Taming the SRU

SEPTEMBER 1, 2023

to divert the plane). for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

Taming the SRU

MAY 11, 2024

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

Administration 91

Administration Resuscitation Fluid Resuscitation Research 91

American Medical Compliance

APRIL 17, 2024

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve healthcare outcomes. It covers construction, protection, and operational features designed to provide safety from fire, smoke, and panic.

Documentation/Coding 52

Documentation/Coding Best Practices Operations Outcomes 52

The Skeptics' Guide to EM

MAY 11, 2019

Background: The first documented appendectomy was done by Claudius Amyand in 1735. This is an example of why things in evidence-based medicine can be “complicated” ( SGEM#115 and SGEM#180 Clinical Question: Operative treatment or non-operative treatment of acute Grade 1 (uncomplicated) appendicitis? Reference: Sceats et al.

Documentation/Coding 40

Documentation/Coding Operations Academics Ultrasounds 40

RebelEM

AUGUST 12, 2024

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

Outcomes 81

Outcomes Hospitals Operations Shock 81

PulmCCM

FEBRUARY 5, 2024

You can read the document here. Also, many patients with infection won’t have fevers, and those that don’t may be at the highest risk for poor outcomes. Read the original document here. Please comment below if you have any suggested additions or edits to this document. What’s a Fever?

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

RebelEM

JUNE 8, 2023

Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose.

Administration 97

Administration Emergency Department Outcomes Documentation/Coding 97

RebelEM

NOVEMBER 6, 2024

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)

Dislocations 103

Dislocations Fractures Soft Tissue Injuries Outcomes 103

Don't Forget the Bubbles

OCTOBER 10, 2024

Reviewed by: Isabella Davenport Article 2: Does it improve outcomes if you replace the nail in nail bed repair? Children with nail bed injuries were randomly assigned to nail replacement or discarding , with the primary outcomes being secondary infection in 7 days and cosmetic outcome in four months.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

The Skeptics' Guide to EM

JULY 30, 2022

Background: Somewhere between two and four percent of patients presenting to US EDs with abdominal pain have a small bowel obstruction (SBO) – those who are managed operatively (who are only 20-30%) account for 60,000 hospitalizations and 565,000 inpatient care days per year. Also joining us is Dr. Andrew Goldsmith.

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

Don't Forget the Bubbles

JANUARY 1, 2024

However, children who had an operation experienced improvements in behaviour, symptoms, and quality of life and had lower blood pressure. Outcomes From a Randomized Clinical Trial. Two-Year Autism Risk Screening and 3-Year Developmental Outcomes in Very Preterm Infants. They enrolled 459 children aged 3 to 12.9 Lock JD, et al.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

PHEM Cast

DECEMBER 12, 2016

Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. 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. Injury; 2006 (37): 1-19.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

The Skeptics' Guide to EM

NOVEMBER 21, 2020

The American College of Emergency Physicians ( ACEP ) has a number of documents discussing APPs in the ED. Clinical Question: How does the productivity of advanced practice providers compare to emergency physicians and what is its impact on emergency department operations? Reference: Pines et al. AEM November 2020.

Emergency Department 52

Emergency Department Telemedicine Academics Outcomes 52

Ziqitza HealthCare Ltd

JUNE 18, 2023

Ziqitza Healthcare ltd embraces precision medicine by leveraging AI to analyze genomic data, enabling the delivery of tailored therapies to patients for improved treatment outcomes. By automating these processes, healthcare providers can improve efficiency, reduce errors, and lower operational costs.

Documentation/Coding 52

Documentation/Coding Administration Ambulance Services Outcomes 52

Don't Forget the Bubbles

JULY 26, 2023

Cardiac testing and outcomes in infants after an ALTE, Hoki et al, Archives of Disease in Childhood 2012 showed significant cardiac disease was present in <1% of patients presenting with ALTE (although cardiac abnormalities were found in 4% overall). A 12 year old girl was heard to be coughing in the middle of the night.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

The Skeptics' Guide to EM

JANUARY 23, 2021

That SGEMHOP episode asked how the productivity of APPs compare to emergency physicians and what is its impact on ED operations? The SGEM bottom line was that increasing APP coverage has minimal effect on ED flow and safety outcomes based on the data. Intervention: Evaluated by an APP * Comparison: Evaluated a physicial * Outcome:

Poisoning 52

Poisoning Research Documentation/Coding Operations 52

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. This is a critical error that leads to poorer outcomes for patients in need of critical care. Unfortunately, its not clear whether the documentation came from RTs or ED providers.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

PulmCCM

JANUARY 6, 2025

A cluster randomized trial using all-cause mortality as an outcome was always needed to determine whether EMR alerts improve outcomes for suspected severe infection. This led the authors to speculate that qSOFA parameters were being documented more diligently on the wards randomized to screening.

Sepsis 45

Sepsis Documentation/Coding Hospitals Outcomes 45

Taming the SRU

OCTOBER 30, 2024

Despite adherence to strict ACLS protocols, neurologic outcomes remain poor.​ The VA-ECMO set-up is specifically used for eCPR​ Meta-analyses for eCPR have shown aggregate survival rates with good neurologic outcomes up to 21.3% Debrief codes and odd encounters for yourself, your team, and your hospital system. R2 CPC: WITH drs.

Hospitals 52

Hospitals Emergency Department EKG/ECG Documentation/Coding 52

AED Leader

JULY 3, 2024

This durability is essential, particularly for businesses operating in demanding or outdoor environments. With a Cardiac Science AED defibrillator, you can have confidence that your CPR efforts are optimized for the best possible outcome. Yes, Cardiac Science provides a warranty on its AED defibrillators.

CPR 52

CPR Resuscitation Pediatrics Operations 52

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? However, with ultrasonography becoming more prevalent in EDs, it may be possible that initial imaging may avoid this radiation risk and still have similar outcomes for patients. Would you be satisfied with only US and no follow-up CT?

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

AED Leader

AUGUST 22, 2024

This blog post aims to demystify the operation, importance, and application of AED defibrillators for both healthcare professionals and laypersons alike. AEDs are designed for easy use, so even people without medical training can operate them effectively in critical situations. How does an AED Work?

CPR 52

CPR Shock Operations Outcomes 52

Don't Forget the Bubbles

MAY 10, 2023

Then you hear the words coming out of the speaker, “ Paediatric code black. Paediatric code black ”. You’ve heard the phrase code black before – it’s a traumatic cardiac arrest. You know a paediatric code black means paediatric traumatic cardiac arrest. Then the patient is rapidly moved to the operating theatre.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

Taming the SRU

JULY 25, 2024

Femoral nerve block case review - morbidity & mortality - community practice - r2 Clinical pathologic case - visual diagnosis - when time matters - operational aspects of stroke care Femoral nerve Block Case Review WITH dr. stolz Why do we care about regional anesthesia, specifically femoral nerve blocks?

Stroke 97

Stroke Fractures Operations Outcomes 97

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

Don't Forget the Bubbles

JULY 5, 2023

Furthermore, educating both patients and their families is important in order to achieve good treatment compliance and better clinical outcomes. Afro-Caribbean patients should be screened for sickle cell before anaesthesia for possible pre-operative transfusion. What could be the differential diagnosis?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

EB Medicine

MARCH 1, 2019

Post opiate hypotension in prehospital trauma patients is a rare but documented complication. In one RCT, the FAST exam reduced the time from arrival in the ED to operative care by 64% in the setting of trauma. Jeff: Operative management, specifically ED thoracotomy is a heavily debated topic, and it’s next on our list to discuss.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

RebelEM

SEPTEMBER 11, 2023

Outcomes: Primary: Percent change in management decisions after introducing the Radiology Department RUQ US. Similarly, surgeons might hesitate to operate on older patients with multiple comorbidities due to higher associated risks.

Ultrasounds 68

Ultrasounds Radiology Radiology Emergency Department 68

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. ➢ Latex paint-gun injuries of the hand: are the outcomes better? J Am Acad Orthop Surg. Hand (N Y).

Fractures 52

Fractures Documentation/Coding Operations Research 52

Don't Forget the Bubbles

AUGUST 10, 2023

Descriptive Terms When describing injuries of the hand for documentation or referral purposes it is important to know the terminology that is widely in use in order to convey an accurate description to others. Hand dominance, mechanism of injury and vascular, neurological, and musculoskeletal status should all be evaluated and documented.

Fractures 52

Fractures Soft Tissue Injuries Emergency Department Operations 52

EB Medicine

JULY 8, 2019

Nachi: Unfortunately this procedure is associated with a relatively high re-operation rate – one study found 20% of patients required removal or revision. Jeff: Even more shockingly, some series showed a 52% repeat operation rate. Vitamin D, B12, Calcium, foate, iron, and thiamine deficiencies are all well documented complications.

Emergency Department 40

Emergency Department Sepsis Operations Ultrasounds 40

EB Medicine

JUNE 6, 2019

Nachi: And remember that hypothermic patients who are septic have worse outcomes than those who are hyperthermic and septic. Nachi: Few things are more important prior to discharge of an abdominal pain patient than documenting repeat exams and a PO trial. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EMDocs

NOVEMBER 16, 2024

4 Pain is the most common reason for presentation in the early post operative period. 5 Highest risk of dislocation early in the post operative course due to laxity of the soft tissue after surgery. 6 Hip flexion or adduction in the early post-operative period can cause atraumatic dislocations (typically avoided for 6 weeks post-op).

EMS 88

EMS Dislocations Fractures Operations 88

EB Medicine

JANUARY 2, 2019

With opportunities to improve outcomes for both the fetus and the mother, I’m confident that this episode will be worth your time. Nachi: For patient who have a threatened miscarriage in the first trimester, there is a 2-fold increased risk of subsequent maternal and fetal adverse outcomes. Jeff: Up first is the urine pregnancy test.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

EB Medicine

DECEMBER 4, 2019

The authors note that the air is actually comparable to that of an operating room. Nachi: AEDs are also required and have been since 2001 and amazingly when a shock was delivered in flight, 40% survived to hospital discharge with a good outcome. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%.

Dehydration 40

Dehydration EMS Wellness Burns 40

EB Medicine

AUGUST 1, 2018

In fact, cannabis use has been documented for medical use dating as far back as 600 BC in West and Central Asia. Jeff: It’s also worth noting that cannabis is known to cause adverse outcomes on babies such as low birth weight and more frequent perinatal ICU placement. Counsel them on drug abuse also.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful. These premonitory symptoms were negative predictors of adverse outcomes in EGSYS.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52