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

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 119

Emergency Department Stroke Operations Hospitals 119

Don't Forget the Bubbles

NOVEMBER 29, 2023

You are the Paediatric doctor on call and receive a call for an incoming patient to the emergency department. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. A 12-year-old male is being transported by ambulance after a road traffic accident. His name is Ben.

Airway Management 135

Airway Management Emergency Department Resuscitation Psychiatric 135

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. 1 The Rise of the Miami BBL An entire industry has emerged around gluteal AFTs in Miami.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

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 The primary outcome was in-hospital mortality.

Hospitals 86

Hospitals Emergency Department EMS Outcomes 86

ACEP Now

NOVEMBER 14, 2023

In 1901, UVA opened its first hospital with 25 beds and three operating rooms. The emergency department (ED) at UVA was rebuilt in 2019 and the department had not fully optimized its operations when COVID-19 hit. She is a consultant with Quality Matters Consulting, and her expertise is in ED operations.

Academics 52

Academics Emergency Department Leadership Operations 52

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. Patients who require inpatient boarding remain a significant challenge to ed operations. The pandemic saw the time interval increase.

Emergency Department 52

Emergency Department Hospitals EMS Operations 52

Don't Forget the Bubbles

JANUARY 31, 2024

As a Trauma Unit within the Thames Valley Trauma Network, Wexham Park Hospital hosts trainees from across the spectrum of acute specialties. Article 1: What predicts parental anxiety in the Paediatric Emergency Department? Predictors of parental anxiety in a paediatric emergency department. Martin, S.R.,

Hospitals 72

Hospitals Ultrasounds Emergency Department Pediatrics 72

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.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

Taming the SRU

MARCH 11, 2024

Acute knee dislocations are rare orthopedic injuries that have high morbidity and need to be recognized quickly by the emergency physician; if unrecognized or inadequately treated, these injuries can lead to vascular and limb compromise (1,2). Knee dislocations make up less than 0.5% An abnormal ABI (<0.9)

Dislocations 107

Dislocations Emergency Department Fractures Operations 107

Taming the SRU

MARCH 12, 2024

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. Acad Emerg Med 2023;30(8):800–8. ED visits per 1000 adults with diabetes based on 2018 data resulting in over 500,000 annual hospital days. This amounts to annual hospital costs of $5.1 Acad Emerg Med 2023;30(8):800–8.

Operations 96

Operations Hospitals Best Practices Wellness 96

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. Case You are working solo coverage in a community hospital during a busy evening shift in the ED.

Fractures 100

Fractures Operations Emergency Department EMS 100

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. Dr. Helman is an emergency physician at North York General Hospital in Toronto. CREDIT: Dr. P.

Airway Management 90

Airway Management Operations Resuscitation Pediatrics 90

The Trauma Pro

OCTOBER 4, 2024

Clinical outcomes assessed at 60 days included an unplanned return to the emergency department (ED), re-admission, complications, and development of new bleeding confirmed by surgery, ultrasound, or computed tomography (CT) at 60 days post-injury. Adherence to guidelines was assessed by a follow-up phone call two months after injury.

Pediatrics 113

Pediatrics Outcomes Operations Emergency Department 113

ACEP Now

JULY 7, 2023

Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. emergency departments (EDs), with statistics reporting more than 356,000 out-of-hospital cardiac arrests per year. Adult cardiac arrest in the emergency department – A Swedish cohort study. Circulation. 2018;137(12). Kimblad H, et al.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

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 127

Ultrasounds Outcomes COPD Hospitals 127

EB Medicine

OCTOBER 21, 2024

Eckler, MD discuss the October 2024 Pediatric Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Departmen t 00:00 Welcome and Introduction 00:13 Free Subscription for Emergency Medicine Residents 01:05 Introduction to Pediatric Emergency Medicine Practice 01:37 Discussion (..)

Pediatrics 59

Pediatrics Elder Abuse Risk Management Emergency Department 59

Emergency Medicine Journal

JULY 22, 2024

This retrospective study compared the performance of 21 EWS scores to predict clinical deterioration using vital signs (VS) measured in the prehospital or emergency department (ED) setting. The discriminative ability of the EWS scores was assessed using the area under the receiver operating characteristic curve (AUROC).

Ambulance Services 52

Ambulance Services Hospitals Operations Emergency Department 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. Strategies to Reduce Delays It doesnt have to be this way.

EMS 98

EMS Hospitals Operations Emergency Department 98

RebelEM

APRIL 29, 2024

Many clinicians don’t consider IO placement while others consider it a last resort or only a pre-hospital procedure. The IO can actually be your “GO-TO” emergency line or your second choice after failed PIV access. World J Emerg Surg 2023 PMID: 36918947 3. Int J Emerg Med 2009 PMID: 20157465 4. Crit Care Med. Resusc Plus.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Emergency Medicine Journal

NOVEMBER 28, 2023

Introduction Most Irish emergency departments (EDs) do not record diagnosis in a standardised way at the conclusion of each patient care episode. This lack of data hampers service planning and the transformation of ED funding from a block grant system to one based on activity.

Documentation/Coding 40

Documentation/Coding Emergency Department Administration Operations 40

The Skeptics' Guide to EM

DECEMBER 14, 2024

He specializes in Paediatric Emergency Medicine and is a passionate believer and advocate of FOAMed. Dr. Damian Roland Case: A 3-year-old boy arrives at the emergency department (ED) with a high fever, rapid breathing, and lethargy. Damian is also part of theDont Forget the Bubbles Team. Reference: Sanchez-Pinto, L.N.,

Sepsis 81

Sepsis Pediatrics Shock Hospitals 81

The Skeptics' Guide to EM

JUNE 15, 2024

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. Pre-hospital personnel placed the patient in a cervical spine collar, obtained peripheral intravenous (IV) access, administered 250cc of 0.9%

Resuscitation 89

Resuscitation Patient Safety Operations Emergency Department 89

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta.

Operations 79

Operations Diabetic Emergencies Hospitals Research 79

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. He practices clinically at Grady Memorial Hospital in Atlanta.

Leadership 98

Leadership Administration Research Risk Management 98

Don't Forget the Bubbles

JUNE 30, 2023

However, patients in the 1:1 group had the lowest 24-hour mortality ( 14% vs 18% vs 22% vs 24% ; p = 0.01), and in-hospital mortality ( 32% vs 36% vs 40% vs 44% ; p = 0.01). These procedures require an experienced operator. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this. Really, in a 14-year-old?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

ALiEM

SEPTEMBER 13, 2024

A 32-year-old male with no significant past medical history presented to the emergency department (ED) from an outside hospital for further management of right eye pain and vision loss sustained after he was struck by a metal wire while at work. An emergent ophthalmology consult is needed to plan for operative repair.

Emergency Department 64

Emergency Department Fractures Academics Hospitals 64

ACEP Now

JUNE 14, 2024

Transferring patients from one ED to another hospital is an established part of emergency medicine practice. Patients who need inpatient services do not match the index hospitals’ capabilities, or the patient requests such a transfer, or the hospital has no available inpatient space. emergency departments.

Emergency Department 52

Emergency Department Operations Hospitals Leadership 52

Greater Sydney Area HEMS

FEBRUARY 20, 2024

The cohort of patients that require this intervention in the pre-hospital setting are likely to be the most critically unwell patients we encounter. It is currently the subject of future research and publication in the emergency department setting. i] Leibowitz A, Oren-Grinberg A, Matyal R.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

ACEP Now

SEPTEMBER 3, 2024

Hahnemann University Hospital in Philadelphia closed in 2019, a year and a half after it was acquired along with St. Christopher’s Hospital for Children by private equity (PE) firm Paladin Healthcare Capital for 170 million dollars. 14 Dr. Stinson remembers what it was like to work for a PE-owned hospital early in her career. “I

Hospitals 113

Hospitals Radiology Radiology Administration 113

Taming the SRU

MAY 13, 2024

Acute stump appendicitis without evidence of perforation or abscess (Figure 1) HOSPITAL Course Acute Care Surgery was consulted from the ED and recommended admission for operative resection of a 3 cm remnant of the appendix. The patient was discharged on hospital day 5. No organized or rim-enhancing fluid collection. Nelson, B.

Ultrasounds 96

Ultrasounds Emergency Department Wellness Operations 96

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. J Med Toxicol. Epub 2019 Jul 3. Intensive Care Med.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Don't Forget the Bubbles

OCTOBER 10, 2024

This time the team from Bristol Royal Children’s Hospital ED tell us what is new in the world of paediatric literature… Led by Dr John Coveney a Paediatric Emergency Medicine Trainee in Bristol who has revived The Journal Club at Bristol Royal Children’s Hospital ED on a monthly basis. Arch Dis Child.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

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]. Patients in the standard care alone group had more intensive care unit-free and hospital-free days.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

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). to 2.39) might outweigh the benefits.

Outcomes 77

Outcomes Emergency Department Operations Hospitals 77

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 110

EKG/ECG Emergency Department Academics Operations 110

ACEP Now

OCTOBER 15, 2023

4,5 Notably, patients weighing 166 kg or more may have altered absorption of insulin and were eventually excluded from one hospital system’s protocol. ICU and step-down beds are a limited resource and generate higher hospital charges. Diabetes care in the hospital: standards of care in diabetes-2023. Acad Emerg Med.

Hospitals 80

Hospitals Operations Emergency Department Research 80