip fractures if the attending physician believes the fracture caused or contributed to the cause of death. . · County of Los Angeles. MS, JD, RN.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

ACEP Now

FEBRUARY 11, 2024

The clavicle is one of the most commonly fractured bones in the human body. Every year, approximately 332,000 people in the United States suffer from a clavicular fracture. The clinician should note the fracture site (either via palpable landmark or ultrasound visualization). Epidemiology of clavicle fractures.

Ultrasounds 52

Ultrasounds Fractures Emergency Department Hospitals 52

ACEP Now

MAY 6, 2023

The emergency physician’s documentation of these injuries may prove to be crucial in law enforcement’s reconstruction of the crash and may have significant implications for subsequent legal proceedings. Clavicular and humeral fractures are more common in passengers than in drivers. Discussion There were over 2.1

Forensics 52

Forensics Documentation/Coding Head Injuries Fractures 52

Cook County EM Blog

MARCH 28, 2023

As the patient was also having facial pain and reported multiple episodes of blunt facial trauma over the past months, CT facial bones was completed which demonstrated chronic fracture deformities of the left inferior orbital wall, a communited chronic nasal bone fracture, and confirmed posterior lens dislocation.

Dislocations 52

Dislocations Ultrasounds Fractures Radiology 52

ACEP Now

OCTOBER 30, 2023

This makes documentation and communication of the utmost importance for these patients for their health and safety. Communication between providers and nursing regarding indwelling devices, bed sores, cleanliness, or signs of neglect is important, as the thoroughness of each examination may vary.

Sexual Assault 98

Sexual Assault Teamwork Dehydration Outcomes 98

The Injectable Orange

APRIL 4, 2017

Quite simply, document your intended personal learning objective; identify a high quality resource that addresses this (article, workshop, conference); document a reflection on your achieved personal learning outcome. The x-ray of her left shoulder is negative for any fracture.

Emergency Department 52

Emergency Department Evidence-Based Practice Academics Documentation/Coding 52

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47

Stroke 133

Stroke Outcomes Hospitals Administration 133

PEMBlog

OCTOBER 18, 2024

Orthopedic Risks: Watch for Fat Embolism DMD patients are prone to fat embolisms following fractures due to the fatty infiltration of their bone marrow. Any trauma that results in fractures should raise immediate concern for fat embolism syndrome, which can present rapidly and lead to respiratory and cardiovascular complications.

Emergency Department 52

Emergency Department Fractures Best Practices Documentation/Coding 52

PulmCCM

JANUARY 16, 2024

You can read the document for all the caveats. This looks like the major fracture between the two expert panels. Neither document commented on treating ARDS patients with statins, which seemed very likely to have benefited some patients with hyperinflammatory ARDS in past trials. ” What About Statins for ARDS?

Research 87

Research Documentation/Coding Outcomes Fractures 87

Taming the SRU

SEPTEMBER 15, 2023

ETT onto a fiberoptic scope. ETT onto a fiberoptic scope.

CPR 90

CPR Burns Airway Management Wellness 90

Mind The Bleep

JUNE 18, 2023

ICD-10 codes: F00-03 are the ICD codes for dementia and its subtypes F02. This article outlines the main factors related to the presentation, aetiology, and treatment of BPSD. There are additional learning points for juniors, who may be asked to manage these symptoms out of hours. What can I use in an emergency?

Psychiatric 52

Psychiatric Documentation/Coding Stroke Fractures 52

Taming the SRU

JULY 31, 2024

However, believers in this superstition will perceive crazier shifts if the word is uttered so you probably shouldn’t say it, or use cautiously Full moons have no impact on ED, EMS, or HEMS volumes or acuity.

EKG/ECG 52

EKG/ECG Sepsis Documentation/Coding Stroke 52

Taming the SRU

APRIL 22, 2023

Study design This was a retrospective-IRB approved study evaluating adult patients >18 years of age who had documented heart failure with reduced ejection fraction (HFrEF) or heart failure with preserved ejection fractures (HFpEF).

Outcomes 52

Outcomes Stroke Fractures Documentation/Coding 52

RebelEM

MARCH 9, 2023

Assess for blood in the nares or signs of basal skull fracture, including battle signs, raccoon eyes, or hemotympanum. Check that clavicles are intact and that there are no obvious rib fractures or spinal step-offs. As always, document clinical sobriety before discharge. Remove all clothing and do a full skin exam.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

ACEP Now

AUGUST 15, 2023

The AMA Code of Medical Ethics’ Opinion on Physicians Treating Family Members advises against it. When I fracture-dislocated my ankle on Mount Rainier, there was no one to do the emergency reduction; so, aided by a rush of endorphins and the lack of swelling, I did it myself. 1 Nevertheless, most physicians do not follow this dictum.

Hospitals 52

Hospitals Documentation/Coding Fractures Dislocations 52

EMDocs

JULY 11, 2023

Fractures and dislocations are indications for full dose factor replacement. PMID: 7382250 MASAC Document 257 – Guidelines for Emergency Department Management of Individuals with Hemophilia and Other Bleeding Disorders. If LP is absolutely necessary, pretreat with clotting factors and speak with hematology. PMID: 23968747.

Head Injuries 74

Head Injuries Pediatrics Dislocations CDC 74

Taming the SRU

NOVEMBER 14, 2023

A thorough trauma history and physical exam should be performed including evaluation for bony fracture in the surrounding structures of the face. This is usually caused by blunt trauma and is most commonly seen in wrestlers, mixed martial artists, or boxers. A) on LEFT: Auricular hematoma with overlying tattoos.

Emergency Department 94

Emergency Department Pediatrics Wellness Fractures 94

Northwestern EM Blog

APRIL 25, 2022

X - ray : Many times, next step will be to get an X-ray to look for associated fractures. Ideally your exploration should be in a bloodless, painless field and documented as such. It provides additional information about any associated fractures. This may bring the wound tract into your field of view. CT is painless.

Soft Tissue Injuries 52

Soft Tissue Injuries Fractures Sepsis Documentation/Coding 52

PulmCCM

FEBRUARY 8, 2024

You can read the document for all the caveats. This looks like the major fracture between the two expert panels. Neither document commented on treating ARDS patients with statins, which seemed very likely to have benefited some patients with hyperinflammatory ARDS in past trials. ” What About Statins for ARDS?

Research 52

Research Documentation/Coding Fractures Outcomes 52

Don't Forget the Bubbles

OCTOBER 10, 2024

The study excluded complex nail bed injuries, including those with distal phalanx fractures, germinal matrix injury or pulp lacerations, meaning outcomes are only relevant to simple nail bed injuries. However, in the secondary outcome of parental assessment, nail discard patients had higher median scores.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

ACEP Now

MARCH 14, 2024

In our case, the patient had a CT of the head, cervical spine, and chest, abdomen, and pelvis with intravenous contrast demonstrated a C2, C7 compression fracture with significant bowel edema (Figure 4), and was taken to the operating room for left arm disarticulation, left below knee amputation and right above knee amputation. Am J Cardiol.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Cook County EM Blog

MARCH 20, 2023

Further document handedness, occupation, site of injury, and thorough review of systems to evaluate for potential complications ○ Complications as distant as pneumomediastinum following air injection of the hand have been reported5,6. ➢ X-rays showed radiopaque foreign bodies confined to the distal thumb without fracture.

Fractures 52

Fractures Documentation/Coding Operations Research 52

EB Medicine

MARCH 1, 2019

Post opiate hypotension in prehospital trauma patients is a rare but documented complication. In terms of radiography, a chest x-ray should be obtained as rib fractures, hemopneumothorax, and mediastinal free air are all things you wouldn't want to miss and are also associated with blunt cardiac injury. Nachi: Definitely.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EMDocs

NOVEMBER 16, 2024

6 Periprosthetic fracture Occurs at an estimated rate of 3.5-4.1%. Posterior – Shortened, adducted, internally rotated 5,6 Anterior – Shortened, abducted, externally rotated 5,6 As with all dislocations, perform and document distal neurovascular exam before and after management. 5 CT if concern for occult fracture.

EMS 94

EMS Dislocations Fractures Operations 94

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

In fact, one of my surgeon grandfather's ortho buddies (perhaps with the help of some lunchtime martinis) took a look at the x-rays of my Boxer's Fracture and snapped it back into place without any analgesia or procedural sedation, casted me, and sent me home. EMS in America: The Foundation Documents. Still no pain medicine.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Taming the SRU

FEBRUARY 22, 2023

STEP-UP Self Physical and Psycological IM-SAFE Illness Medications Stress Alcohol Fatigue Eating Psychological Cognitive Threat/Challenge appraisal: PERCEIVED demands vs. resources Threat appraisal - stress levels excessive, performance impaired – vapor lock (autonomic arousal, tunnel vision, auditory exclusion, loss of time awareness, impaired memory (..)

Hospice 40

Hospice EKG/ECG Resuscitation Seizures 40

EB Medicine

JUNE 6, 2019

Nachi: And as a brief aside, before we continue… Missed appendicitis is one of the three most common causes of emergency medicine malpractice lawsuits - with MI and fractures being the other two. Nachi: Few things are more important prior to discharge of an abdominal pain patient than documenting repeat exams and a PO trial.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Don't Forget the Bubbles

DECEMBER 2, 2024

This study relied on coding, and if the patient had not been coded as asthma, for example, and coded as pneumonia instead, these patients would not have been included in the study set. This may lead to either missing potential fractures or overcall injuries, leading to increased use of hospital resources and increased morbidity.

Documentation/Coding 98

Documentation/Coding Pediatrics Emergency Department Fractures 98

The Skeptics' Guide to EM

JANUARY 30, 2021

The X-ray demonstrates a fracture of the distal radius that is in an acceptable position and does not require a reduction. You immobilize her in a below elbow splint which provides significant pain relief and refer her to the local orthopedic fracture clinic. J Bone Joint Surg Am. Reference: George et al. J Bone Joint Surg Am.

Fractures 52

Fractures Documentation/Coding Outcomes 52

EMDocs

JULY 3, 2023

3 Common associated injuries may include skull fractures, intracerebral contusion, cervical spine injuries, and vascular injuries of the head and neck. This neurological evaluation should include assessment and documentation of the GCS, the presence of any neurologic deficits, and an NIHSS.

Seizures 98

Seizures Stroke Outcomes EMS 98

Taming the SRU

SEPTEMBER 1, 2023

These were adult trauma patients with compromised vitals, clinical suspicion for life-threatening injuries, and/or presence of a severe injury Negative study for this primary outcome, but potentially an under-powered study Also, study involved mortality of all trauma patients, lumping together patients with polytrauma and those with TBI’s Secondary (..)

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95