RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. More pertinent and relevant takeaway messages have to do with staffing and operations.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

ACEP Now

DECEMBER 7, 2024

As emergency departments (EDs) have become the focus of bottlenecks in the entire health care systemfrom insufficient inpatient beds leading to hospital boarding to dwindling access to primary carea siege atmosphere has developed. This leads to a vicious circle of more and more professionals exiting the EMS workforce.

EMS 98

EMS Hospitals Operations Emergency Department 98

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. Secondary hemorrhage occurs between days five and 14 post-operatively, peaking around days five to seven. Special thanks to Dr. Kevin Wasko, guest expert on the EM Cases podcast on this topic, who inspired this column.

Airway Management 98

Airway Management Operations Resuscitation Pediatrics 98

ACEP Now

NOVEMBER 7, 2023

And in our comment letter responding to the FTC and Department of Justice’s proposed updates to health care merger guidelines, ACEP urged the agencies to finalize these changes that would bring more scrutiny to health care mergers and slow down consolidation. Learn more at openbook.acep.org.

Leadership 98

Leadership Administration Research Risk Management 98

EMDocs

OCTOBER 3, 2023

Emergency Physician and founder of Orman Physician Coaching Host of the Stimulus Podcast Learn more at roborman.com If you want to hear the coaching session where Brit and Rob deconstructed his shift and came up with this strategy, it’s here. Episode 87: Conquering Mid-Shift Overwhelm Mid-shift in an emergency department is a special beast.

Documentation/Coding 109

Documentation/Coding EMS Operations Emergency Department 109

ACEP Now

MAY 4, 2023

A 58-year-old male with a history of alcohol abuse presented to the emergency department (ED) as a category 2 trauma for a fall with a reported flail chest. EMS recognized a chest wall deformity with movement of the chest wall, and a splint was devised and taped around his chest for what was suspected to be a flail chest.

EMS 52

EMS Fractures Operations Ultrasounds 52

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives Chest drains are commonly inserted in the Emergency Department (ED) with a complication rate of 30-40%. Training in chest drain insertion is essential in Emergency Medicine (EM) as approximately 25,000 patients undergo in England and Wales undergo this procedure annually.

Emergency Department 40

Emergency Department EMS Research Operations 40

EMDocs

DECEMBER 11, 2023

As we all know, a critical concern for emergency physicians is identifying patients with heart tissue-threatening ischemia that could benefit from percutaneous catheterization via stent deployment by an interventional cardiologist. Notably, only 0.5mm of elevation is necessary in V7-9 to meet criteria. J Am Coll Cardiol. PMID: 36241466.

EKG/ECG 118

EKG/ECG Emergency Department Academics Operations 118

RebelEM

NOVEMBER 25, 2024

Included patients from out-of-hospital, emergency department, intensive care unit, and operating-room intubations. Intubation performed in all settings (out-of-hospital, emergency department, ICU, and operating room). Randomized controlled trials or comparative non-randomized observational studies.

Outcomes 93

Outcomes Emergency Department Operations Hospitals 93

ACEP Now

JULY 7, 2023

emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. One operator should perform defibrillation in the anterolateral position, followed by another operator providing a second shock in the anteroposterior position after a delay of less than one second.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

RebelEM

APRIL 29, 2024

One may speculate that the US-guided CVC placement would have a higher first-pass success rate with fewer complications, however, this may potentially add time to the procedure depending on the operator and institution’s use of ultrasound during emergencies and maintaining sterile technique with the US probe. Crit Care Med.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Don't Forget the Bubbles

JUNE 19, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Children in the validation cohort were admitted to the intensive care unit or operating room less frequently than those in the derivation cohort.

CPR 124

CPR Research Outcomes Documentation/Coding 124

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 Study protocol involved investigators measuring EtCO2 of patients arriving via the lobby or EMS.

Hospitals 87

Hospitals Emergency Department EMS Outcomes 87

ACEP Now

JUNE 14, 2024

Two years ago, an ACEP Now article covered the issue of transfer challenges resulting from early pandemic operations. 1 As fresh challenges of the pandemic and hospital operations changed emergency medicine practice, one of the more challenging areas was the movement of admitted patients out of the first emergency department (ED).

Emergency Department 52

Emergency Department Operations Hospitals Leadership 52

PHEM Cast

DECEMBER 12, 2016

Emergency thoracotomy in thoracic trauma: a review. Emergency Department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. World Journal of Emergency Surgery; 2006: 1:4. Survival after Emergency Department thoracotomy: review of published data for last 25 years.

Military 52

Military Resuscitation Emergency Department Documentation/Coding 52

The Skeptics' Guide to EM

SEPTEMBER 3, 2017

EmergeNcy Department use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial). EmergeNcy Department use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial). Reference: Caputo et al.

Emergency Department 52

Emergency Department Resuscitation Operations EMS 52

Taming the SRU

AUGUST 4, 2024

The largest retrospective cohort study to date (Beyde et al.) shows that most will improve with empiric antibiotics.

Dislocations 85

Dislocations Emergency Department Documentation/Coding Burns 85

RebelEM

JUNE 8, 2023

If pre-made syringes are not financially feasible then the creation of these medications should be done by a dedicated emergency department pharmacist. Clinical Bottom Line: Acute hypotension must be treated emergently in order to decrease morbidity and mortality. Am J Emerg Med. J Med Toxicol. Epub 2019 Jul 3.

Administration 97

Administration Emergency Department Outcomes Documentation/Coding 97

ACEP Now

SEPTEMBER 5, 2024

Our state chapter members and leaders are uniquely positioned to follow EMRA’s lead in partnering with local EM residency programs to improve communication of ACEP’s value to EM-bound medical students and EM residents by hosting residency visits or local events relevant to our shared mission.

Leadership 98

Leadership PPE EMS Wellness 98

Resus Review

APRIL 10, 2015

Important properties for the include: Highly conductive at frequencies used by the flow sensor Non-marring Does not dry out Easy to remove Non toxic The most popular ultrasound gel found in emergency departments and intensive care units is Parker Labs Aquasonic. A better product to use is Em-tec Ultrasonic Coupling Paste.

Ultrasounds 52

Ultrasounds Operations Emergency Department EMS 52

RebelEM

NOVEMBER 6, 2024

Elbow Dislocations in the Emergency Department: A Review of Reduction Techniques. J Emerg Med. PMID: 31082090 Post Peer Reviewed By: Anand Swaminathan MD, MPH (Insta @EMSwami) The post Elbow Dislocations appeared first on REBEL EM - Emergency Medicine Blog. Anatomy, Shoulder and Upper Limb, Radial Nerve.

Dislocations 103

Dislocations Fractures Soft Tissue Injuries Outcomes 103

RebelEM

NOVEMBER 20, 2023

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12]. J Spec Oper Med. PMID: 30566723 Bulger EM, Perina DG, Qasim Z, et al. 2018;18(4):37-55.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

RebelEM

JANUARY 25, 2024

In many emergency departments (ED), US machines are readily available and can be used to rapidly assess and monitor patients with acute dyspnea at the bedside. What They Did: Design: Randomized, controlled, blinded-outcome trial Sites: Three emergency departments in Denmark Duration: October 9, 2019 to May 26, 2021.

Ultrasounds 122

Ultrasounds Outcomes COPD Hospitals 122

Downeast Emergency Medicine

DECEMBER 17, 2021

Emergency medicine (EM) was first recognized as a specialty by the American Medical Association (AMA) in 1972. Since that time, EM residencies have grown and evolved to provide academic support and training for graduating medical students interested in pursuing a career in the field.

EMS 52

EMS Academics Operations Emergency Department 52

Taming the SRU

MAY 22, 2023

As an EM physician, it is important to have an understanding of the spectrum of ankle injuries and how these are appropriately evaluated. weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge: Counsel on expected course of injury, supportive care (e.g.,

Fractures 77

Fractures Dislocations Operations Radiology 77

Mind The Bleep

DECEMBER 27, 2024

Im currently in my third year of working in a rural district general hospital Accident and Emergency Department, and one of the things that has struck me most is the use of pre-hospital medicine. Throughout university, I always sought out opportunities for experience in emergency and pre-hospital care.

Hospitals 52

Hospitals Ambulance Services Operations Teamwork 52

Ziqitza HealthCare Ltd

JULY 23, 2023

Ventilators are used in operating rooms, emergency departments, critical care transport units, and air medical transports. Ziqitza Health Care operates the ALS and BLS ambulances for various purposes under their 108 , 102 and 1298 helpline numbers. It is a very efficient and well-invented service in the emergency field.

Ambulance Services 52

Ambulance Services Basic Life Support Blood Transfusions Patient Safety 52

Don't Forget the Bubbles

MAY 17, 2023

Post-operative pain in children: Comparison of pain scores between parents and children. Hegeman EM, et al. Schwindt EM, et al. Invasive bacterial infection in children with fever and petechial rash in the emergency department: a national prospective observational study. J Pediatr Gastroenterol Nutr. 2023 Apr 24.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

ACEP Now

JULY 7, 2024

35-year-old man presents by EMS with seizures. He has been seizing for 30 minutes, despite treatment of intravenous lorazepam by EMS. 1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). Ann Emerg Med. Am J Emerg Med. 2014;63(4):437-447.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

The Skeptics' Guide to EM

JULY 30, 2022

Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: A 63-year-old woman presents to your emergency department (ED) with two-day history of nausea, vomiting and constipation. Charles Brower is a second-year resident training in Emergency Medicine at the University of Cincinnati.

Ultrasounds 52

Ultrasounds Operations Documentation/Coding Outcomes 52

EB Medicine

MARCH 19, 2020

15:38 When did you create dirty and clean zones in the emergency department? 17:03 What is your annual emergency department volume? 18:04 How many treatment rooms are in your emergency department? 24:36 What are your surgeons, who cannot operate, currently doing? 15:21 What PPE do you currently use?

PPE 40

PPE Emergency Department Ultrasounds Operations 40

ACEP Now

JUNE 6, 2023

EMS is called and finds his blood pressure 175/100. POCUS: Point-of-care ultrasound for AD is highly specific, but operator-dependent, and lacking in sensitivity—although late–model units can have sensitivity as high as 80-85 percent. The murmur is readily auscultated. The patient is treated surgically and survives.

EKG/ECG 85

EKG/ECG Stroke Documentation/Coding Operations 85

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

Taming the SRU

MAY 23, 2023

As an EM physician, it is important to have an understanding of the spectrum of foot injuries and how these are appropriately evaluated. weight-bearing status, operative vs. non-operative) If necessary/helpful to ensure adequate follow-up At time of discharge Counsel on expected course of injury, supportive care (e.g.,

Fractures 57

Fractures Dislocations Operations EMS 57

EM Updates

MARCH 24, 2021

Video laryngoscopy uses a blade with a camera at the end; once the blade is positioned, the operator intubates looking at the screen. HAVL , which uses a blade that goes around the tongue, requires that the operator look at the screen. VL can employ either SG or HA blades.

Operations 52

Operations Airway Management EMS Wellness 52

Critical Care Now

JULY 7, 2024

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. Methodological challenges, such as extended prehospital transport times, limited operator experience, and small sample size, introduce uncertainty to these findings.

Resuscitation 52

Resuscitation Military Outcomes Hospitals 52

Taming the SRU

OCTOBER 30, 2024

Although cancer diagnosis is not the primary goal of the care we provide in the emergency department, we can make a substantial impact on long term mortality​ HNSCC is rapidly invasive and the time to diagnosis often significantly impacts long-term morbidity and mortality in these patients.

Hospitals 52

Hospitals Emergency Department EKG/ECG Documentation/Coding 52