EMDocs

JUNE 8, 2023

and 9 hours after onset of symptoms, with non-infarcted brain tissue, does the administration of alteplase improve functional outcome at 90 days? and 9 hours of symptom onset; stroke symptoms that started during sleep were assumed to have started halfway between the actual last known well and the time of wake-up. to 53.54, p=0.053).

Stroke 77

Stroke Administration Outcomes Documentation/Coding 77

Dr. Smith's ECG Blog

OCTOBER 18, 2023

1-3] But these studies were very short duration and used cardiology interpretation of ECGs or emergent angiography rather than patient outcomes. 4,5] We have now formally studied this question: Emergency department Code STEMI patients with initial electrocardiogram labeled ‘normal’ by computer interpretation: a 7-year retrospective review.[6]

EKG/ECG 119

EKG/ECG Documentation/Coding Emergency Department Outcomes 119

ACEP Now

OCTOBER 3, 2023

This document is an update of guidelines first published in 2000, and then updated in 2007. These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations.

Documentation/Coding 98

Documentation/Coding Fluid Resuscitation Resuscitation EMS 98

Mind The Bleep

NOVEMBER 21, 2023

” Yes, I have seen clerking look like this and I can confirm, it does not go down well. Unless you’re documenting something hilarious, please keep it brief and to the point. History of Presenting Complaint In this section use SOCRATES to document the pain.

Documentation/Coding 52

Documentation/Coding COPD EKG/ECG Wellness 52

RebelEM

JUNE 22, 2023

Population: Adults aged 30-85 years of age with BMI > 25 ( > 23 in those identifying as Asian or Latino) who had COVID-19 symptoms for fewer than 7 days and a documented SARS-CoV-2 positive PCR or antigen test within 3 days of enrollment without prior SARS-CoV-2 infection. Prior vaccination was not an exclusion criteria.

Outcomes 131

Outcomes Research Documentation/Coding Wellness 131

Sensible Medicine

AUGUST 21, 2023

Administrative data sets are often collected for the purpose of billing, or costing, or administrative organization, and thus are extremely vulnerable to up coding or intentional or accidental omissions. ” For example, mortality is a patient outcome—provided it can be reliably ascertained. It is our goal.

Administration 89

Administration Outcomes Research COPD 89

Downeast Emergency Medicine

DECEMBER 1, 2021

The primary outcome was enrollment in and receiving addiction treatment at 30-days post-randomization. Additional outcomes included self-reported days of illicit opioid use, urine testing for illicit opioids, HIV risk, and use of addiction treatment services. Annals of Emergency Medicine. 2021; 78(3): 434-442.[

Emergency Department 52

Emergency Department Documentation/Coding Leadership Hospitals 52

AENJ: Current Issue

SEPTEMBER 30, 2023

The overuse of computed tomographic (CT) scans for patients who present to the emergency department (ED) after mild traumatic brain injury (mTBI) has been well-documented. The outcomes measured were the number of CT scans ordered, ED length of stay, and the cost of avoidable CT scans. Cost of care was also estimated.

Emergency Department 53

Emergency Department Documentation/Coding Outcomes Wellness 53

ACEP Now

OCTOBER 9, 2023

percent) do not speak English as a primary language, and 25 million of those speak English less than well (known as “limited English proficiency” or LEP); many indicators show this number will only continue to grow. Physicians should document the interpreter’s name and identification number if available in the patient’s chart.

Emergency Department 64

Emergency Department Documentation/Coding EMS Wellness 64

RebelEM

JULY 3, 2023

Currently, the infusion of IV calcium before diltiazem is not well understood, and more studies have focused on administering IV calcium prior to verapamil than diltiazem. Secondary outcome All secondary outcomes were found to be similar (Not statistically significant) between groups (See table above). Article: Rossi N et al.

Administration 84

Administration Outcomes Documentation/Coding Emergency Department 84

Don't Forget the Bubbles

MAY 31, 2023

The DIMPLES study by PERUKI sought to investigate the incidence of new-onset diabetes in the paediatric population across the UK and Ireland, as well as the characteristics of these ED presentations, and to determine if SARS-CoV2 infection was involved. What outcomes did they look at? Which patients were involved?

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

Don't Forget the Bubbles

JUNE 19, 2024

Well-designed multicentre large studies in children were warranted; cue Leonard et al. A proportion of the patients who were initially missed using the CDR were found to actually have risk factors documented in EMS reports or the medical record. Were the predictor variables and the outcome evaluated in a blinded fashion?

CPR 121

CPR Research Outcomes Documentation/Coding 121

American Medical Compliance

APRIL 29, 2024

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve healthcare outcomes. A Framework Against Abuse and Neglect in Nursing Homes Federal Code has established regulations to safeguard nursing home residents from abuse and neglect.

Elder Abuse 52

Elder Abuse Documentation/Coding Administration Outcomes 52

Total Medical ComplianceHIPAA

APRIL 14, 2023

On April 11, 2023, the HHS published a notice on upcoming new rules to add greater protection to reproductive health care because of new state laws passed due to the outcome of the Supreme Court ruling on Roe v. You can even call and talk to your patient and document this. New HIPAA rules proposed by Health and Human Services (HHS).

Documentation/Coding 83

Documentation/Coding Outcomes Wellness 83

RebelEM

MARCH 13, 2024

This was not a Code 3 respiratory distress, fentanyl overdose with minimal response to Narcan or even an unconscious stroke patient with the blood pressure of a giraffe. Would they ever be well enough to be extubated? If we tried to wait it out, could he pull through on BiPAP alone? How would the hemodynamics respond to RSI?

Documentation/Coding 55

Documentation/Coding Outcomes EMS Stroke 55

Don't Forget the Bubbles

MAY 6, 2024

Outcomes included clinical status when urine culture was available, subsequent antibiotic treatment within seven days and subsequent UTI within 30 days. of patients with follow-up documentation, 70.8% (95% CI 62.9–77.9) The primary outcome was the successful intubation on the second attempt. Of the 74.9% Why does it matter?

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). While ABGs and VBGs usually correlate well, there are a few situations where this correlation is disturbed.

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

Taming the SRU

APRIL 22, 2023

If untreated, atrial fibrillation can increase clot formation and lead to an increased risk for heart attack and stroke as well as development of congestive heart failure. There were similar lengths of say overall and no significant difference in safety outcomes. The diltiazem group had greater reduction in HR at 30 and 60 minutes.

Outcomes 52

Outcomes Documentation/Coding Stroke Fractures 52

The Skeptics' Guide to EM

MAY 11, 2019

Background: The first documented appendectomy was done by Claudius Amyand in 1735. Exclusion: Patients with co-occurring diagnosis or procedure codes consistent with complicated appendicitis and patients lacking appendectomy codes. Omar et al (2008) showed just how safe laparoscopic appendectomies have become.

Documentation/Coding 52

Documentation/Coding Operations Academics Ultrasounds 52

ACEP Now

OCTOBER 30, 2023

One case report highlighted an unfortunate outcome from aspiration pneumonia, later found to be due to crayons rather than the expected culprits such as food, secretions, or beverages. This makes documentation and communication of the utmost importance for these patients for their health and safety.

Sexual Assault 98

Sexual Assault Teamwork Outcomes Dehydration 98

The Skeptics' Guide to EM

MAY 8, 2021

He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR […] The post SGEM#329: Will Corticosteroids Help if…I Will Survive a Cardiac Arrest? He is an EMS medical director with Lexington Fire/EMS as well as the AMR/NASCAR Safety Team. first appeared on The Skeptics Guide to Emergency Medicine.

CPR 52

CPR Hyperthermia / Hypothermia EMS Documentation/Coding 52

Dr. Smith's ECG Blog

JULY 7, 2024

But because Code STEMI was cancelled on arrival and the patient had delayed angiography, the discharge diagnosis was 'non-STEMI' despite having the exact same pathology. The patient also had a 100% proximal LAD occlusion, with a peak troponin of 100,000 ng/L.

EKG/ECG 69

EKG/ECG Documentation/Coding EMS Wellness 69

Taming the SRU

SEPTEMBER 1, 2023

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 88

Sepsis Administration Documentation/Coding Fractures 88

American Medical Compliance

JULY 9, 2024

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve patient care outcomes. Observe and document any signs of abuse, such as unexplained injuries or changes in behavior.

Elder Abuse 52

Elder Abuse Documentation/Coding Outcomes Wellness 52

RCEM Learning

JANUARY 23, 2024

This can include randomisation procedures, recruitment and follow-up response rates, what outcome measures patients will prefer, whether patients agree to complete the intervention (in this case the exercise programme) and so on. There was nothing further I could do at that point to change the outcome of the trial.

Research 72

Research Wellness Outcomes Documentation/Coding 72

Sensible Medicine

DECEMBER 1, 2023

PP has a long history of hypertension and type II diabetes, both well controlled. When I first learned about shared decision making, I was taught that when patient and doctor stay in their lanes – doctors say what is or is not indicated and patients express their preferences – things tend to go well. What do you think?

Wellness 83

Wellness Documentation/Coding Outcomes Stroke 83

American Medical Compliance

JULY 2, 2024

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve patient care outcomes. Document observations consistently to identify patterns and trends over time.

Patient Safety 76

Patient Safety Documentation/Coding Outcomes Wellness 76

Dr. Smith's ECG Blog

AUGUST 9, 2024

He had no previously documented medical problems except polysubstance use. The LCx and OM vessels are not as well visualized. Opioids associate with worse outcomes in myocardial infarction , probably because they eliminate the pain signal that informs the clinician of the urgency of revascularization. Do not treat AIVR.

EKG/ECG 85

EKG/ECG EMS Emergency Department Outcomes 85

Sensible Medicine

APRIL 12, 2024

For probably the twelfth time on Sensible Medicine, I’ll reference Lisa Rosenbaum’s essay, Being Well while Doing Well — Distinguishing Necessary from Unnecessary Discomfort in Training which brought some of the current inter-generational angst to the fore. What could possibly go wrong?

Radiology 76

Radiology Radiology Hospitals Documentation/Coding 76

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 85

Administration Resuscitation Fluid Resuscitation Research 85

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. Ultrasound is well-suited for identifying most serious biliary system abnormalities. What’s a Fever?

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

Sensible Medicine

JUNE 16, 2023

This can happen while watching my daughter’s track meet; during a swim; even while documenting another patient’s visit. I may be unaware of bad outcomes, and, like most doctors, without this knowledge I assume good outcomes rather than bad. A patient joins the ghost-patient panel when I realize I no longer see them.

Outcomes 84

Outcomes Documentation/Coding Wellness 84

PulmCCM

JULY 31, 2023

severe hypoxemia not doing well or on a bad trajectory while receiving conventional care). To make that leap, I for one would need to see improved outcomes with caloric restriction in patients with less-severe shock. Extracorporeal membrane oxygenation (ECMO) was encouraged, based largely on the EOLIA trial.

Shock 98

Shock Documentation/Coding Outcomes Wellness 98

Dr. Smith's ECG Blog

JUNE 15, 2023

I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict: You can subscribe for news and early access (via participating in our studies) to the Queen of Hearts here: [link] queen-form Then I learned that a Code STEMI was activated for concern of anterior "STEMI" in V1-V2. High sensitivity troponin I was 23 ng/L.

EKG/ECG 90

EKG/ECG Documentation/Coding Outcomes Hospitals 90

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. You’re just about aware of the tannoy in the background.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

SheMD

JULY 27, 2023

What were their outcomes: Physician mothers report having more domestic responsibilities than their partners. Unequal distribution of domestic responsibility has been documented as a factor in the underrepresentation in female physicians in leadership roles in academic medicine as well as contributing to career satisfaction.

Academics 52

Academics Leadership Documentation/Coding Research 52

Northwestern EM Blog

SEPTEMBER 26, 2022

It is well-documented that ED physicians have historically high rates of burnout compared to other specialties as well as a high incidence of post-traumatic stress disorder (PTSD) compared to the general population. PTSD is 2 times more prevalent in physicians (14.8%), with EM resident physicians falling in the range from 11.9%-21.5%.

Resuscitation 52

Resuscitation Emergency Department Academics Wellness 52