Pediatric EM Morsels

APRIL 19, 2024

Trauma season is at hand and like all other pediatric emergency departments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. Hospital versus home management of children with buckle fractures of the distal radius. We see all different flavors of upper extremity injuries.

Fractures 290

Fractures Pediatrics Best Practices Outcomes 290

Emergency Medicine Journal

DECEMBER 30, 2024

Does your emergency department (ED) feel like a constant battle? When you think about battles, you think about frontline casualties (an irony given the origins of emergency medicine (EM)) and how there must be sacrifice for the majority to succeed. Is EM the sacrifice for your hospital to succeed?

EMS 52

EMS Emergency Department Hospitals 52

EMDocs

NOVEMBER 19, 2024

He was extubated on hospital day 2 and was able to be discharged to psychiatry on hospital day 5. Movement Disorder Emergencies. His roommate found an empty pill bottle on the floor next to him. The bottle contained 100 mg quetiapine tablets, and 50 tablets were unaccounted for. The patient gradually improved. Published 2019.

Poisoning 108

Poisoning Hyperthermia / Hypothermia EKG/ECG Seizures 108

Pediatric EM Morsels

JUNE 2, 2023

Today we are talking about a rare disease called FPIES (food protein induced enterocolitis syndrome) and how you might encounter these patients in the Pediatric Emergency Department. link] The post Food Protein Induced Enterocolitis Syndrome (FPIES) appeared first on Pediatric EM Morsels.

Dehydration 193

Dehydration Shock Pediatrics Emergency Department 193

Pediatric EM Morsels

JULY 19, 2024

If bleeding has completely stopped, most of these children still come into the hospital for observation so access will likely be necessary and helpful should patient have rebleed event. If bleeding, the only lab that is needed in the Emergency Department is a type and cross. Get IV access! Int J Pediatr Otorhinolaryngol.

Pediatrics 290

Pediatrics Airway Management Wellness Operations 290

RebelEM

MAY 11, 2023

Background: The emergency department is frequently visited by patients suffering from symptomatic alcohol withdrawal, and the traditional management has been dominated by repeated doses of benzodiazepines. Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal.

Emergency Department 89

Emergency Department Administration Hospitals Academics 89

Taming the SRU

DECEMBER 11, 2023

PATIENT PRESENTATION A young woman with a past medical history of major depressive disorder presented to the emergency room via EMS for a report of intentional ingestion of an unknown substance. EMS reported that she was vomiting profusely on their arrival to the scene but during transport became increasingly lethargic.

EMS 97

EMS Psychiatric Emergency Department Poisoning 97

EMDocs

SEPTEMBER 23, 2023

We’ll keep it short, while you keep that EM brain sharp. Admit symptomatic patients to the hospital for further evaluation and EP studies. A 23-year-old man with no significant medical history presents to the emergency department for evaluation of a syncopal episode. Mazzanti A, Tenuta E, Marino M, et al. Heart Rhythm.

EMS 102

EMS EKG/ECG Documentation/Coding Emergency Department 102

EMDocs

JULY 29, 2023

We’ll keep it short, while you keep that EM brain sharp. A 75-year-old male with past history of HTN, CVA, DM II presents to the emergency department with right facial swelling since last night. Clin Pract Cases Emerg Med. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Afr J Paediatr Surg.

EMS 90

EMS Dehydration Ultrasounds Emergency Department 90

Taming the SRU

JUNE 11, 2023

End-tidal carbon dioxide measured at emergency department triage outperforms standard triage vital signs in predicting in-hospital mortality and intensive care unit admission. Acad Emerg Med 2023; 10.1111/acem.14703 Acad Emerg Med 2023; 10.1111/acem.14703 EtCO2 is a valuable tool in many medical specialties.

Hospitals 88

Hospitals Emergency Department EMS Outcomes 88

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. Special thanks to Dr. Kevin Wasko, guest expert on the EM Cases podcast on this topic, who inspired this column. Dr. Helman is an emergency physician at North York General Hospital in Toronto.

Airway Management 98

Airway Management Operations Resuscitation Pediatrics 98

EMDocs

JUNE 17, 2023

We’ll keep it short, while you keep that EM brain sharp. Acute Periorbital Infections: Who Needs Emergent Imaging? 2009-1709 The post EM@3AM: Periorbital Cellulitis appeared first on emDOCs.net - Emergency Medicine Education. Parents report the swelling has progressively worsened and is greater in the upper eyelid.

EMS 91

EMS Infectious Diseases Pediatrics Emergency Department 91

EMDocs

OCTOBER 21, 2023

We’ll keep it short, while you keep that EM brain sharp. In hospital mortality estimated at 30-40%. 17 65-78% of survivors have significant disability one month after hospital discharge. Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department. Arch Neurol.

EMS 93

EMS Stroke Outcomes Hospitals 93

ACEP Now

JUNE 7, 2023

Software attacks crippled operations in large hospital chains, and physical assaults on ED staff continued unabated. The preliminary results of the 2022 Emergency Department Benchmarking Alliance performance measures survey found a significant deterioration in patient processing due to inpatient boarding.

Emergency Department 52

Emergency Department Documentation/Coding Operations EMS 52

EMDocs

NOVEMBER 18, 2023

We’ll keep it short, while you keep that EM brain sharp. Emergency department visits and unanticipated readmissions after liver transplantation: A retrospective observational study. David Gatz, A narrative review of the evaluation and management of liver transplant complications in the emergency department.

EMS 89

EMS Ultrasounds Emergency Department Outcomes 89

ACEP Now

DECEMBER 11, 2023

The Emergency Department Benchmarking Alliance (EDBA) is a membership organization composed of high-performance emergency departments (EDs) that share a commitment to quality. EMS arrivals increased; many of those patients (35 percent) were admitted. The pandemic saw the time interval increase.

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

ACEP Now

JANUARY 4, 2025

Clarke had begun an emergency medicine residency at what was then known as LA CountyUSC Hospital, Los Angeles. The specialty, he said, spoke to his interest in surgery and EMS in a way that family medicine did not. Clarke was set to begin a decades-long career in emergency medicine and he brought along his camera.

Forensics 52

Forensics Urgent Care Hospitals Emergency Department 52

The Skeptics' Guide to EM

MARCH 2, 2024

Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. Case: A 59-year-old man walks into your community emergency department (ED) complaining of chest pain.

Emergency Department 131

Emergency Department Stroke Operations Hospitals 131

ACEP Now

OCTOBER 13, 2023

An official reason for the closure was not immediately available from the hospital administration, but residents there said they were told the surprise move was likely because of financial reasons. “We We feel that this decision was made without adequate assessment of the negative impacts this WILL have on our patients.

Patient Safety 132

Patient Safety Emergency Department Administration EMS 132

EMDocs

JUNE 9, 2023

How do we manage the agitated child in the pre-hospital environment? There are protocols in place that assist highly trained Emergency Medical Service providers in assuring that agitated children are safely transported to their destination. That includes the patient, EMS personnel, and general public.

EMS 95

EMS Documentation/Coding Pediatrics Psychiatric 95

Pediatric EM Morsels

MAY 24, 2024

Evaluation of unintentional injury and trauma is one of the hallmarks of the EM and PEM physician. Low Risk Inta-Adbominal Trauma: Just Light ‘Em Up? IAI Rule – The Validation A multicenter prospective validation was planned at hospitals distinct from those where the initial derivation was performed. Ann Emerg Med.

Pediatrics 164

Pediatrics Blood Transfusions EMS Fractures 164

PEMBlog

JUNE 7, 2023

After listening to this episode you will be able to: Identify unique aspects of the pre-hospital environment that impact assessment and treatment of agitated children Describe the role of EMS personnel and EMS director in the care of agitated children.

Pediatrics 123

Pediatrics Psychiatric Emergency Department EMS 123

RebelEM

APRIL 3, 2024

Monica Saxena is a practicing emergency physician and assistant professor at Stanford University School of Medicine. Her research focuses on reproductive justice and women’s health in the emergency department setting. REBEL Cast – EMTALA + Reproductive Health Click here for Direct Download of the Podcast.

Emergency Department 113

Emergency Department EMS Research Hospitals 113

The Skeptics' Guide to EM

OCTOBER 19, 2024

Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Annals of EM 2024. Annals of EM 2024. mg/kg nebulized or 0.3 mg/kg intravenously? Reference: Nguyen et al.

Emergency Department 94

Emergency Department EMS Research Administration 94

EB Medicine

JUNE 12, 2024

Eckler, MD interview Corey Hazekamp, MD, MS, one of authors of the June 2024 Emergency Medicine Practice article, Managing Emergency Department Patients With Opioid Use Disorder Current State of Opioid Epidemic Overview of overdose deaths and trends. In this episode, Sam Ashoo, MD and T.R.

Emergency Department 84

Emergency Department Administration EMS Research 84

EMDocs

DECEMBER 6, 2023

Authors: Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA); Alec Pawlukiewicz, MD (EM Attending Physician; Killeen, TX) // Reviewed by: Brit Long, MD (EM Attending Physician, San Antonio, TX) Even prior to COVID-19’s strain on emergency departments (ED), boarding has been a longstanding issue.

Emergency Department 90

Emergency Department EMS Hospitals 90

The Skeptics' Guide to EM

APRIL 27, 2024

Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care. Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation.

Resuscitation 90

Resuscitation Airway Management EMS Outcomes 90

RebelEM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. J Crit Care. N Engl J Med. Crit Care Explor.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

The Skeptics' Guide to EM

JUNE 1, 2024

Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children’s National Hospital and The George Washington School of Medicine and Health Sciences in Washington, DC. His research focuses on the pre-hospital care of children by EMS.

Pediatrics 87

Pediatrics EMS Emergency Department Research 87

The Skeptics' Guide to EM

JULY 8, 2023

Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: a systematic review and meta-analysis. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital. Managing editor of EM:RAP and Associate Editor at REBEL EM.

CDC 107

CDC Hospitals EMS Emergency Department 107

Taming the SRU

JULY 8, 2023

Admit/Transfer/Discharge - Breakng bad News - History of EM Admit-Transfer-Discharge WITH Dr. Paulsen There are many factors that influence disposition, including independence of the patient and family/friend support, access to follow up, resources at your hospital, and transfer environment Why Transfer?

EMS 88

EMS Emergency Department Hospitals 88

RebelEM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.

Emergency Department 52

Emergency Department Administration Dehydration EMS 52

The Skeptics' Guide to EM

JULY 29, 2023

Emergency Medical Services (EMS) is called and on arrival the patient is walking but has obvious facial trauma and is complaining of some neck pain. As an EMS crew member, you are tasked with deciding what method of spinal motion restriction to use. He has midline neck tenderness but no limb numbness or paresthesia.

Head Injuries 95

Head Injuries EMS Research Emergency Department 95

ACEP Now

MAY 9, 2024

Jon Krohmer, MD, FACEP, who says he has “the EMS blood type,” practically had a front row seat to the growth of EMS care starting as a volunteer EMT more than 50 years ago. The evolution of EMS really mirrors the evolution of emergency physicians.” Dr. Krohmer said. So physicians need to be involved.

EMS 52

EMS Emergency Department CPR Wellness 52

RebelEM

JULY 1, 2024

Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial.

COPD 129

COPD Emergency Department Outcomes EMS 129

EMDocs

SEPTEMBER 26, 2024

An attorney is consulted and a lawsuit filed against the hospital, the first ED physician, the EM group, and the PCP. Even if we don’t know who the second EP was, he was an agent of the hospital, so the hospital is also liable. Defense : Cardiomegaly is a chronic problem, not an emergency. Baccei SJ et al.

Radiology 93

Radiology Radiology EKG/ECG Documentation/Coding 93

ACEP Now

AUGUST 22, 2023

Regardless of the domain, somewhere an expert panel has convened to issue a pronouncement informing all of the ideal care of patients under their specialty umbrella, indirectly extending to their care in the emergency department. Therefore, the authors of GRACE-3 call for wide training of the EM workforce in the use of HINTS.

Emergency Department 98

Emergency Department Academics Critical Access Research 98