EM Literature of Note

OCTOBER 9, 2024

This exploration of LLMs in the emergency department is a bit unique in its conceptualization. and GPT-4T – is asked: Should this patient be admitted to the hospital? Does this patient require radiologic investigations? Specifically, the LLM – here GPT-3.5T Does this patient require antibiotics?

Radiology 86

Radiology Radiology Emergency Department Documentation/Coding 86

ACEP Now

JANUARY 4, 2025

Emergency medicine was approved as the 23rd medical specialty in 1979, shortly after a young Elsburgh Clarke, MD, discovered the burgeoning specialty. 1 Just one year prior, Dr. Clarke had begun an emergency medicine residency at what was then known as LA CountyUSC Hospital, Los Angeles. Click to enlarge.) Click to enlarge.)

Forensics 52

Forensics Urgent Care Hospitals Emergency Department 52

EMDocs

DECEMBER 6, 2024

Pediatric Emergency Care, 27 (10), 978-985. Radiology in the management of acute iron poisoning. Iron Ingestion: an Evidence-Based Consensus Guideline for Out-of-Hospital Management. link] The post ToxCard: Iron appeared first on emDOCs.net - Emergency Medicine Education. doi: 10.1097/PEC.0b013e3182302604. Hosking CS.

Poisoning 96

Poisoning Fluid Resuscitation Seizures Resuscitation 96

Don't Forget the Bubbles

SEPTEMBER 13, 2023

The parents of 18-month-old Susie brought her to the Emergency Department after she had a seizure at home. The American College of Radiology guidelines provide further detail on imaging recommendations based on different age and seizure type variants. 2006;67(9):1542-1550 Royal Children’s Hospital Melbourne. Pediatrics.

Seizures 131

Seizures Pediatrics Emergency Department Radiology 131

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 Emergency Department 113

ACEP Now

DECEMBER 7, 2024

In addition to the reduced risk for major bleeding, use of mechanical thrombectomy techniques has been shown to decrease hospital costs by reducing the need for post-procedural critical care following intervention.

Ultrasounds 52

Ultrasounds Radiology Radiology EKG/ECG 52

Don't Forget the Bubbles

NOVEMBER 8, 2023

7-year-old Tilly is brought to your emergency department at 11 p.m. Abdominal pain in children is common, accounting for over 1 in 20 attendances to paediatric emergency departments [1]. She had a low-grade fever and an episode of vomiting before coming to the hospital. Hospital Admitted Patient Care Activity.

Emergency Department 105

Emergency Department Ultrasounds Pediatrics Best Practices 105

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives CT Head scans are commonly requested in the Emergency Department (ED), but the increasing demand has led to longer radiology report turnaround times, affecting ED flow. Emergency medicine clinicians of various grades and backgrounds participated. to 83%) and specificity (65.8%

Emergency Department 40

Emergency Department Radiology Radiology Research 40

The Skeptics' Guide to EM

FEBRUARY 3, 2024

March 2023 Date: January 30, 2024 Guest Skeptic: Dr. Alexandra (Ali) Espinel is an Associate professor of pediatrics and otolaryngology at Children’s National Hospital and George Washington University. For Pediatric Oropharyngeal Trauma first appeared on The Skeptics Guide to Emergency Medicine. Laryngoscope. I’m the Problem.

Pediatrics 68

Pediatrics Radiology Radiology Head Injuries 68

The Skeptics' Guide to EM

AUGUST 24, 2024

Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Case: A 67-year-old male presents to your hospital emergency department (ED) after a fall from his bicycle. Reference: Partyka et al.

Fractures 53

Fractures Emergency Department Ultrasounds Radiology 53

Taming the SRU

OCTOBER 23, 2023

THE CASE A female in her early 20s, G4P2012, presents to the emergency department (ED) with a 5 day history of left lower quadrant abdominal pain which has been worsening since onset. After a short period of recovery in the hospital, she is discharged home in stable condition with follow-up with OBGYN. Epub 2019 Mar 21.

Ultrasounds 98

Ultrasounds Operations Radiology Radiology 98

Don't Forget the Bubbles

MAY 22, 2023

You’ve just started working in the Children’s Emergency Department (CED). Robin is an LTV patient and will likely need some extra planning should he need to be admitted to hospital. Gemma responds, ‘Ask the hospital physio to come and see him?’ The triage nurse comes to let you know about Robin. You think fast.

Radiology 98

Radiology Radiology Hospitals Wellness 98

SheMD

APRIL 24, 2023

I break bad news almost every shift in the emergency department. An email with a sad face to a woman jacked up hormones was not the best approach. A colleague met me at the hospital and performed an ultrasound once more to confirm. My husband left the fire station and rushed to the hospital to be with me.

Ultrasounds 83

Ultrasounds Radiology Radiology Emergency Department 83

Taming the SRU

OCTOBER 1, 2023

This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department. May be considered first line in the future however results may be dependent upon provider training and hospital resources [17].

Fractures 96

Fractures COPD Hospitals Emergency Department 96

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Date: March 22, 2023 Reference: Hilsden et al.

Ultrasounds 52

Ultrasounds Emergency Department Dislocations Radiology 52

EMDocs

DECEMBER 4, 2023

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.

Ultrasounds 92

Ultrasounds Documentation/Coding Wellness EMS 92

Taming the SRU

SEPTEMBER 15, 2023

ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airway management Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED? ETT onto a fiberoptic scope.

CPR 90

CPR Burns Airway Management Wellness 90

Northwestern EM Blog

MAY 16, 2022

1 Low-dose non-contrast abdominal CT has become the gold standard for diagnosis as it has become readily available in emergency departments nationwide, with some studies touting sensitivity and specificity of 97% and 95%, respectively.2 were hospitalizations during f/u period; 26.4% were hospitalizations during f/u period; 26.4%

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

RebelEM

NOVEMBER 20, 2023

Patients with torso hemorrhage present a clinical conundrum often requiring interventional radiology or surgery, both of which take time to mobilize. Patients in the standard care alone group had more intensive care unit-free and hospital-free days. Paper: Jansen JO, Hudson J, Cochran C, et al. 97% of patients sustained blunt trauma.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

The Skeptics' Guide to EM

NOVEMBER 9, 2019

Diagnostic Performance of Emergency Physician-Performed Point-of-Care Ultrasonography for Acute Appendicitis: A Meta-Analysis. Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant (PA) working primarily in rural Missouri in community hospitals. first appeared on The Skeptics Guide to Emergency Medicine.

Ultrasounds 52

Ultrasounds Fractures Pediatrics Radiology 52

The Skeptics' Guide to EM

JULY 18, 2020

Background: Depending on the time of year, fever and cough can be one of the most common presentations seen in the emergency department. However, being an evidence-based medicine enthusiast, you wonder what aspects of the patient’s presentation are going to be truly helpful in making a diagnosis.

Radiology 52

Radiology Radiology Emergency Department Outcomes 52

RebelEM

OCTOBER 5, 2023

Pneumonia diagnosis supported by clinical and radiologic criteria. Lastly, although C-reactive protein (CRP) is not typically used in the emergency department to diagnose bacterial pneumonia, patients with CRP levels exceeding 15mg/dL (or > 150 mg/L) may derive benefits from corticosteroid therapy. Lancet 2011;377:2023-30.

Research 94

Research Outcomes Administration Shock 94

ACEP Now

MAY 9, 2024

It has been well over a year since the controversial publication of the Agency for Healthcare Research and Quality (AHRQ) report on diagnostic errors in the emergency department (ED). Active extravasation of blood into the hematoma was identified, and the patient was referred to interventional radiology. Ann Emerg Med.

Emergency Department 52

Emergency Department Research Infectious Diseases Hospitals 52

EMDocs

FEBRUARY 26, 2024

Laboratory evaluations that return after admission to the hospital are remarkable for microcytic hypochromic anemia (hemoglobin 9.2 Mortality predictors of Pneumocystis jirovecii pneumonia in human immunodeficiency virus-infected patients at presentation: Experience in a tertiary care hospital of northern Taiwan. 1999;6(2):149-155.

Radiology 108

Radiology Radiology Outcomes Ultrasounds 108

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. The following day, Interventional Radiology placed a percutaneous cholecystostomy tube. coli) empyema due to complicated pneumonia, and a prior perisplenic abscess requiring percutaneous drainage.

Ultrasounds 79

Ultrasounds Sepsis Radiology Radiology 79

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

ACEP Now

NOVEMBER 14, 2023

One of the most hair-raising presentations to the emergency department (ED) can be massive hemoptysis with respiratory failure. Dr. Helman is an emergency physician at North York General Hospital in Toronto. The emergency department evaluation and management of massive hemoptysis. Am J Emerg Med.

Radiology 52

Radiology Radiology Emergency Department Airway Management 52

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. On hospital day 2, he was taken to the operating room for surgical rib fixation. Case FIGURE 1: Chest X-ray of multiple rib fractures (arrows). Click to enlarge.)

EMS 52

EMS Fractures Operations Ultrasounds 52

Taming the SRU

APRIL 5, 2023

THE CASE An elderly female patient presents to the emergency department (ED) with 1 week of generalized weakness leading to numerous falls. Outside hospital records were obtained and upon review, it was noted that the patient had recently been diagnosed with a horseshoe kidney on CT imaging. and hyponatremia to 125.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

Northwestern EM Blog

DECEMBER 20, 2021

Written by: Tommy Ng, MD (NUEM ‘24) Edited by: Patricia Bigach, MD (NUEM ‘22) Expert review by : Terese Whipple, MD '20 So your kid won’t walk One of the most common complaints in a pediatric Emergency Department is a child refusing or inability to ambulate. 2021, Dec 20). Hip Pain in Pediatrics. Expert Commentary by Whipple, T].

Pediatrics 52

Pediatrics Ultrasounds Emergency Department Radiology 52

PEMBlog

JUNE 5, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Pediatric Emergency Playbook

FEBRUARY 1, 2016

After balloon occlusion, blood pressure improved sufficiently to take the patient either to interventional radiology or to the OR. Pediatric emergency department thoracotomy: a large case series and systematic review. Withholding or termination of resuscitation in pediatric out-of-hospital traumatic cardiopulmonary arrest.

Resuscitation 40

Resuscitation Pediatrics Fractures Emergency Department 40

EB Medicine

JUNE 6, 2019

Taylor and Shaukat of Emory and Coney Island Hospital respectively for their efforts in peer reviewing this huge topic. CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Nachi: All valid points, but let’s dive in too some actual detail.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

PEMBlog

SEPTEMBER 13, 2023

The Choosing Wisely Pediatric Emergency Medicine Recommendations The Choosing Wisely Campaign Toolkit Expert Contributors Paul Mullan, MD Children’s Hospital of the King’s Daughters Norfolk, VA, USA mullan20@gmail.com Jim Chamberlain Children’s National Hospital Washington, DC, USA JCHAMBER@childrensnational.org During your time in the Emergency Department (..)

Seizures 52

Seizures Pediatrics Point-of-Care Testing Wellness 52

Pediatric Emergency Playbook

APRIL 1, 2017

16 found that of 142 patients evaluated at a single site university hospital, 61 had a foreign body. Am J Emerg Med. Emergency department management of foreign bodies of the external ear canal in children. Radiologic Cases in Pediatric Emergency Medicine; University of Hawaii. Radiol Cases Emerg Med.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Paediatr Int Child Health. 2024 Jan 11:1-7. Epub ahead of print.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

EMDocs

NOVEMBER 16, 2024

16 US or CT guided biopsy/joint aspiration (typically performed by Orthopedic surgery or Interventional Radiology). 9,23 Disposition: Dislocation : If successfully reduced in the emergency department may discharge with strict mobility restrictions and Orthopedic follow up. Hospitals, 2018. 2021 Aug 31. Bone Jt Open.

EMS 96

EMS Dislocations Fractures Operations 96