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

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 133

Stroke Outcomes Hospitals Administration 133

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. Guidelines also support not administering HTS in the pre-hospital setting, yet the available data is weak. Usually presents consistent with failure of that organ. What do we do at UC?

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

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). Click to enlarge.) for the ED clinician.

Ultrasounds 52

Ultrasounds Fractures Emergency Department Hospitals 52

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

These include, but are not limited to the following: · Persons dying within 24 hours of admission to the hospital, or not medically attended by a physician within 24-hours of the time of death, unless the attending physician has established a natural cause of death. ·

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

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

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED? ETT onto a fiberoptic scope. ETT onto a fiberoptic scope.

CPR 90

CPR Burns Airway Management Wellness 90

The Injectable Orange

APRIL 4, 2017

For many Australian hospitals, April is ‘No Falls Month’ This month we have a full-scale education attack against one of the most prevalent forms of in hospital patient harm – the fall. The x-ray of her left shoulder is negative for any fracture.

Emergency Department 52

Emergency Department Evidence-Based Practice Academics Documentation/Coding 52

Mind The Bleep

JUNE 18, 2023

It is a very common presentation or comorbidity to see in community services and general hospital. ICD-10 codes: F00-03 are the ICD codes for dementia and its subtypes F02. ICD-10 codes: F00-03 are the ICD codes for dementia and its subtypes F02. What can I use in an emergency?

Psychiatric 52

Psychiatric Documentation/Coding Stroke Fractures 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. I continue to go to this hospital for my medical care.

Hospitals 52

Hospitals Documentation/Coding Fractures Dislocations 52

RebelEM

MARCH 9, 2023

Assess for head and neck trauma : A 2014 study out of NYU/Bellevue Hospital found that 39% of patients who frequented the emergency department with acute alcohol intoxication had a moderate to severe brain injury over a three-year period. Check that clavicles are intact and that there are no obvious rib fractures or spinal step-offs.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

Don't Forget the Bubbles

OCTOBER 10, 2024

This time the team from Bristol Royal Children’s Hospital ED tell us what is new in the world of paediatric literature… Led by Dr John Coveney a Paediatric Emergency Medicine Trainee in Bristol who has revived The Journal Club at Bristol Royal Children’s Hospital ED on a monthly basis. 2023 Mar 30;110(4):432-438.

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

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. Herndon, A.

Soft Tissue Injuries 52

Soft Tissue Injuries Fractures Sepsis Documentation/Coding 52

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Still, except for the public hospital, other hospitals did little emergency work and would have unattended first aid or treatment room in which one could meet one's physician or have an intern provide care in the meanwhile. Rebuilding of EDs in proximity to Radiology, Blood Bank, OR, and ICU, becoming organic to the hospital.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Taming the SRU

FEBRUARY 22, 2023

Paske et al.

Hospice 40

Hospice EKG/ECG Resuscitation Seizures 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

EB Medicine

JUNE 6, 2019

Taylor and Shaukat of Emory and Coney Island Hospital respectively for their efforts in peer reviewing this huge topic. 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. Jeff: True.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Don't Forget the Bubbles

DECEMBER 2, 2024

An international team joining DFTB Bubble Wrap from Aghia Sophia Childrens Hospital ED , Athens, Greece, tell us what is new in thepaediatric literature Led by Spyridon Karageorgos, a Paediatrician enthusiastic about Paediatric Emergency Medicine, reducing antibiotic use in paediatric patients, and Medical Education. and 16.7% , respectively.

Documentation/Coding 98

Documentation/Coding Pediatrics Emergency Department Fractures 98

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. Bakr A, Silva D, Cramb R, et al.

Seizures 98

Seizures Stroke Outcomes EMS 98

Taming the SRU

SEPTEMBER 1, 2023

Lane & Mcdonough Definition of an immediate whole body CT (iWBCT) scan Shortly after patient arrival.

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

Mind The Bleep

JANUARY 28, 2025

Enquire about any associated trauma such as head injuries and fractures. First Aid Measures : Document if any initial care has been done, such as cleaning or dressing the wound. Documentation Clearly record findings, including measurements and descriptions of the wound, and consider photographic documentation if appropriate.

Documentation/Coding 52

Documentation/Coding Head Injuries Fractures Emergency Department 52

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Mind The Bleep

NOVEMBER 21, 2023

It is important to be accurate when assessing and documenting wounds as it can have medico-legal implications, should your assessment later come up in a court case. Often wounds will have stopped bleeding pre-hospitally. Open fractures that need to be seen by orthopaedics. Some hospitals have dedicated pre-tibial clinics.

Fractures 40

Fractures Burns Documentation/Coding Hospitals 40

ACEP Now

FEBRUARY 11, 2025

1 Regional anesthesia services are typically provided by anesthesiologists; however, there are various reasons why not all hospital models can support a dedicated service line run by anesthesiologists including physician shortage. Regional anesthesia has been shown to decrease hospital LOS for hip fractures up to 0.9

Emergency Department 80

Emergency Department Fractures Ultrasounds Hospitals 80

Don't Forget the Bubbles

AUGUST 10, 2023

This is partly because the hands (including fingers) of children & young people have a tendency to fracture without as much compressive force being applied to the bones when compared with adult hands. The resulting injuries include crush injuries, fractures, avulsions, lacerations and amputations.

Fractures 52

Fractures Soft Tissue Injuries Emergency Department Operations 52

American Medical Compliance

JANUARY 8, 2025

Recognizing the Signs of Abuse Healthcare providers must remain vigilant for signs of abuse, which can include: Physical Signs : Unexplained bruises, burns, or fractures, along with frequent hospitalizations for preventable issues. Documentation : Detailed documentation is crucial.

Incident Reporting 105

Incident Reporting Documentation/Coding Dehydration Burns 105

American Medical Compliance

MARCH 3, 2025

Common Cal/Osha Violations No formal workplace violence prevention plan Lack of staff training on de-escalation techniques Failure to report and document violent incidents Inadequate security measures in high-risk areas How to Avoid This Violation Develop a Workplace Violence Prevention Plan as required by Cal/OSHA.

PPE 103

PPE Legal Issues Head Injuries Burns 103

PEMBlog

DECEMBER 4, 2024

Um, with the first documented epidemic occurring in Paris in 1578. And the mechanical complications can include rib fractures, subconjunctival hemorrhage, and even rectal prolapse due to intense coughing and valsalva. Greater than 50 percent of kids under 12 months of age with pertussis could require hospitalization.

Pediatrics 52

Pediatrics PPE Wellness Infectious Diseases 52

Mind The Bleep

SEPTEMBER 17, 2024

Epidemiology The number of animal bites presented to A&E is largely underestimated, as many who are bit don’t present to receive medical care 1 or won’t receive treatment in a hospital setting so they are not counted in the statistics for bites 2. Nevertheless, approximately 1-2% of attendances per year to A&E are from bites 3.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

Advanced Emergency Nursing from AENJ

MARCH 27, 2015

Many authors feel NTI is absolutely or relatively contraindicated with potential basilar skull fractures; there is also opinion arguing that airway protection trumps the extreme rarity of this complication. Intracranial placement of a nasotracheal tube after facial fracture: a rare complication. Sinusitis can occur in long intubation.

Airway Management 40

Airway Management Resuscitation EMS CPR 40

Mind The Bleep

NOVEMBER 2, 2024

Every baby has a NIPE performed, either in hospital before discharge or at home by a community midwife. Bruising- this can be common after a vaginal or instrumental birth or in babies who are large for gestational age, and should be documented carefully. Head When looking at the baby’s head, does the size look too large or too small?

Dislocations 52

Dislocations Documentation/Coding Ultrasounds Wellness 52