Emergency Medicine Cases

MARCH 26, 2020

Not only do we discuss the details of all PPE from head protection to footwear, but we give tips on the equally important non-PPE protection as well. We touch on PPE conservation strategies as we struggle with supplies, give you the bottom line on donning/doffing sequencing, and discuss the core principles of the protected code blue.

PPE 52

PPE Documentation/Coding Resuscitation Wellness 52

RebelEM

JUNE 29, 2023

REBEL Cast Ep119: A Discussion with Scott Weingart on the CT FIRST Trial Click here for Direct Download of the Podcast Timing Is 6hrs reasonable because most pts excluded because of this Right before heading up to ICU seems good 1st couple hours after ROSC…pts are high risk for re-coding Where Not single coverage or stand-alone EDs Optimize and transfer…scans (..)

CPR 145

CPR EMS Documentation/Coding Outcomes 145

Dr. Smith's ECG Blog

NOVEMBER 27, 2023

But the resource cost of false positives is not insignificant, and the ideal goal would be to identify both false negatives in need of emergent reperfusion as well as false positives that don’t need cath lab activation. hyperacute T waves are tall relative to their QRS, as well as bulky/inflated with a large area under the curve 3.

EKG/ECG 96

EKG/ECG Documentation/Coding Wellness 96

EM Ottawa

SEPTEMBER 28, 2023

You are treating a 43-year-old male with two days of left lower quadrant abdominal pain, a documented fever of 38.4 He looks well by ED standards. and malaise. He has no urinary or bowel symptoms. His past medical history is unremarkable. After a focused history and physical examination, you narrow the differential to diverticulitis.

Documentation/Coding 112

Documentation/Coding Wellness Infectious Diseases EMS 112

Dr. Smith's ECG Blog

MARCH 4, 2024

I have often written about how an ECG interpreted as "normal" by a conventional algorithm may well be manifesting OMI, or even long QT or hyperkalemia. link] Or use the QR code: 10 Cases: Case 1 Do you want to be interrupted to view what the computer calls normal or nonspecific ECGs? 2 cases at once! You can use it an unlimited amount.

EKG/ECG 118

EKG/ECG Documentation/Coding Wellness Resuscitation 118

Science Based Medicine

AUGUST 14, 2024

These benefits are all well researched and copiously documented. We have often stated here on SBM that vaccine programs are the most effective, and most cost effective, public health measures in human history. They save lives, prevent disease, and save money.

CDC 91

CDC Documentation/Coding Research Wellness 91

Stop and Think

JANUARY 1, 2024

Well, that can be a problem. Sometimes things we do are well grounded in evidence. Things like reading ECGs, echocardiograms, as well as learning to do procedures. Well, do you know the actual trials underpinning this evidence? They sit in a Google document. It will be a working document.

Documentation/Coding 98

Documentation/Coding Wellness EKG/ECG Hospitals 98

Sensible Medicine

DECEMBER 18, 2023

Now let’s compare the two documents. That is my conclusion as well, and I favor large, pragmatic randomized trials in adults and kids with staggered starting times (adults first — to protect kids from harms we may not yet know). From their document. The AAP champions surgery and medications. Better food?

Pediatrics 141

Pediatrics Documentation/Coding Burns Academics 141

Ken Grauer, MD

JULY 29, 2023

The "good news" — is that we clearly see sinus P waves in ECG #1 , that document conversion to sinus rhythm ( ie, upright P waves in lead II that precede each QRS complex with a constant and normal PR interval ). This young woman did well for a year — but unfortunately suffered another cardiac arrest, from which she could not be resuscitated.

EKG/ECG 370

EKG/ECG Resuscitation Documentation/Coding Hospitals 370

Dr. Smith's ECG Blog

OCTOBER 18, 2023

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] have published a number of warnings about the previous reassuring studies.[4,5] Am J Emerg Med. 2022 ; 55 : 180 - 182 6.

EKG/ECG 123

EKG/ECG Documentation/Coding Emergency Department Outcomes 123

Dr. Smith's ECG Blog

MARCH 14, 2024

It is well known that NOMI usually has a normal ECG or nonspecific ECG. We also studied 7 years of Code STEMI patients requiring emergent reperfusion, and found that 4% presented with an ECG labeled ‘normal’, often confirmed by the final blinded interpretation.

EKG/ECG 116

EKG/ECG Documentation/Coding Patient Safety Outcomes 116

EM Ottawa

DECEMBER 28, 2023

There is a well-documented correlation amongst EMS and adult ED physicians who provide less pediatric care to […] The post Pediatric Traumatic Cardiac Arrest appeared first on EMOttawa Blog. Trauma is the leading cause of child and youth mortality globally (1). Pediatric trauma is a high acuity but low frequency event (2).

Pediatrics 80

Pediatrics Documentation/Coding EMS Wellness 80

American Medical Compliance

MARCH 11, 2024

These are recordkeeping and documentation. While the primary focus in dentistry is patient health and well-being, carefully keeping records is equally needed. Informed Consent Documentation Before initiating any treatment, informed consent must be obtained from the patient or their legal guardian.

Documentation/Coding 88

Documentation/Coding Best Practices Operations Outcomes 88

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.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

American Medical Compliance

APRIL 1, 2024

What you will learn Principles, code of professional conduct, and advisory opinions Patient Autonomy Nonmalfience Benefience Indiana Statuses and Administrative Rules Licensure of Dentists Licensure of Dental Hygienists Details Course length: 2 hours. These are the ADA Principles of Ethics and Code of Professional Conduct (ADA Code).

Documentation/Coding 59

Documentation/Coding Administration Wellness 59

Stop and Think

NOVEMBER 19, 2023

Also well known—from old data—was that myocarditis is a cause of cardiac arrest during sport. This was a 20-year survey in which the authors used 4 independent databases to document the incidence and causes of sudden cardiac death in NCAA athletes. Young males had the highest risk of this adverse effect. But it was real.

Documentation/Coding 128

Documentation/Coding Wellness Resuscitation 128

Dr. Smith's ECG Blog

JANUARY 5, 2024

The documentation does not describe any additional details of the history. They also documented "Reproducible chest tenderness." The proximal LAD has mild disease, but the distal LAD and diagonal branches are not well evaluated in this view. The distal LCx is seen, and the OM is not well visualized here.

EKG/ECG 115

EKG/ECG Burns Urgent Care Documentation/Coding 115

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.

Documentation/Coding 124

Documentation/Coding Hospitals Administration Emergency Department 124

Total Medical ComplianceHIPAA

AUGUST 15, 2024

Document what worked well and what did not. Clear Communication Channels : Confirm that communication channels are well-defined and tested. Documentation and Compliance Comprehensive Documentation : Maintain detailed documentation of the DRP, including all tests, training sessions, and updates.

Documentation/Coding 59

Documentation/Coding Best Practices Risk Management Wellness 59

Dr. Smith's ECG Blog

SEPTEMBER 12, 2024

The paramedic called the EM physician ahead of arrival and discussed the case and ECGs, and both agreed upon activating "Code STEMI" (even though of course it is not STEMI by definition), so that the acute LAD occlusion could be treated as fast as possible. So the cath lab was activated.

EKG/ECG 123

EKG/ECG EMS Documentation/Coding Shock 123

American Medical Compliance

OCTOBER 3, 2024

As dental professionals, it’s crucial to understand and adhere to OSHA dental compliance standards to ensure the well-being of both staff and patients. This can be achieved by maintaining a centralized document repository. Have a digital document management system or a physical binder in a prominent area of the dental office.

PPE 95

PPE Hazardous Materials Documentation/Coding Operations 95

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Macroscopic T-Wave Alternans: A Red Flag for Code Blue. This 1910 description by Lewis serves well to this day to remind us of the 2 principal clinical situations in which electrical alternans is most often encountered: i ) Supraventricular reentry tachycardias; and , ii ) Pericaradial tamponade. J Am Coll Cardiol. doi: 10.1016/j.jacc.2005.08.066.

EKG/ECG 128

EKG/ECG Documentation/Coding Psychiatric EMS 128

EMDocs

AUGUST 22, 2024

13 Interventions may include: Ascertaining a patient’s preferred language early in the clinical encounter (during registration, for instance), and clearly documenting this preference in a place that is visible to all providers. Well-meaning providers who are not highly fluent may contribute to miscommunication and diagnostic errors.

Documentation/Coding 82

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

EMDocs

JULY 25, 2024

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. There is no documented handoff to the on-coming emergency physician (EP) who assumes care. ” 0700 : The PA-C goes off-shift.

Documentation/Coding 82

Documentation/Coding Hospitals Patient Safety Emergency Department 82

The Trauma Pro

DECEMBER 26, 2023

Screening looks at patient factors such as age, obesity, and previous VTE, as well as injury risk factors like spine and pelvic fractures and decreased mobility. But the key fact is that every compression device manufacturer includes existing DVT as a contraindication in their product documentation.

Documentation/Coding 124

Documentation/Coding Fractures Hospitals Research 124

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. Which patients were involved? How good was this paper? Do you believe the results?

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

EMDocs

OCTOBER 3, 2023

This is also where keeping up with documentation starts to slip. You’ll need to put the following tasks in a rank order list: new patient evaluations, dispositions, managing critical or potentially critical patients, results review, team huddle, running the board, calling consults, doing procedures, and documentation. It’s up to you.

Documentation/Coding 97

Documentation/Coding EMS Operations Emergency Department 97

Don't Forget the Bubbles

AUGUST 23, 2023

Definitive emotional support is critical to our emotional and psychological well-being. 2016) “Implementation of a Post-Code Pause: Extending Post-Event Debriefing to Include Silence”. 2012) “Implementation of a Rapid Post-Code Debrief Quality Improvement Project in a Community Emergency Department Setting”. & Liska, H.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

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. Broad inclusion criteria increasing external validity.

Outcomes 145

Outcomes Research Documentation/Coding Wellness 145

Sensible Medicine

MAY 16, 2024

This works reasonably well. They documented that these patients had high vagal tone. A few short words about our conversation: Two decades have passed and electrophysiologists have learned little about how to ablate atrial fibrillation. Now, and then, we simply ablate circles around the orifices of the pulmonary veins.

Documentation/Coding 88

Documentation/Coding Wellness 88

Sensible Medicine

MAY 15, 2024

At the same time, I struggle to see how such a person could run codes and work in trauma surgery. There are so many things students are not learning instead — like how to read a paper or how to take care of heart failure (well). I am a firm believer that someone who is paralyzed can be an oncologist (my job) or psychiatrist.

Administration 120

Administration Documentation/Coding Hospitals Wellness 120

American Medical Compliance

NOVEMBER 8, 2024

Proper injury reporting protects patients, supports a safe workplace, and shields healthcare providers from potential legal issues that may arise due to negligence or lack of documentation. Carefully recording incidents and examining their causes can address specific safety concerns and prevent future incidents.

Documentation/Coding 85

Documentation/Coding Legal Issues Operations Incident Reporting 85

Pediatric EM Morsels

JULY 5, 2024

We collected data directly from the bedside clinician which enabled us to gather pertinent patient symptoms and physical examination findings that may not be well documented in the medical record, but more accurately identify the child’s injuries.”

Pediatrics 161

Pediatrics Head Injuries Dislocations Research 161

American Medical Compliance

AUGUST 14, 2024

This training not only raises awareness but also empowers dental teams to take action, ensuring that they can contribute to the safety and well-being of their patients. ” This broad definition underscores the variety of ways in which a child’s well-being can be compromised.

Burns 89

Burns Documentation/Coding Wellness 89

American Medical Compliance

FEBRUARY 17, 2024

Ensuring the safety and well-being of both patients and staff is paramount. Maintain Comprehensive Recordkeeping Document workplace injuries and illnesses.

Best Practices 89

Best Practices PPE Infectious Diseases Documentation/Coding 89

ACEP Now

JUNE 7, 2023

Whereas previous versions of GPT were unable to pass the medical examinations, GPT-4 demonstrated scores of approximately 85 percent correct on each Step of USMLE, well above the passing threshold. Future versions are likely to have greater accuracy and error-checking abilities, as well as improved domain-specific generative abilities.

Documentation/Coding 78

Documentation/Coding Wellness Administration Research 78

The Trauma Pro

OCTOBER 31, 2023

Explain to the consultant that you truly believe that harm will occur, and you will have to document that fact in the medical record as well as their failure to respond. 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