Emergency Live

DECEMBER 21, 2023

The Importance of Color Codes in Hospital Emergency Situations and on Rescue Vehicles Color Codes in Hospital Emergencies In hospital settings, color codes are used to communicate specific emergency situations quickly and effectively.

Documentation/Coding 105

Documentation/Coding Hospitals 105

Ken Grauer, MD

FEBRUARY 28, 2023

Figure-2: I've color-coded P waves from Figure-1 according to P wave morphology ( See text ). NOTE: For clarity — I've color-coded P waves in the long lead II rhythm strip according to morphology. Microvascular dysfunction — cardiac vasculitis — intravascular thrombosis.

EKG/ECG 195

EKG/ECG Documentation/Coding Sepsis COPD 195

PDC Healthcare

AUGUST 17, 2023

Key Takeaways from a Recent Pharmacy Survey PDC surveyed 6,400 Hospital Pharmacy Managers and Directors to get feedback on their priorities and challenges. Below we explore the results and key takeaways of the PDC survey, along with some helpful tips for pharmacy professionals.

Hospitals 98

Hospitals Patient Safety Documentation/Coding 98

The Trauma Pro

MARCH 14, 2024

They can range from very spacious… to very tight… Most trauma bays that I have visited were somewhere between 225 and 300 square feet (21-28 sq meters), although some were quite large (Rashid Hospital in Dubai at nearly 50 sq meters!). Related link: Facilities Guidelines Institute documents

Resuscitation 162

Resuscitation Documentation/Coding Hospitals 162

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. One of the most creative solutions I’ve seen is the use of a hospital security officer. Think about it.

Documentation/Coding 130

Documentation/Coding Best Practices Resuscitation Administration 130

The Trauma Pro

JULY 5, 2024

If the specialist insists on the emergency physician providing care because they do not want to come to the hospital, the specialist opens themselves up to major problems if any actual or perceived problem occurs afterwards. Be sure to fill out a consent as soon as practical, and document any attempts that were made to obtain it.

Documentation/Coding 113

Documentation/Coding Fractures Emergency Department Wellness 113

PDC Healthcare

MAY 1, 2023

But in mass-casualty incidents and large-scale hazards, chaotic scenes […] The post PDC Partners with Pulsara to Streamline Communication Between EMS, Hospital Personnel, and Emergency Management appeared first on connectID - PDC Healthcare Blog.

Mass Casualty Incidents 98

Mass Casualty Incidents EMS Hospitals Patient Safety 98

Pediatric EM Morsels

FEBRUARY 2, 2024

In one ED study, ALL cases of missed travel-related illness did not have a documented travel history in their ED note , whereas 90% of the identified travel-related illnesses had a provider documented travel history (Greenky 2022) Those who are visiting friends and relatives (VFR) are typically at highest risk. Pediatr Emerg Care.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

ACEP Now

JANUARY 11, 2024

The wave of increasing hospital closures and service line cutbacks continues to sweep the United States. A recent article documents 56 additional U.S. hospitals that are closing clinical departments or ending or reducing services. 2 Of these 56 additional hospitals, many are not rural; thus, this specter is expanding.

Hospitals 52

Hospitals Administration Documentation/Coding Research 52

ACEP Now

JANUARY 13, 2024

The 2,414-page final rule is the document that informs what Medicare payments will be for the following year. Physician Fee Schedule Conversion Factor As expected, the conversion factor, a dollar amount which, when multiplied by the relative value units assigned to a code, determines the payment amount, is expected to drop by 3.39

Documentation/Coding 52

Documentation/Coding Hospitals 52

The Trauma Pro

MAY 3, 2024

They separated all patients with acetabular and pelvic ring fractures using ICD-10 codes. Various hospital outcomes were tabulated, including hospital charges, mortality, and discharge location. They further narrowed their dataset to patients with angioembolization (AE) or peri-pelvic packing (PPP) as their primary procedure.

Fractures 113

Fractures Documentation/Coding Radiology Radiology 113

EMDocs

JUNE 13, 2024

An attorney is consulted, and a lawsuit is filed against the EP, the hospital, the pharmacy, and the dentist. We just don’t document it. Result : Pre-trial settlement against the hospital and EP for a minimal amount. Documenting our warnings should be standard care. difficile enterocolitis. difficile colitis.

Documentation/Coding 77

Documentation/Coding Patient Safety Emergency Department Hospitals 77

PDC Healthcare

APRIL 2, 2024

Every year the ISBT 128 publishes labeling standards for essential items that hospital lab professionals use, including blood bags. The ISBT 128 is the “global standard for the terminology, identification, coding and labeling of medical products of human origin (including blood, cell, tissue, milk, and organ products).

Documentation/Coding 81

Documentation/Coding Hospitals Patient Safety 81

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 85

Elder Abuse Emergency Department Documentation/Coding Hospitals 85

Emergency Medicine Journal

NOVEMBER 28, 2023

Accordingly, this pilot study aimed to test whether clinician-assigned ED discharge diagnosis coding could be implemented in an Irish ED, and whether coded data would be of sufficient quality to support operational needs and the proposed model of activity-based funding (ABF). 67% of available codes were used.

Documentation/Coding 40

Documentation/Coding Emergency Department Administration Operations 40

ACEP Now

OCTOBER 26, 2023

One of the HCFA letters, written by then Medicaid Director Tim Westmoreland (the Westmoreland Letter) specifically cited that the CPT 9928X codes should be reimbursed under federal PLP unless the Medicaid plan believed there were program integrity issues with the claim. The provision similarly downcoded hospital facility fees.

Documentation/Coding 124

Documentation/Coding Hospitals Administration Emergency Department 124

Ken Grauer, MD

JULY 29, 2023

The ECG in Figure-1 was obtained from an 18-year old woman — who moments before been resuscitated from out-of-hospital cardiac arrest. An ICD ( I mplantable C ardiac D efibrillator ) was inserted — and the patient was discharged from the hospital. QUESTIONS: In light of the above clinical history. MRI confirmed ARVC.

EKG/ECG 370

EKG/ECG Resuscitation Documentation/Coding Hospitals 370

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

EMDocs

JULY 25, 2024

The brother’s wife calls the airport police who are able to locate him and send him to a nearby hospital. 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.

Documentation/Coding 82

Documentation/Coding Hospitals Patient Safety Emergency Department 82

Dr. Smith's ECG Blog

MARCH 14, 2024

The most recent study found a NPV of 100% of triage ECGs labeled ‘normal’ or ‘otherwise normal’ for final hospital diagnosis of ACS, and concluded that avoiding physician interruption would “alleviate interruptions in workflow and improve patient safety.”

EKG/ECG 116

EKG/ECG Documentation/Coding Patient Safety Outcomes 116

PulmCCM

JANUARY 29, 2024

Read the document for all the details (it’s not long). A randomized trial showed improvement in ROSC with 20 IU vasopressin + 40 mg methylprednisolone after the first dose of epinephrine for in-hospital arrests, without any survival or neurologic benefit seen. PulmCCM is not affiliated with the American Heart Association.

Seizures 115

Seizures CPR Documentation/Coding Hyperthermia / Hypothermia 115

Don't Forget the Bubbles

MARCH 19, 2024

This has coincided with a widespread shortage of specialist placements for children facing behavioural, psychiatric, and child protection challenges, leading to an over-reliance on the placement of these children in hospitals. A paediatric social admission is one where a child is admitted to the hospital but not for a medical reason.

Hospitals 52

Hospitals Psychiatric Documentation/Coding Pediatrics 52

Northwestern EM Blog

JULY 22, 2024

Tandlich, M. 2024, Jul 22).Posterior Posterior Reversible Encephalopathy Syndrome (PRES) [NUEM Blog. Expert Commentary by Maas, MB]. Retrieved from [link] Other Posts You May Enjoy

Seizures 97

Seizures Documentation/Coding Hospitals 97

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 94

Documentation/Coding Pediatrics Emergency Department Fractures 94

EMDocs

AUGUST 22, 2024

3,4 Notably, institutions receiving federal funding (such as hospitals receiving Medicare reimbursement) must abide by Title VI of the 1964 Civil Rights Act, which entitles persons with NELP to language assistance. Utilizing certified interpreters and documenting their use. Educating patients on their rights.

Documentation/Coding 82

Documentation/Coding Emergency Department Best Practices Federal Emergency Management Agency 82

Sensible Medicine

FEBRUARY 16, 2024

Bill had coded and died overnight. A nurse had a needlestick during the code. I learned from the nursing staff that Bill’s family was in his hospital room, hoping to speak with someone about what had gone wrong. She had called Cara in the middle of the night to find out whether Bill had any HIV risk factors.

Documentation/Coding 122

Documentation/Coding Academics Shock Research 122

PulmCCM

JUNE 5, 2023

veterans’ hospitals did not show a mortality reduction from low-dose methylprednisolone. Patients receiving hydrocortisone required more insulin, but did not have higher observed rates of hospital-acquired infections or gastrointestinal bleeding. iatrogenic or hospital-acquired) were excluded.

Advances Cardiac Life Support (ACLS) 96

Advances Cardiac Life Support (ACLS) Documentation/Coding CPR Shock 96

The Trauma Pro

DECEMBER 26, 2023

Everyone knows that venous thromboembolism (VTE) is a potential problem in hospitalized patients, and especially so in trauma patients. But the key fact is that every compression device manufacturer includes existing DVT as a contraindication in their product documentation. And we probably won’t, ever.

Documentation/Coding 124

Documentation/Coding Fractures Hospitals Research 124

The Trauma Pro

JUNE 20, 2023

Documentation provided by the nurse or other providers in the medical record must demonstrate that they were in some way involved in care of the patient. The exact duties may vary somewhat geographically and even between individual hospitals. Following are the basics of malpractice as it relates to nurses.

Documentation/Coding 130

Documentation/Coding Operations Hospitals 130

Dr. Smith's ECG Blog

JUNE 13, 2024

Her first set of vitals were documented: BP 116/57 Pulse 94bpm Respiratory rate 24/min O2 sat 90% on room air Temp 97F She had been cleaning a Jeep in the sun, and was sunburned. The physician documented “normal sinus rhythm”. The physician documented that she was “improved” and the patient was discharged. CK MB was 1.9

EKG/ECG 94

EKG/ECG Documentation/Coding EMS Burns 94

Stop and Think

JANUARY 1, 2024

My friend Dr. Andrew Foy had this idea: during rounds in the hospital with learners, Foy noticed that many things get done (drugs prescribed, tests ordered) as a matter of culture or history. They sit in a Google document. It will be a working document. As in…we do this because that is what we do. One review at a time.

Documentation/Coding 98

Documentation/Coding Wellness EKG/ECG Hospitals 98

The Trauma Pro

JULY 13, 2023

Inclusion of extraneous information from later in the hospital stay. Lack of accurate team arrival documentation. Which ultimately means that you (this really means your hospital) will have to pay for more registrars / PI coordinators / nurses! Reams of paper, typically 20-30 pages. Ebola screens. Sepsis score.

Sepsis 100

Sepsis Documentation/Coding Hospitals 100

The Trauma Pro

OCTOBER 31, 2023

If you believe that harm will occur, here are your options, from least to most damaging to your professional status at the hospital: Contact another consultant in the same or overlapping specialty (if there is one). Contact the trauma medical director, service chief, or hospital administrator and see if they can intervene.

Risk Management 113

Risk Management Documentation/Coding Fractures Hospitals 113

EMDocs

SEPTEMBER 26, 2024

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.

Radiology 74

Radiology Radiology EKG/ECG Documentation/Coding 74

The Skeptics' Guide to EM

FEBRUARY 3, 2023

Temperature Control After In-Hospital Cardiac Arrest: A Randomized Clinical Trial. September 2022 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You are working an overnight shift at a small rural hospital. Circulation. Circulation.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Documentation/Coding Outcomes 52

EMDocs

OCTOBER 10, 2024

Exam is normal except for tenderness as documented in the diagram. Hospital Inpatient : R thigh is indurated and blistered but abdomen is all but ignored. On the 2nd hospital day, she becomes obtunded and is intubated. She only gets worse, and by the 4th hospital day she is unresponsive. I just failed to document it.

Documentation/Coding 75

Documentation/Coding Hospitals Sepsis Infectious Diseases 75

EM Literature of Note

OCTOBER 9, 2024

and GPT-4T – is asked: Should this patient be admitted to the hospital? while also relying upon finished human documentation for its “decision-support” The prompts – “should”/”does” – replicate the intent of the decision-support concept of the exploration, but not the retrospective nature of the content.

Radiology 84

Radiology Radiology Emergency Department Documentation/Coding 84