EM Literature of Note

OCTOBER 1, 2023

” This brief report in Annals describes a retrospective experiment in which 30 written case summaries lifted from the electronic documentation system were fed to either clinician teams or ChatGPT. Each case was tested both solely on the recorded narrative, as well as with laboratory results added. UpToDate) as augments.

Documentation/Coding 86

Documentation/Coding Operations Emergency Department Wellness 86

PulmCCM

FEBRUARY 5, 2024

You can read the document here. Read the original document here. As all radiologists are ostensible experts, this reads more like an endorsement of POCUS in the ICU for intensivists well-trained and experienced in the technique. Ultrasound is well-suited for identifying most serious biliary system abnormalities.

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

RebelEM

AUGUST 22, 2024

1,2 Intra-arterial (IA) tPA has also shown benefit but is less well studied. Moreover, there are multiple operational and patient-specific barriers rendering timely thrombolytic administration difficult. Patients whose last known well (LKW) time was within 24 hours of presentation. Within 24 hours after treatment.

Stroke 85

Stroke Administration Outcomes Documentation/Coding 85

Don't Forget the Bubbles

JUNE 19, 2024

Well-designed multicentre large studies in children were warranted; cue Leonard et al. Children in the validation cohort were admitted to the intensive care unit or operating room less frequently than those in the derivation cohort. In practice, questions remain about who applies the CDR and the inter-rater reliability.

CPR 124

CPR Research Outcomes Documentation/Coding 124

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane).

Sepsis 95

Sepsis Documentation/Coding Fractures Administration 95

American Medical Compliance

AUGUST 7, 2024

Moreover, compliance with HIPAA helps healthcare providers avoid substantial fines and legal penalties associated with data breaches, thereby maintaining compliance with federal standards and ensuring the smooth operation of their practices. It protects the health and well-being of staff.

Hazardous Materials 81

Hazardous Materials Documentation/Coding Legal Issues Patient Safety 81

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

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

Taming the SRU

MAY 11, 2024

Of note, HTS is more effective in trauma patients because it is used as a resuscitative fluid as well. 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

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

The cut points for what constitute OMI and not OMI as well as confidence levels are calibrated to maximize sensitivity and specificity according to the receiver operating characteristic. The diagonal branches are overlapping one another and not well visualized in this view. Next is RAO cranial shot.

EKG/ECG 70

EKG/ECG Operations Wellness Ultrasounds 70

ACEP Now

SEPTEMBER 5, 2024

Creation of an accurate database of emergency physicians living and working within a state, as well as a network of each states’ EM groups and ED medical directors would help chapter leaders disseminate relevant information, strengthen advocacy efforts, and plan regional solutions summits to focus on unique challenges.

Leadership 98

Leadership PPE EMS Wellness 98

AED Leader

JUNE 25, 2024

Philips is a well-known and trusted brand in the AED market, providing reliable and user-friendly devices. Keep Track of Maintenance and Servicing Proper documentation of maintenance and servicing activities is crucial for record-keeping and compliance purposes.

Operations 52

Operations Best Practices Documentation/Coding Shock 52

RebelEM

JUNE 8, 2023

Epinephrine – 10ug/mL, 10mL syringe Phenylephrine – 100ug/mL, 10mL syringe Phenylephrine bolus doses from 100-200ug and epinephrine 10-20ug administered every 2-5 minutes pursuant to provider order Inclusion Criteria: Adults age >18 years old Received at least one bolus dose of phenylephrine or epinephrine pre-filled syringes Exclusion (..)

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Taming the SRU

AUGUST 4, 2024

We discussed some practices to push learners outside of their comfort zone and promote learning, based on their level as well as their goals for the shift. The largest retrospective cohort study to date (Beyde et al.) shows that most will improve with empiric antibiotics. It is better to finish early than rushing through your presentation

Emergency Department 85

Emergency Department Dislocations Documentation/Coding Burns 85

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. While adenotonsillectomy may not directly impact cognitive functions, it can benefit other aspects of health and well-being in children with mild sleep-disordered breathing. Pediatrics. 2023 Dec 27.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

Don't Forget the Bubbles

JULY 26, 2023

A cardiac family history should of course be sought, but think a little outside the box as well. On arrival at hospital the child was well with normal observations. The Fontan circulation was an operation initially developed around 50 years ago to treat tricuspid atresia. Family history. What are the important investigations?

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

Resus Review

FEBRUARY 12, 2015

The patient is positioned and prepped in the same way as for the standard operative tracheostomy. Elimination of scheduling difficulty associated with operating room and anesthesiology teams for critical care patients. Dont forget to document your perc trach procedure well.

Operations 52

Operations Documentation/Coding Ultrasounds Wellness 52

ACEP Now

MARCH 13, 2024

Consequences of this are well documented and include delayed treatment, exposure to error, increased length of stay, and increased mortality. Conclusion/Recommendation ED crowding is a national patient safety issue driven by hospitals routinely operating over capacity. ED crowding impairs this mission. Click to enlarge.

Ethical Issues 52

Ethical Issues Emergency Department Operations Hospitals 52

RebelEM

AUGUST 12, 2024

Thus further adding to the well known safety of amino acid infusions The lack of a diversified patient population in combination with having used only one type of amino acid formulary greatly limits this study’s generalizability.

Outcomes 81

Outcomes Hospitals Operations Shock 81

Advanced Emergency Nursing from AENJ

AUGUST 2, 2016

" [Coroners Society] King Richard I (the Lionheart) needed vast sums of money for the Third Crusade, operation of the kingdom, and for his ransom fro m Duke Leopold of Austria. All efforts to identify the decedent by hospital staff, law enforcement agencies or social service agencies should be well documented in the medical records.

Documentation/Coding 40

Documentation/Coding Forensics CDC Fractures 40

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 American College of Emergency Physicians ( ACEP ) also has a number of documents discussing APPs in the ED. Background: We covered the use of advanced practice providers (APPs) on the SGEM#308.

Research 52

Research Poisoning Documentation/Coding Outcomes 52

Taming the SRU

OCTOBER 30, 2024

Case #2: Facial Swelling CT imaging has seen a significant increase in the last 20 years. ​ Although there has been an increase in imaging, diagnostic yield has remained relatively stable​ Factors the impact imaging decision includes reliability of the physical exam as well as extrinsic factors such as consultants and admitting services.​

Hospitals 52

Hospitals Emergency Department Documentation/Coding EKG/ECG 52

Don't Forget the Bubbles

OCTOBER 10, 2024

Ten thousand children in the UK are operated on a year for fingertip injuries, and 96% of surgeons currently report replacing the nail plate intra-operatively. Adopting this approach would reduce time in surgery for the child as well as the financial cost of nail bed repair. Twenty studies were included (13,102 patients).

Emergency Department 75

Emergency Department Outcomes Research Operations 75

Northwestern EM Blog

SEPTEMBER 12, 2022

This post will discuss a brief overview of hospital planning and operational setup with key elements of a disaster response from events that cause high numbers of blunt trauma, penetrating trauma, burns or crush injuries that may be seen following explosive events, mass shootings, or large scale motor vehicle collisions, to name a few.

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Hazardous Materials 52

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

Regarding my Systematic assessment of ECG #1: There is significant baseline artifact , as well as baseline wander. I therefore feel it relevant to document ( in your dictation/on the medical chart ) when significant artifact potentially impairs the accuracy of your interpretation. Smith's ECG Blog.

Seizures 111

Seizures EKG/ECG EMS Stroke 111

Mind The Bleep

MAY 1, 2024

If the limb is pale and pulseless this needs urgent referral to vascular as well as orthopaedics and the fracture needs reducing immediately. Appropriate first line management will help protect and resuscitate the soft tissues and keep the fracture still either to allow healing or until definitive management (operative fixation) is possible.

Fractures 52

Fractures Documentation/Coding Head Injuries Dislocations 52

Medagadget

MAY 23, 2023

It requires the integration of data from a kidney transplant biopsy ( i.e. , histological lesions scores), as well as clinical, immunological, and transcriptomic data. These multimodal data and rules are necessary to provide a precise diagnostic, which considers all the biological operating processes, grades, and types of rejection.

Research 83

Research Hospitals Documentation/Coding Operations 83

AED Leader

JULY 3, 2024

When it comes to ensuring the safety and well-being of your business and its employees, having a reliable automated external defibrillator (AED) is essential. This durability is essential, particularly for businesses operating in demanding or outdoor environments. Yes, Cardiac Science provides a warranty on its AED defibrillators.

CPR 52

CPR Resuscitation Pediatrics Operations 52

Advanced Emergency Nursing from AENJ

MAY 3, 2014

Although told several times, the story of the development by Henning Ruben of the prototypical modern manual resuscitator, the self-refilling bag with unidirectional non-rebreathing valves which now dominate the world of resuscitation, is still not well-known. Evaluation of Manually Operated Resuscitators CARDEN, E., & HUGHES, T.

Resuscitation 40

Resuscitation Military Operations Emergency Nursing 40

RebelEM

MARCH 27, 2023

First ED-based study to evaluate how operational effects such as crowding can affect patient care in the form of LPV Included ARDS criteria relating to the usage of LPV in the ED allowing evaluation as to whether patients with ARDS were more likely to receive LPV settings. Prior studies have used annual census or shift level crowding.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

Don't Forget the Bubbles

OCTOBER 14, 2024

The government recognizes they cannot return to their country of origin owing to a well-founded fear of being persecuted for the reasons provided for in the United Nations Refugee Convention or European Convention on Human Rights (such as persecution due to race, sexuality, political opinions, or religion).

Documentation/Coding 59

Documentation/Coding Hospitals Wellness Operations 59

ACEP Now

JULY 8, 2024

1 Other, non-transformer-based ML methods can be used on clean, well-structured data sets, but LLMs are frequently capable of feats of unanticipated competence right out of the box. As a mechanism for augmenting clinical operations, this approach may show value in passively collecting and feeding information into other systems.

Emergency Department 52

Emergency Department Operations Documentation/Coding EKG/ECG 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

Emergency Medicine Ireland

JANUARY 28, 2021

Perhaps the most common form of pacing will be in the cardiac ICU where we often receive patients from the operating theatre with epicardial wires and a pacing box hanging from the drip stand. There is a strange little secret code used to describe the type of pacing being delivered.

Documentation/Coding 40

Documentation/Coding Operations EKG/ECG Wellness 40

ACEP Now

MARCH 14, 2024

These can be delayed, up to weeks later, so it’s important to educate patients on the importance of follow-up with burn care well-versed with electrical injuries or neurology if they have or develop these symptoms. In the operating room, there was minimal urinary output and the bladder pressures were 35 mmHg under sedation and analgesia.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Don't Forget the Bubbles

MARCH 11, 2024

There are many causes, and it is less well understood than plagiocephaly. Craniosynostosis needs urgent referral and is usually corrected operatively before a child’s first birthday. Recommendations for sudden infant death syndrome prevention: a discussion document. Craniosynostosis Craniosynostosis is rare. link] Mitchell, E.

Radiology 59

Radiology Radiology Pediatrics Documentation/Coding 59

Taming the SRU

OCTOBER 14, 2024

Tissue cultures obtained in the operating room grew nonspecific gram positive cocci in chains and pairs and gram positive bacilli. CONCLUSION While growing, the current literature documenting the utilization of POCUS in evaluation of orbital and periorbital infections is minimal.

Ultrasounds 52

Ultrasounds Urgent Care Emergency Department Documentation/Coding 52