EMDocs

MAY 11, 2024

We’ll keep it short, while you keep that EM brain sharp. A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. Ann Emerg Med. Erratum in: Ann Emerg Med.

Stroke 111

Stroke EMS EKG/ECG Radiology 111

Pediatric EM Morsels

SEPTEMBER 20, 2024

Diarrhea is one of the most common complaints in the pediatric emergency department, especially in the summer and early fall. It is critical to detect HUS early in its disease course to ensure the best outcomes. Predicting Adverse Outcomes for Shiga Toxin-Producing Escherichia coli Infections in Emergency Departments.

Pediatrics 164

Pediatrics Ultrasounds Dehydration Emergency Department 164

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 114

Dislocations Fractures Soft Tissue Injuries Outcomes 114

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 95

Emergency Department Administration Hospitals Academics 95

EMDocs

APRIL 27, 2024

We’ll keep it short, while you keep that EM brain sharp. A 67-year-old man with a history of hypertension and diabetes presents to the emergency department with right ear pain for 2 weeks. link] The post EM@3AM: Malignant/Necrotizing Otitis Externa appeared first on emDOCs.net - Emergency Medicine Education.

EMS 105

EMS Infectious Diseases Radiology Radiology 105

EMDocs

OCTOBER 21, 2023

We’ll keep it short, while you keep that EM brain sharp. The NIHSS cutoff that predicts outcomes is 4 points higher in AC compared with PC infarctions. Basilar artery occlusion remains a challenging diagnosis to make, and the delays in reaching the diagnosis can have considerable impact on health outcomes.

EMS 98

EMS Stroke Outcomes Hospitals 98

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. Early hepatic artery thrombosis after liver transplantation: a systematic review of the incidence, outcome and risk factors. Acad Emerg Med.

EMS 96

EMS Ultrasounds Emergency Department Outcomes 96

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. Paediatr Anaesth.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

Pediatric EM Morsels

JULY 21, 2023

In emergency medicine, we often use illness scripts and protocols to help drive our decision-making. We had just received a young child from EMS who was post-ictal with decreased mentation. Predicting outcome in individual patients after severe head injury. Less than 8, intubate! A practical scale. 1974 Jul 13;2(7872):81-4.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

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 100

Emergency Department EMS Research Administration 100

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 132

COPD Emergency Department Outcomes EMS 132

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? Ann Emerg Med. The post Low Risk Intra-Abdominal Trauma: Rebaked Morsel appeared first on Pediatric EM Morsels. 2013;62:107-116. doi:10.1016/j.annemergmed.2012.11.009.

Pediatrics 164

Pediatrics Blood Transfusions EMS Fractures 164

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 132

Emergency Department Stroke Operations Hospitals 132

The Skeptics' Guide to EM

APRIL 27, 2024

She is also the local director of the difficult airway EMS course at Washington State. Case: EMS arrives with a 58-year-old woman who suffered an out-of-hospital cardiac arrest (OOHCA). When emergency department (ED) staff roll her to remove her clothing her humeral intraosseous (IO) is dislodged. tibial & 2.3%

Resuscitation 93

Resuscitation Airway Management EMS Outcomes 93

The Skeptics' Guide to EM

JUNE 1, 2024

His research focuses on the pre-hospital care of children by EMS. He is the principal investigator for EMSC State Partnership in Washington, DC and is also involved in various multi-center EMS studies with the Pediatric Emergency Care Applied Research Network (PECARN). EMS placed him in a C-collar and brought him to you.

Pediatrics 88

Pediatrics EMS Emergency Department Research 88

ACEP Now

JULY 7, 2023

Last month’s article focused on ACEP’s efforts and resources to support EDs and patients with psychiatric emergencies. Emergency departments (EDs) focus on rapid initiation of medical treatment. However, rapid initiation of treatment is actually patient-centered care that can both lead to better outcomes and limit ED boarding.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Emerg Radiol. 2013 Aug;20(4):337-9.

Hyperthermia / Hypothermia 154

Hyperthermia / Hypothermia Emergency Department Seizures Pediatrics 154

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. This is a critical error that leads to poorer outcomes for patients in need of critical care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Emergency Medicine Journal

SEPTEMBER 27, 2023

Clinical negligence claims allocated to emergency medicine (EM) now account for the equal-highest volume notified to NHS Resolution (NHS-R), the body responsible for handling negligence claims on behalf of NHS organisations, sponsored by the Department of Health and Social Care. 3 The aim of this study was to report the.

Emergency Department 52

Emergency Department EMS Outcomes 52

EMDocs

DECEMBER 6, 2024

7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. A partner at bedside reports recent depressed mood, abdominal pain, and vomiting yesterday. 6 Absence of visualized tablets on x-ray does not exclude iron ingestion. Antiemetics as needed.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

ACEP Now

JUNE 7, 2023

Clinical Question What is the Emergency Severity Index (ESI), triage pain score, emergency department (ED) length of stay (LOS), and acute ED revisit rate in deaf and hard-of-hearing (DHH) American Sign Language speakers and DHH English speakers who utilize the ED? Acad Emerg Med. 1,6 Reference: James TG, et al.

Emergency Department 52

Emergency Department Outcomes Research Academics 52

ALiEM

OCTOBER 30, 2024

Case A patient arrives via EMS from the bus station complaining of fever, vomiting, and back pain. Bupe Allergy Buprenorphine induction has been the mainstay of emergency department treatment of opioid use disorder for more than a decade [11, 12]. They report insufflating ‘a bundle’ of tranq dope per day. 2017 Jun;32:660-6.

Emergency Department 64

Emergency Department Operations Psychiatric Hospitals 64

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 EMS Dehydration 52

Dr. Smith's ECG Blog

JUNE 21, 2023

EMS was called, and they recorded the following ECG on scene at 13:16: What do you think? In this medical system, the EMS provider can then be routed to the ED or to a type of urgent care facility that is open 24 hrs/day and staffed by a primary care provider. In this case, the EMS provider was routed to the urgent care facility.

Urgent Care 98

Urgent Care EKG/ECG EMS Emergency Department 98

The Skeptics' Guide to EM

AUGUST 10, 2024

He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Case: A 65-year-old man is brought into the emergency department (ED) by emergency medical services (EMS) after his family saw him slump over at the dinner table.

Stroke 90

Stroke Airway Management Documentation/Coding Outcomes 90

Broome Docs

OCTOBER 6, 2024

Mols EM, Haak H, Holland M, Schouten B, Ibsen S, Merten H, Christensen EF, Nanayakkara PWB, Nickel CH, Weichert I, Kellett J, Subbe CP, Kremers MNT; Safer@Home Research Consortium. Can acutely ill patients predict their outcomes? Emerg Med J. Emergency Medicine Journal Published Online First: 12 September 2024.

Emergency Department 102

Emergency Department EMS Research Outcomes 102

Taming the SRU

SEPTEMBER 25, 2023

Musculoskeletal injuries are a common occurrence, representing a substantial number of Emergency Department visits on an annual basis. 1) Oftentimes, Emergency Physicians are the first provider patients encounter after an injury. This places a significant responsibility on the EM physician to diagnose and treat fractures.

Fractures 101

Fractures Operations Emergency Department EMS 101

RebelEM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. RSI inherently carries with it risks of complications such as post-intubation hypotension and cardiac arrest in the most extreme cases.

Outcomes 97

Outcomes Emergency Department Administration Resuscitation 97

The Skeptics' Guide to EM

JULY 8, 2023

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. first appeared on The Skeptics Guide to Emergency Medicine. Managing editor of EM:RAP and Associate Editor at REBEL EM.

CDC 108

CDC Hospitals EMS Emergency Department 108

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 129

Ultrasounds Outcomes COPD Hospitals 129

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch.

Hyperthermia / Hypothermia 110

Hyperthermia / Hypothermia Resuscitation CPR EMS 110

EMDocs

DECEMBER 23, 2024

Gorgels et al (5) looked at procainamide vs lidocaine and again and primary outcome was VTach termination. Its narrow indication for stable VT means many emergency departments may not routinely stock the medication. His initial EKG is the following: What do you think?

EKG/ECG 75

EKG/ECG Shock Wellness EMS 75

EMDocs

OCTOBER 30, 2023

Pillai, MBBS (@sspillai01, EM Resident Physician, University of Kentucky) and Christopher N. 2 In response to the constrained availability of contrast media, emergency medicine (EM) and radiology departments were compelled to enact modifications in their imaging techniques. Authors: Saran S. 11 Table 1.

Radiology 101

Radiology Radiology Emergency Department Hospitals 101

RebelEM

JULY 24, 2023

Population: Patients > 14 years of age who underwent RSI with either etomidate or ketamine from the National Emergency Airway Registry (NEAR). Outcomes: Primary: Postintubation hypotension (SBP < 100 mm Hg) 15 minutes post-intubation. Emerg Med J. appeared first on REBEL EM - Emergency Medicine Blog.

Resuscitation 98

Resuscitation Outcomes Emergency Department EMS 98

EMDocs

SEPTEMBER 26, 2024

This story, while unlikely to reflect the standards of most readers, has a somewhat surprising outcome. An attorney is consulted and a lawsuit filed against the hospital, the first ED physician, the EM group, and the PCP. What role do discharge instructions play? Do they establish a standard of care? Baccei SJ et al. Tyler W et al.

Radiology 98

Radiology Radiology EKG/ECG Documentation/Coding 98

EMDocs

AUGUST 22, 2024

12 How do we address these disparities in the emergency department? Certified interpreter use can improve communication and patient outcomes. An implementation science approach improves language access in the emergency department. One cohort study in a public ED found that 84.5% 45:446-458. Taira B, et al.

Documentation/Coding 105

Documentation/Coding Emergency Department Federal Emergency Management Agency Best Practices 105

ACEP Now

OCTOBER 10, 2023

A 76-year-old female presents to the emergency department obtunded with left hemiplegia. Both INTERACT-2 and ATACH-2 showed no statistical difference in their primary outcome between intensively lowering the BP and a less-intensive strategy. Symptoms began just prior to presentation. Her blood pressure (BP) is 195/104 mmHg.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52